Nothing Beats a Blood Test, Brett Lewis MD Roche UK, Dr Iain Cranston, Portsmouth University Hospita

KIT

NOTHING BEATS A

BLOOD TEST

A look at the evolving business of blood test technology from

two experts in the field, one from the supplier side of the

fence, the other a diabetes consultant's view. By Sue Marshall

continued over

(Part 6)

Industry

Brett Lewis, recently retired as MD

at Roche Diabetes Care after 35

years' service, looks back at a career

bringing blood glucose testing to

people with diabetes.

Says Lewis, "Self-monitoring of blood

glucose is getting on for 40 years old

now, and we are just now moving the

standards of care for people with Type 1

diabetes to include reliable technologies

that allow for continuous monitoring of

glucose. Development of CGM started

in the mid-1990s along with non-invasive

glucose monitoring with a view to creating

an 'automated pancreas.' But will this

spell the end of the pricking of fingers

to manage Type 1 diabetes? Is this the

answer for people with diabetes to live an

unrestricted life? I think it unlikely."

On average the NHS now budgets

about £3,000 per Type 1 diabetes per

year in total, excluding access to newer

technologies. Lewis says, "What the call

'fingerstick' blood glucose monitoring

(BGM) is by far the least expensive

option when it comes to the products

currently available, but also in terms of

the amount of clinical and personal time

required to manage it as a method. If you

are well controlled, a smart BGM meter

with an insulin dosing algorithm is very

unrestrictive. Leaving those times for

CGM when one is - for example - ill, or

in a changing circumstance, or to briefly

monitor your status as a backup to see

how you are managing."

For some people the idea of wearing

both CGM and an insulin pump may

seem a daunting amount of kit to wear,

even if it does create something like a

semi-automated pancreas. "The recent

introduction of implantable CGM with

six-month implant life does go in the right

direction of being less restrictive," continues

Lewis, "If the in-body 'dwell time' - in other

words how long you can keep an implant

in without needing to replace it - were

further extended, and the need reduced for

calibration with fingerstick tests, this could

go a long way in supporting an unrestricted

life with diabetes."

Based on those sorts of developments,

we might even find ourselves sometimes

forgetting we even have Type 1 diabetes.

But what about Type 2s? "There is

a new study for oral anti-diabetes drugs

(OADs) that showed that blood testing did

help them to improve their blood glucose

control outcomes," says Lewis. "It was

actually proven many years ago," says

Lewis, "but at the time I think the industry

failed to show how testing for Type 2s

can save money, not cost money. As

and when someone with Type 2 diabetes

graduates to being an insulin user, then as

far as I'm concerned an insulin user is an

insulin user, no matter how their condition

progressed to that point. I therefore think

that it would be good for T2s to also get

CGM access, at a minimum for a specific

amount of time at least, like maybe for a

month per six months."

Consultant

Dr Iain Cranston, Consultant

Physician (Diabetes, Endocrinology)

at Portsmouth Hospitals NHS Trust

since 2001.

Says Cranston, "The development of

technologies for measurement of glucose

levels as a prompt to therapy change

has been continuous since their first

incorporation into clinical diabetes selfmanagement in the 1970s. Over time,

the barriers to the technology use have

slowly been chipped away. Blood test

systems have become simpler to use,

take less time to do a test, and need

Index

  1. Free online Desang diabetes magazine diabetes information, insulin pump overview
  2. Dexcom CGM, continuous glucose monitoring
  3. Desang diabetes, magazine diabetes information, Sue Marshall diabetes
  4. sport and diabetes, Partha Kar, diabetes foodball community
  5. Air Liquide Healthcare UK Tandem t:slim insulin, Basal-iQ, Control-iQ
  6. Desang diabetes magazine, diabetes news
  7. Home test HbA1c A1C Now
  8. diabetes news, Carbs&Cals, Chris Cheyette, Yello Balolia, Talking About Diabetes
  9. BD, Becton Dickinson, injection kit, injection technique, injecting insulin, injection education, fr
  10. World Diabetes Day, Ascensia Diabetes Care
  11. World Diabetes Day, Ascensia Diabetes Care, GlucoRx diabetes care
  12. Diabetes UK, World Diabetes DayDiabetes UK
  13. Diabetes UK, World Diabetes Day
  14. Desang Magazine Reader Survey
  15. Desang Magazine Reader Survey
  16. Desang magazine, diabetes food news, Pitchfork Cheddar
  17. Abbott Freestyle Libre, Flash Glucose Monitoring
  18. Desang diabetes insulin pump overview
  19. Air Liquide Tandem S:slim X2 insulin pump
  20. Advanced Therapeutics Dana insulin pumps
  21. GlucoRx equil insulin pump
  22. Desang insulin pump overview, Insulet Omnipod
  23. Omnipod Insulet insulin pump with insulin pods, podders
  24. Desang insulin pump overview, Medtronic insulin pumps Minimed 670g
  25. Desang diabetes kitbags
  26. JDRF Input
  27. Accu-Chek Insight insulin pump for Animas users
  28. Kaleido insulin pump, patch pump, ViCentra diabetes
  29. Kaleido insulin pump, patch pump, ViCentra diabetes
  30. Air Liquide Healthcare UK Tandem t:slim insulin pump with Basal IQ
  31. Air Liquide Healthcare UK Tandem t:slim insulin pump with Basal IQ
  32. Desang diabetes free online magazine
  33. Desang diabetes free online magazine
  34. Nothing Beats a Blood Test, Brett Lewis MD Roche UK, Dr Iain Cranston, Portsmouth University Hospita
  35. Ascensia Contour Next One Diabetes blood test meters
  36. Nothing Beats a Blood Test, Brett Lewis MD Roche UK, Dr Iain Cranston, Portsmouth University Hospita
  37. Trividia Health UK True Metrix blood glucose monitoring (BGM)
  38. Making Carbs Count, carb content of halloumi cheese, diabetes diet, low carb food
  39. Making Carbs Count, carb content of halloumi cheese, diabetes diet, low carb food
  40. Making Carbs Count, carb content of halloumi cheese, diabetes diet, low carb food
  41. Accu-Chek Insight insulin pump for Animas users
  42. Free diabetes magazine, Desang Diabetes Magazine

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