Continuous Glucose Monitoring

Insulin pump with sensor

The insulin pump already gives a better regulation and adjustment of your treatment to trends, but this can be further enhanced by adding a continuous glucose sensor. This sensor measures the glucose value in the subcutaneous fat every few minutes. This is different from measuring in the blood with a finger prick, where the level is always a few minutes behind the actual blood level, which sometimes calls for an extra check-up in a blood sample. This delay appears not to be important for seeing trends and responding to them. With a sensor people can react long before a level gets too high or low, thereby avoiding hypos or hypers. In the meantime when it comes to hypos this has become partly automatic by control of the pump through the sensor. Judging from the trend in the decrease of the glucose the pump computer can decide to stop the insulin supply (with the first generation pumps this was called low glucose suspend) but with the newer pumps the computer can predict a hypo even at an earlier stage. We call this a predictive low glucose suspend.

At this point, the sensor still calls for a lot of handicraft, such as calibration every two or three days and reaction by the patient or the parents to the borders of the alarm. The sensor is not yet fully automatic, like for instance an artificial pancreas is, but we are on the way to achieving this goal. In the meantime, people are learning to deal with the technique and get good results from it. Almost ninety percent of them reach an HbA1c lower than 7,5% (58 mmol/mol). This is one of the things that helps us towards our goal of a future without complications.