Abbott Freestyle Libre 2, Flash Glucose Monitoring, FSL2

23

LIVING

we should just improve the sensors

for the CGM devices we have

already and, so far, the successes

are few. However, demand is high

and research and development

continues apace.

Here is an overview of what is

available now as well as some of

the most promising devices on

the horizon.

Minimally invasive

This method of measuring sugar

levels has rocketed in popularity

in the past few years. Since flash

glucose monitoring by Abbott's

FreeStyle Libre became available

on the NHS to people with Type 1

diabetes in April 2019, over half of

those with the condition in the UK

have migrated from finger pricking

to the Libre. And at the end of March

this year, NICE widened the choice

further, with all adults with Type 1

being eligible for a choice of either

flash or CGM on the NHS, all children

with Type 1 offered access to CGM,

and adults with Type 2 diabetes who

inject insulin at least twice a day also

eligible for flash monitoring if they

have severe hypos or a disability that

prevents them finger-prick testing.

Whereas CGM transmits

information about glucose levels

continuously via Bluetooth, flash -

specifically Abbott's FreeStyle Libre -

gives this information when you pass

your mobile or other device over the

sensor. The FreeStyle Libre has been

shown to improve blood sugar and

quality of life. A recent University of

Manchester study of 156 people with

Type 1 diabetes using the FreeStyle

Libre 2 found that participants'

HbA1c dropped by 8.46 mmol/mol

on average after 24 weeks, reducing

their risk of diabetes-related

complications over time. They also

reported being happier with their

diabetes treatment and suffered

less emotional strain associated

with living with the condition. The

newly available FreeStyle Libre 3

is essentially a CGM device. The

system sends real-time glucose

readings every minute to the user's

smartphone, and its sensor is the

smallest currently available. However,

it is unlikely to be made available on

the NHS.

Available CGM systems in the

UK are:

• A6 Touchcare Nano from Medtrum,

which sends glucose readings

every two minutes from a sensor

that lasts 14 days.

• Dexcom G6, considered the most

accurate, giving readings every

five minutes, though sensors have

to be changed every ten days. The

new G7 with a sensor that is 60%

smaller is more accurate still, with

a mean absolute relative difference

(MARD) of 8.2.%, compared to

9% for the G6 and 9.3% for the

Libre 2. With MARD, it's the lower

the better!

• Eversense, is a sensor that lasts

for six months, but it has to be

implanted (and later removed

and replaced) by a healthcare

professional, making it the most

invasive CGM available.

• Guardian Connect from Medtronic,

which compiles time-in-range

data, though the Guardian Sensor 3

that goes with it has to be changed

every seven days.

Both flash and CGM devices measure

the glucose in interstitial body fluid

(the fluid surrounding cells), and

allow you to see what your levels

are doing day and night, and what

affects them. Alarms on most devices

can alert you to an imminent hypo,

invaluable if you are hypo unaware,

and the data from your monitor

can also be made available to your

healthcare provider. Unlike flash,

CGM can be used with an insulin

pump, creating a closed-loop system.

Most people tolerate a sensor well,

though irritation can be a problem.

Pain is rarely an issue but keeping the

sensor in place can be.

A promising new product in the

busy CGM marketplace is French

company PKvitality's K Watch, which

takes a glucose measurement when

you press a button on the watch. It

uses microneedles on a biosensor

located under the watch to 'taste'

interstitial fluid. Billed by PKvitality

as "the world's first continuous

glucose monitoring smartwatch" for

people with Type 1 or Type 2. In the,

albeit limited, first in-human trials, it

performed well on glucose tracking,

and no pain or irritation from the

microneedles or the adhesive patch

under the watch were reported.

Non-invasive optical

While minimally invasive glucose

testing is now a familiar process to

many people with diabetes, the same

can't yet be said for non-invasive

optical glucose monitoring. Many of

the devices seem excitingly futuristic

and very few are yet on the market,

with the most notable exception

being GlucoTrack, which is geared

for people with Type 2 diabetes.

GlucoTrack clips onto the ear lobe

and in the words of the developer,

Israel-based Integrity Applications,

uses a "patented combination of

PKvitality's K'Watch

Index

  1. Desang diabetes magazine, Making Carbs Count, non-invasive glucose testing, Glooko
  2. Desang diabetes, magazine diabetes information, Sue Marshall diabetes
  3. Desang diabetes magazine, Making Carbs Count, Diabetes KIT, non-invasive glucose testing, Glooko
  4. Desang diabetes magazine, diabetes news
  5. insulin pump, Dana i system, artificial pancreas, Advanced Therapeutics UK, CamAPS FX, Dexcom G6
  6. Desang diabetes magazine, diabetes news
  7. Dexcom G6 CGM, continuous glucose monitoring
  8. Desang diabetes magazine, diabetes news
  9. Glooko diabetes data download software. Stay on track in between visits.
  10. Desang diabetes magazine, diabetes news
  11. Medtronic MiniMed 780G System Automated for an easier way to stabilise glucose levels
  12. Desang diabetes magazine, diabetes news
  13. Air Liquide Healthcare UK, Tandem t:slim insulin pump, Control-iQ
  14. Dexcom G6 CGM, continuous glucose monitoring, comedian Ed Gamble
  15. Dexcom G6 CGM, continuous glucose monitoring, Dexcom G6, CGM diabetes, diabetes testing,
  16. Desang diabetes magazine, Diabetes UK, diabetes news
  17. Ascensia GloucoContro diabetes blood test result sharing software
  18. Diabetes kit, diabetes magazine, Type 1 diabetes Pete Davies, diabetes information
  19. Home test HbA1c, A1C Now Self-Check
  20. Needle-free glucose monitoring, non-invasive glucose monitoring, bloodless glucose monitoring, non-i
  21. Needle-free glucose monitoring, non-invasive glucose monitoring, bloodless glucose monitoring, non-i
  22. Needle-free glucose monitoring, non-invasive glucose monitoring, bloodless glucose monitoring, non-i
  23. Abbott Freestyle Libre 2, Flash Glucose Monitoring, FSL2
  24. Needle-free glucose monitoring, non-invasive glucose monitoring, bloodless glucose monitoring, non-i
  25. Insulet Omnipod DASH insulin pump with insulin pods, podders, Omnipod DASH Personal Diabetes Manager
  26. Glooko diabetes data download software. Stay on track in between visits.
  27. Diabetes kit, diabetes magazine diabetes information
  28. Desang Diabetes Magazine, free diabetes magazine, living with diabetes, the diabetic diet, carb coun
  29. Desang Diabetes Magazine, free diabetes magazine, living with diabetes, the diabetic diet, carb coun
  30. Desang diabetes magazine diabetes diet
  31. Diabetes technology education from Diabetes Technology Network DTN
  32. Desang diabetes magazine diabetes diet
  33. Medtrum Touchcare Nano Patch Pump and CGM
  34. DRWF wellness days and events
  35. Desang diabetes, Inside Diabetes guides, guide to injecting insulin, guide to injecting for people w
  36. Desang Diabetes Magazine, Making Carbs Count, carbohydrate counting for diabetes
  37. Desang Diabetes Magazine, Making Carbs Count, carbohydrate counting for diabetes
  38. Desang Diabetes Magazine, Making Carbs Count, carbohydrate counting for diabetes
  39. Desang diabetes kitbags, bag for diabetes kit
  40. Desang Diabetes Magazine, free diabetes magazine, living with diabetes, the diabetic diet, carb coun

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