A Closer Look at Glucose Monitoring Technologies

A Closer Look at Glucose Monitoring Technologies
A Closer Look at Glucose Monitoring Technologies
Accuracy of glucose monitoring systems remains an issue of concern, but new technologies are on the horizon.

The variety of blood glucose monitoring devices currently available differ in accuracy, amount of blood required for testing, ease of use, testing speed, ability to transmit data to other devices, cost and display features.1

According to Barry Ginsberg, MD, PhD, of Diabetes Technology Consultants in Wyckoff, New Jersey, “with modern lancets and lancing devices, it is possible to get a drop of blood with virtually no pain. The blood glucose monitoring systems of 15 years ago required 30 uL of blood. Current systems often require 0.3 uL, 1/100 of the previous amounts.”

The type of device physicians recommend varies, depending on whether a patient has type 1 or type 2 diabetes. A blood glucose meter is commonly recommended for patients with type 2 diabetes, but a continuous glucose monitor (CGM) is regularly recommended for patients with type 1 diabetes.

“Generally, I believe that the patient with type 1 diabetes on a pump for intensive insulin therapy would benefit from continuous monitoring. Patients with type 2 diabetes, or those with type 1 diabetes on only two shots of insulin per day, can do fine with standard blood glucose meter. There is some data to suggest that patients with type 2 diabetes placed on continuous glucose meter for 2 to 4 weeks every 6 months do better,” said Ginsberg.

Blood Glucose Meters Vary in Accuracy, Cost and Insurance Coverage

The different types of blood glucose meters available also vary in terms of accuracy.3

“Blood glucose meters don’t give you a vector, and they are not all that accurate. Blood glucose testing at home has a 4% to 5% inaccuracy and laboratory testing has a 2% to 3% inaccuracy. The worst blood glucose meters are up in the 8% to 9% range,” said Ginsberg.

In addition, they commonly differ in extent of insurance coverage, cost of testing strips, ease of use, maintenance required, special features, data storage and retrieval, and customer support.2

“The problem with [treating] type 2 diabetics is that most are not on insulin. Those on insulin are largely within the Medicare population, and Medicare would not likely pay for more expensive meters, as they do not pay for convenience,” said Ginsberg.

CGMs Provide Glucose Vector With Limited Accuracy

It is very important for people with type 1 diabetes to understand whether glucose levels are on an upward or downward trend, which is why continuous glucose monitoring is important for these patients. A glucose value with a vector provides much more useful information than glucose value alone.

“For example, if a type 1 diabetic patient measures their glucose level and it is high at 150, and they are considering taking insulin prior to eating but they know it has come down from 200 a half hour ago, then they would consider just taking the regular amount of insulin at mealtime, rather than add extra insulin,” Ginsberg said.