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Continuous Glucose Monitoring Systems...

A Continuous glucose monitor is a small device warn under the skin that uses interstitial fluid to monitor blood glucose levels. It then transmits readings to a receiver and allows a person with diabetes to have a guide to what blood glucose levels may be at a given time and whether they are expected to rise or fall in the near future.

 

What is the difference between testing and using a Continuous Glucose Monitor?

Glucometers are portable devices that read glucose levels from a blood sample that is placed on a tiny test strip. Test strips are discarded after a single use.  Some meters store a limited number of glucose results in memory. The results can be downloaded into a computer.

A glucose sensor is a tiny electrode that is inserted under a patient’s skin (subcutaneous tissue) and continuously records glucose levels around the clock. The sensor is worn for between three to seven days before it is discarded and replaced by the patient.  Glucose readings are transmitted to a monitor or insulin pump where the values are displayed. Trend reports and charts can be viewed after data is downloaded to a computer.

posted with permission from 2006 Medtronic MiniMed, Inc.

 

DexCom Generation4

dexcom The latest DexCom is now available in the US and Canada.  It comes in three colors. The Dexcom G4 PLATINUM Receiver is sleek and small and slips easily into a coin pocket. And at 2.4 ounces, it's the lightest CGM around. Transmission distance of up to 20 feet! Tones/ Melodies - Setting high or low ear-pleasing alerts! In Canada, this device is currently approved for use in children as young as 2 years of age.

 

 

Medtronic Paradigm Real Time System®

Real Time System

The Real Time System weighs 4oz, uses the Paradigm 522/722 screen, and transmitter/sensor size is 2"x1.5"/.75" diameter. Sensors last 3 days and have a 14mm cannula with 23 gauge sensor probe which is inserted at 45 degrees with a Sens-serter or manually. Start-up initialization time is 2 hours. Calibration is 2 hours after insertion, within the next 6 hours after the first and then every 12 hours.  An alarm will sound if calibration does not take place. Predictive alarms for high/low at 10, 20 or 30 minutes. Displays glucose numbers every 5 minutes. Displays directional graphs for 3 and 24 hours. Displays rate of change. Review glucose data for the last 24 hours. Will vibrate, use and escalating alarm or both.  Transmitter is waterproof but not recommended for use in hot water. Transmitter batteries last 9 months. The monitor uses 1AAA battery. Has a 6 foot range. Snooze alarms at both the high and low alarm settings. Uses Medtronic Carelink Online software. 6 month warranty on transmitter. Real-Time accuracy: MARE:16.59%-24.84% Clarke Error grid -96% in A+B and 61.7% in A.  MARD (mean) -17.32% MARD (median) -12%. 

Available in the US and Canada

Information from www.diabetesnet.com , www.medtronic.com, www.diabeteshealth.com

 

Comparison Chart...

  The SEVEN PLUS Real Time System
Availability USA
USA and Canada
Communicates with Insulin Pump Planned project with Omni Pod.  Currently used in the Animas Vibe With Paradigm 522 and 722
Accuracy Median ARD 11.4% (vs. SMBG)
* HYPO Clark Error Grid ”A” range 69
MARE: 16.59% - 24.84%% Clark Error Grid - 96% in A+B and 61.7% in A MARD (Mean) - 17.32% MARD (Median) - 12
Sensor Life 7 days 3 days
Length of Sensor Probe 13 mm 14mm
Angle of insertion 45 degree 45 degree
Start up initialization time 2 hours 2 hours 20 minutes
Calibration First calibration after 2 hr warm up needs 2 finger sticks; after that its only 1 each 12 hours. Can use any FDA approved meter and does not require a steady” bg for calibration Calibrate at 10, 12, 24, and 72 hours after insertion with no further calibration for the final 2 days of the 5-day wear. May require more calibrations under certain circumstance
Alarms on user--set high and low threshold Yes, customizable.  Can be turned off if user wants. Exclusive Hypo Safety Alarm set at 55 mg/dl cannot be turned off for extra line of defence Yes, different sounds for different alarms, different volumes. Extremely loud “back up” alarm if no response to the first alarm
Displays glucose numbers Every 5 minutes Every 5 minutes
Displays directional trends Yes, 1,3,9 hour trend screens.  Additional planned screens planned Yes, arrows that display how fast and in what direction, and 3 and 24 hour graph
Displays rate of change yes yes
Vibrate, Alarm or Both Both Vibrate, escalating alarm, or both
Transmitter Water Resistant yes yes
Transmitter/Sensor or body surface size Sensor is the size of a nickel. Transmitter is 1.4"x1.1"x.3" and attaches to sensor 1.5"x.9"x.4"
Transmitter Batteries Built into transmitter, 1 year warranty Rechargeable.  Transmitter life about 1 year.
Monitor batteries Rechargeable, recharge every 3-5 days based on use Displayed on Paradigm 522 or 722 insulin pump which requires one AAA battery.  Pump alerts when change is needed
Range of monitor to transmitter 5 feet 6 feet
Warranty 1 yr on receiver and transmitter 6 months on transmitter, 4 years on pump

 

 Taken in part from http://www.diabeteshealth.com/media/pdfs/PRG1208/DH_CGMs_08-09.pdf  and http://www.childrenwithdiabetes.com/continuous.htm

 

CGM Articles:

 

Comparing the accuracy of two continuous glucose monitors

 

A comparison of 3 models of continuous glucose monitors

 

User Reviews:

 

 I have been T1D for 16 years and for the past year I have been using the Dexcom G4. This amazing piece of technology has drastically changed my life with diabetes. The accuracy is incredible and I have a level of confidence now that I never had before. Always knowing where I'm at and where I'm going truly allows me to live a more "normal" life. The cost is high but to me its worth every penny.

Alyssa, March 2015

 

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