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

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smaller sample volumes and therefore

using lancets has become less of a

discomfort. In addition, measurements

have become more accurate and many

meters no longer require calibrating. All

of these improvements have become a

reality as the upward march of technology

continues."

In fact, change has become faster

over recent years, particularly with the

dawn of continuous glucose monitors,

giving readings every ten minutes or so

via a sensor worn on the body. Confirms

Cranston, "The most recent additions to

glucose monitoring technology advances

have been those relating to continuous

monitoring of interstitial glucose levels. In

the last five-to-10 years, this has radically

changed the landscape for monitoring,

providing accurate, painless glucose

measurements with the additional benefit

of a clear indication of the 'direction of

travel' of the glucose levels - trending up or

down, allowing for the person to intervene,

for example before they go into hypo."

To a very great extent, finger-stick

blood glucose monitoring technology has

possibly gone as far as it can, with recent

years not really seeing much as regards

new developments, other than that of

production methods aiming to reduce

the costs (although occasionally at the

expense of the accuracy). "Interstitial

CGM technologies by contrast, while for

the most part achieving a similar accuracy

to blood test measurements, are in a

phase of rapid evolution," says Cranston,

"With each successive generation (which

appear every six-to-12 months) of

sensor technology showing significant

improvements over the last."

Development pathways

So, what might the future of CGM

technology hold, bearing in mind the

pace of change? Cranston predicts,

"The technology has essentially two

development pathways, the first involving

integration with insulin-delivery technology

in the form of 'loop' systems. This is seen

as the technological 'Nirvana', the ultimate

solution to self-management of diabetes,

but for many it is like the concept of

driverless cars - seen as a step too

far. The second development pathway

involves integrating the data from CGM,

or indeed from self-monitoring of blood

glucose via blood tests (SMBG), into their

own self-management decision-making."

At present the second pathway is

the one far more commonly used by

people living with diabetes, and the one

in which there needs to be far more

development, thinks Cranston, saying,

"In particular, the way we work as health

care professionals (HCPs) advising people

with diabetes needs urgent development,

as many HCPs still do not engage with

glucose data in a meaningful way during

a consultation."

Worldwide clinical standards now

exist highlighting the importance of

directly measured glucose data (from

devices such as CGM) in outcome-based

care, defining optimal control now as

'time spent in target range' (TIR), which

is reported as a percentage, rather than

the more familiar HbA1c, which is a much

less helpful three-month average.

Says Cranston, "If we are able

to harness the rapid technology

developments into clinical management

change too, then the future of diabetes

self-management will be a much brighter

landscape than in the past."

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  7. Home test HbA1c A1C Now
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  10. World Diabetes Day, Ascensia Diabetes Care
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  18. Desang diabetes insulin pump overview
  19. Air Liquide Tandem S:slim X2 insulin pump
  20. Advanced Therapeutics Dana insulin pumps
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  22. Desang insulin pump overview, Insulet Omnipod
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  27. Accu-Chek Insight insulin pump for Animas users
  28. Kaleido insulin pump, patch pump, ViCentra diabetes
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  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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