June 29, 2007
Advances in Diabetes Care
Genesis first in area to offer continuous glucose monitoring system
DAVENPORT, IOWA - For four years, Larry Young of Davenport has monitored his Type 2 diabetes by pricking his finger two to three times a day to check his blood sugar level.
Last week, he got more help in managing his chronic disease. Instead of the two to three “snapshots” a day he receives from the fingerstick testing, he now wears a device that continually checks his blood sugar, giving 288 average readings a day. Better yet, it alerts him to potentially dangerous fluctuations in his blood sugar levels.
The milestone marks another area first for the Genesis Regional Diabetes Care Center. Nine months ago, some of the center’s patients who wear insulin pumps also began wearing Medtronic’s continuous glucose monitoring system. By sounding an alarm when glucose levels become too high or too low, the system warns them to take action to normalize their blood sugar.
Recently, Larry Young, who developed Type 2 diabetes four years ago, became one of the first Genesis patients to use the Guardian Real-Time system – even though he does not wear an insulin pump.
The significance of the breakthrough technology is this: People with Type 1 and Type 2 diabetes have long relied on fingerstick testing to tell them what their glucose level is at that moment in time. A high or low that happens between fingersticks can easily be missed and a large majority of low glucose levels may not be revealed by fingersticks at all.
The Guardian system takes glucose readings continuously, showing glucose averages on a screen every 5 minutes. Patients like Larry always know what their glucose level is, which way it’s heading and how fast it’s heading there. As he approaches his glucose limits, he is warned in plenty of time to take action.
That’s important because unhealthy blood sugar fluctuations can cause long-term complications, such as blindness, kidney failure, amputation, impotence and heart disease, as well as loss of consciousness or even death.
More control, motivation
“For four years, I’ve denied the impact that diabetes is having on my life,” Larry says. “I’m overweight. I have all the criteria for Metabolic Syndrome. I need to exercise more. Every one of those things can be impacted by lifestyle change, and yet I haven’t done anything.
“Now with the Guardian system, I’m not going to be able to kid myself anymore about the impact of my good and bad decisions. I will be able to see the immediate impact of my choices. For me, it will be a great motivator.”
His wife, Jane Young, has had Type 1 diabetes for 34 years and has been wearing the Medtronic insulin pump for the past 13 years. Last fall, she added the Real-Time continuous glucose monitoring system to her insulin pump. “It’s what everyone with diabetes has been waiting for – the ability to see your numbers all the time and to know that you can have an impact and make a difference,” she says.
When she was diagnosed with diabetes more than three decades ago, there were no glucose monitors of any kind. The only way to monitor blood sugar was through unreliable – and inconvenient – urine tests.
“We’ve made more advances in diabetes techology in the past five years than we have had in the last two or three decades,” says Jane, who has worked at the Diabetes Care Center for years and now is a representative for Medtronic. “It’s just growing by leaps and bounds.”
She and her husband now refer to “living between the lines.” The system can be set at individualized targets for high and low parameters for each of them. If their blood sugar levels don’t stay between the lines, the system sounds an alarm.
“When I started wearing the system, I started getting alerts when my blood sugar would be high or low,” Jane says. “It was exciting to know that I could take action and have some impact.”
The system is well-suited for any Type 1 or Type 2 diabetes patient who wishes to reduce erratic blood sugar fluctuations. It’s also ideal for parents closely monitoring their children’s disease; patients who have lost their ability to detect rapid changes in blood sugar levels, and women with gestational diabetes or diabetes patients wishing to become pregnant.
A significant breakthrough
“With the Real-Time system, patients can be continuously aware of their current glucose level and potentially reduce the frequency and severity of low and high blood glucose episodes.
Patients also can learn how diet, exercise, medication, lifestyle and episodes of illness affect their blood sugar,” says Marsha Menke, R.N., Manager of the Genesis Diabetes Care Center in Bettendorf. She stresses that the exciting technology does not take the place of fingerstick testing at least twice a day.
“This was our dream 20 years ago,” says Peggy Scott, R.N., a certified diabetes educator and certified product trainer. “Everyone was talking about it and thinking about it, but we weren’t holding our breath.”
Food alone is not the only factor in fluctuating blood sugar levels. Stress, lifestyle and exercise can also play a role, which makes it all the more challenging to manage diabetes.
“For the most part, people with diabetes are pretty motivated to take control and be healthy, but if they’re only checking their blood sugars a couple of times a day with fingerstick testing, it can be pretty difficult,” Scott says. “The Guardian system is very exciting for our patients.”
A tiny sensor inserts easily under a patient’s skin in a virtually painless process. Once the sensor is in, it is connected to a lightweight wireless transmitter that records patients blood sugar levels continuously, displaying a 5-minute average that goes automatically to a monitor that is worn like a pager.
“I now have real information that will help me decide, ‘Is there a decision I made that I don’t want to make in the future?’ “ Larry Young says. “Learning for the future is my major motivation. “
He’s also thrilled that the system allows him to download his detailed data to his personal computer. He can share his information – made into charts, graphs and tables – with his team of health care providers – from his endocrinologist, to his family practice physician to the diabetes educators at the Genesis Diabetes Care Center.
“It helps us make better decisions as a health care team,” Menke says.
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