Continuous Glucose Monitoring
At the moment, there are two choices for continuous glucose sensors: the MiniMed® and Dexcom G4™. Both are extremely effective in terms of providing glucose trends along with numerical values that measure interstitial glucose. Both lag behind in terms of blood glucose measurements; however, with the provision of measurements overnight, including alarms and the glucose suspend feature of the MiniMed® version, many parents have been able get some sleep overnight.
Why use a continuous glucose sensor?
These sensors provide additional information that is not always available when only evaluating capillary blood sugars with a typical glucose monitor. The glucose monitor provides the magnitude of the blood sugar, the actual milligrams per deciliter, plus or minus 15-30 percent. The continuous glucose monitor (sensor) provides the direction of the blood sugar as well as the magnitude, which is less accurate than the standard meter reading. Therefore, with the combination of magnitude from both devices and direction of the blood sugars from the continuous glucose monitor, those with diabetes and caregivers can make decisions about how much insulin to provide. Direction of blood glucose is an important consideration in view of daily activities such as exercise and sporting events as well as carbohydrate excursions after meals and snacks. Insulin, therefore, may be adjusted in anticipation of the blood sugar trends as well as magnitude.
The latest innovation that has been approved by the Food and Drug Administration is the Dexcom SHARE. According to representatives from Dexcom, Dexcom SHARE allows “the remote viewing of glucose levels, trends, and data through wireless connections” between the person with diabetes and designees from an iPhone® or iPod Touch®. According to the Dexcom website, this information can be shared with up to five different followers.
How does it work?
The Dexcom receiver is placed in the Dexcom SHARE cradle, which is then paired with the sharer’s iPhone® or iPod Touch® via Bluetooth® technology. The data is then sent securely to the cloud. The cloud then sends the data to up to five designees’ iPhone® or iPod Touch®. These designees are chosen by the person with diabetes. In the case of children with diabetes, parents may be the main designees; however, other caregivers or the school nurse or may also be considered in order to be kept aware of glucose trends.
Some Important things to understand when thinking of the Dexcom SHARE is that there is no prescription required for the cradle, and the Dexcom SHARE is not covered by insurance. Unfortunately, the Android platform is not yet supported.
Why is this a major advantage, especially for the pediatric population?
With the ability to observe the blood glucose magnitude and trend, the designee may be able to assist the child in making insulin dosing decisions, reassured that blood sugars are not rising or dropping too rapidly during both the daytime and nighttime. Another strong consideration that plays a role is the observation of blood sugars during sporting events and alerting the child of rapid drops of blood sugar, therefore acting as pre-emptive treatment. Sleepovers, social activities, etc. have been major considerations and worries for parents of children with diabetes. By sharing blood glucose data through the use of this technology, it is hoped that children with diabetes can participate in these common social activities and have an improved quality of life.
For more detailed information about the new Dexcom SHARE technology, visit http://www.dexcom.com/sites/dexcom.com/files/share/Dexcom_SHARE_ifu.pdf