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A JDRF trial shows that continuous glucose monitor (CGM) devices help to maintain tight blood sugar levels whilst lowering the risk of dangerously low blood sugar.

There is extensive research to show that tight blood glucose control is the best way to prevent the onset of type 1 diabetes complications such as kidney failure, retinopathy and heart disease. According to results from the Diabetes Complications and Control Trial, every one point reduction in HbA1C reduces the risk of long-term complications by approximately 40%.

Unfortunately, research has also shown that one of the hurdles to tight blood sugar control is the risk of hypoglycemia – both real and perceived.

Over the past 15 years the use of different insulin analogs as well as improvements in insulin pumps and blood glucose monitoring has had a positive impact on the ability of people to achieve blood sugar control targets. The rates of severe hypoglycemia, however, remain high and occurrence of such events is often followed by a decline of glycemic control due to fears of further hypoglycemic episodes.

In two multi-centre clinical trials – the first concentrating on people with bad glycemic control and the second on people who intensively manage their blood sugars – JDRF researchers have now demonstrated that an excellent solution to this problem is the use of a continuous glucose monitor, or CGM.

According to these trials, people using CGM spent two hours more time per day in the target blood sugar range of 3.9 to 10.0 mmol/l compared with people using fingerprick testing alone. They also found that CGM subjects had a significant overall improvement in HbA1C over time without an increased number of hypoglycemic attacks.

CGM devices are worn in a similar fashion to an insulin pump and provide both a real-time snapshot of glucose levels as well as trend information on whether glucose is moving up or down. They can also provide a warning when glucose is becoming too high or too low.

The continuous glucose monitor is a key component of the JDRF international Artificial Pancreas Program and these results take researchers one step closer to making the artificial pancreas a reality.

Diabetes Care published online 25th May 2009

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6 comments

  1. I would like to see the glucose sensor and transmitter that can be worn with the insulin pump also subsidised by the government. At the moment it is too expensive in Aust for most people. I have been suffering with Type 1 diabetes for 22yrs and have been on a pump for 5yrs, also suffer with Addisons Disease & Chronic Auto-immune thryoditis so my diabetes can be very unpredictable at times even though I try and keep tight contol. Through this I have suffered a few bad hypos while asleep, but if I had been wearing the CGM with the pump it woud have alerted me before it reached that critical stage. I am sure most parents with children wearing an insulin pump for their diabetes would appreciate knowing they have that alam to wake them if their small child was having a low sugar while sleeping or any other time of the day for that matter. I know I sure would.

  2. We are new to diabetes ( 8 yr old son diagnosed 4 months ago) – and although he is on injections rather than a pump – this CGM sounds wonderful and being able to eliminate the daily numerous painful finger pricks, and to get a better picture of his BGLs would be really beneficial. However I can't seem to find any reference to a CGM without it being associated with a pump – does anyone have any details of what it is, can it be used without a pump, and where can I get one.
    Janet

  3. Hi Janet,

    I have been using the CGM for about 2 years and I only know of one type currently available in AU. I had no interest in using a pump but started with this system necause it could provide the CGM benefits of allowing me to keep BG levels lower and not be concerned about more hypos. As it turns out the insulin pump is also a great thing making life easier and making consistent delivery of insulin a problem of the past. No more injections. No more worrying about taking stuff with me every time I leave the house. The only time it leaves my hip is for a shower or a swim. By the waywith the CGM you still need to perform roughly 2 finger pricks every day in order to calibrate the CGM levels to the actual levels in the body. Then for the remainin 12 hours you have constant access to the re altime BG level and can see if it is moving up quickly or down quickly and then act on it. Too expensive though. Until the govt provides some sort of subsidy my family budget just can't keep paying out the $60-$100 per week to keep this going. There is another CGM manufacturer with approval for use in the country but they have not started selling yet.

  4. Hi Everyone,

    I too am very frustrated at the lack of support and avaialabilty in Australia for continuous glucose monitoring. Its not only the lack of availability but the cost associated. Its amazing because healthy blood sugars reduces the need for additional medical services hence reducing the funding required by the govt. I have seen a few sights in the US that offer CGM and have contacted them via email, however I am not hopeful as they appear to require a US perscription. As a diabetic of 29 years with HB1CA of 10.1 I am desperate for this technology to be available here so that I can fulfil my dream of being a mother. All the healthy eating, weight management, constant exercising in the world isnt helping me and hasnt done for 29 years.
    Good luck everyone

  5. i want one, where can i get it? im still on insulin injections, can i still use a CGM?

  6. You can use CGM without needing to purchase the insulin pump that goes along with it. It's just a matter of purchasing a sensor (speak to you D.E. about doing this) and wearing the guardian transmitter that goes along with it. As CGM is so expensive to use on an ongoing basis ($70 for a 3 – 6 day sensor!) this is a great option if for a week or so every once in a while you want to get an idea of what's going on with your BSL's. It doesn't matter what type of pump you're on or if you're injecting YOU CAN STILL USE CGMS. I did try it myself and was suprised that I still had to test (2 – 4 times a day) to calibrate. it doesn't take away the need to still do your finger pricks.