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New insulin pump integrates real-time continuous glucose monitoring
System allows patients to view glucose trends throughout the day and night.
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A major step has been taken toward the development of a closed-loop insulin delivery system that could one day mimic the functions of a human pancreas.
The FDA recently approved an insulin pump with real-time continuous glucose monitoring. The device, which takes glucose readings from interstitial fluid every five minutes, could prove to be a useful source of information for people with diabetes.
MiniMed Paradigm Real-Time system (Medtronic) will help patients take immediate corrective or preventive action to maintain healthy glucose levels. The continuous glucose monitor relays readings every five minutes from a glucose sensor to the insulin pump. The pump displays 288 readings a day — nearly 100 times more information than three daily finger sticks.
Breakthrough in monitoring
“With the overwhelming evidence from randomized controlled trials that tight control of blood glucose prevents complications of diabetes such as retinopathy, nephropathy and neuropathy, it is now imperative that patients have good blood glucose control. However, several studies indicate that such glycemic control is largely suboptimal and is difficult to achieve. That is in part due to the fear of hypoglycemia if you try to tightly control the blood sugar,” said Samy McFarlane, MD, MPH, FACP, associate professor of medicine and chief of the division of endocrinology, diabetes and hypertension at SUNY Downstate Medical Center and associate medical editor of Endocrine Today.
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Courtesy of Medtronic |
“With the introduction of this continuous monitoring system, which I believe is a breakthrough in glucose monitoring, adequate control of glycemia becomes possible, in part because of the continuous feedback to the patient that will help in self-management decisions,” he told Endocrine Today.
The new device is made up of two components: a continuous glucose monitoring system and an insulin pump. The continuous glucose monitoring system sends readings to a sensor. This sensor is a tiny electrode that is inserted under the skin using the Sen-Serter, a small device that patients or their caregivers can use at home to make sensor insertion easier. It then measures glucose in the interstitial fluid found between the body’s cells and is typically discarded and replaced after three days of use.
A transmitter sends the information to the pump, which displays the glucose value, three-hour and 24-hour trend graphs. Real-time glucose information is displayed on the pump and allows patients to make immediate adjustments to their glucose control after taking a confirmatory finger stick test.
Alarm alert
An alarm alerts users when glucose levels become too high or too low. Continuous glucose monitors can help patients with diabetes by alerting them to all glucose level highs and lows throughout the day, information not available from traditional blood glucose monitors.
“Patients will be less likely to have hypoglycemia unawareness if they use this system properly and also will be less likely to have very highly elevated glucose that is detrimental and can lead to acute illnesses and hospitalization on many occasions,” McFarlane said. “Furthermore, this system is useful in both type 1 and type 2 diabetes, making it useful for the entire adult diabetic population, albeit it is not approved for the pediatric population.”
The real-time continuous blood glucose monitoring system is indicated for any patients 18 or older and insulin pump therapy for all patients requiring insulin. – by Leah Smith