It’s no exaggeration to say we’re living through a revolution in diabetes care. New treatments and technological advances are rapidly transforming the outlook for patients – with major improvements in virtually every aspect of managing your condition, from continuous glucose monitoring to insulin pumps. Even so, most people still use simple glucose meters and prick their fingers to get a drop of blood.
Guide to Glucose Monitoring
Blood glucose (sugar) control is very important for people with diabetes. Home blood testing, when done sensibly before and after food, will help you to keep your diabetes under control, as well as give you valuable feedback on how different foods, illness, activity, or stress affect your glucose levels. The Freestyle LibreTM system has made this less painful (no finger pricks) and more useful and we are rapidly moving into a world where our glucose readings will be automatically available on our smartphones or watches.
In addition to monitoring your own glucose levels, your Diabetes Team will request an HbA1c test every 3-6 months. This test is always available in our clinic and you will have the result within 5-10 minutes. This test shows what your average blood glucose has been over the previous 2-3 months. A result of 6.5% or below is desirable to reduce the risk of complications associated with diabetes.
Which blood glucose meter?
The pharmacy at the London Medical has a selection of blood glucose meters. Our Diabetes Specialist Nurse can help you select the most suitable meter for you and provide training on its use.
Update your glucose meter
A modern meter will have added benefits that your old meter did not have: for example:
- the newer models convert the result of whole blood automatically to plasma values;
- require far less blood;
- give the result in less than 5-10 seconds;
- allow you to upload your results onto your computer with a full analysis for easier understanding of what you might need to do and give helpful advice on insulin dosing (MyStar DoseCoachTM).
- some now also have the facility to measure blood ketones, which is important for anyone using insulin or medicines that promote ketosis.
Below are some of our range:
- FreeStyle InsuLinX (glucose and ketones)
- Glucomen LX Plus (glucose and ketones)
- Accucheck Mobile
- One Touch Verio Pro Plus
- BG MyStar Extra and MyStar Plus
- Bayer Contour Next
The Pharmacy at The London Diabetes Centre stocks the full range of test strips to match the glucose meters and the latest lancets to minimise discomfort. These can be delivered to you by post.
How to use your glucose monitoring information
We encourage our patients to work with the Diabetes Team here to improve control by downloading their glucose readings to us using DiasendTM, a web-based diabetes management system.
CGM – Continuous glucose monitoring and flash glucose monitoring
Continuous glucose monitoring (or flash glucose monitoring with the FreeStyle LibreTM system) is a way to measure glucose levels throughout the day and night. A tiny electrode called a sensor is inserted under the skin to measure glucose levels in the tissue fluid. The readings are not in real time and slightly late and are calibrated so as to reflect actual blood glucose readings, so they do not currently offer accuracy comparable to the laboratory. Some have alarms to indicate high or low glucose or rapid change.
Many people can benefit from continuous glucose monitoring:
- Adults and children with type 1 or type 2 diabetes
- People whose glucose level is outside of the normal range, not yet diagnosed with diabetes or other medical conditions
- People with diabetes who have lost the ability to detect hypoglycaemia during the night or day
- Pregnant ladies with diabetes, gestational diabetes or trying to conceive
- People with diabetes wishing to reduce erratic blood glucose fluctuations
- People with diabetes who are involved in sporting activities
- People with diabetes whose concentration is affected by changing glucose levels
- People with diabetes who require additional monitoring whilst driving
- People with diabetes who live alone
- People who are changing diabetes therapy such as starting insulin pump therapy
- People with diabetes who require observation during hospital admission
Research suggests that using a CGM can help reduce Hba1c without the risk of hypoglycaemia.
There are currently various suppliers offering continuous monitoring systems and all are available in our clinic:
- Medtronic – Guardian ConnectTM
- Abbott Navigator and FreeStyle LibreTM
- Dexcom G5
- Medtrum A6
- Roche EversenseTM implantable CGM device
What Is Insulin Pump Therapy?
An insulin pump is a small battery-operated device that provides your body with precise doses of rapid-acting insulin to closely match your body’s needs. The insulin is delivered via a tiny flexible cannula, inserted under the skin. The cannula can be left in for two to three days before it needs to be replaced and moved to a different insulin injection site. Insulin pumps require training and education on their correct and safe use.
At the London Diabetes Centre our pump training programme can be tailor-made to meet your individual needs. The number of appointments and hours required can be planned with the Diabetes Team to ensure you receive adequate training time.
Advantages of insulin pump therapy:
- Better control of your blood sugar levels, with fewer highs and lows.
- Help to prevent long-term complications
- Fewer injections – the cannula only needs replacing two or three times a week.
- More flexibility with what, when and how much you eat.
- Less risk of highs and lows when exercising.
- More predictable absorption of insulin than injections.
- Ability to change your basal (background) insulin if you’re ill.
- Greater accuracy in bringing down high blood sugar levels.
- Better management of blood sugar levels when travelling across time zones.
- Particularly beneficial during pregnancy
What pump types are available?
Pumps vary from being a tethered (line pump) or a patch pump. They also vary in colour, battery life, screen size and extra features, such as a remote control and linking to CGM’s. Our diabetes team will help you choose.
- Medtronic 640G. This is a predictive low glucose suspend pump
- Roche Accuchek Combo
- Dana Diabecare R and RS – full control with smartphone application
The iPORT Advance Injection Port
This is a clever device to help take away the stress and pain of insulin injections, and is very popular with young children.
At London Diabetes our pump training programme can be tailor-made to meet your individual needs. The numbers of appointments and hours required can be planned with the diabetes team to ensure you receive adequate training time.