Better glucose control Improved A1C control More stable BG Less hypoglycemic episodes

 

From a quality of life standpoint, users of CGM can usually cut down significantly on the number of daily fingerstick glucose measurements. Stress & anxiety levels can also drop dramatically for the user as well as their loved ones.

 

Now let's talk about the

Drawbacks of CGMs

Of course, there are some drawbacks to using a CGM. There may be some extra out of pocket costs. Wearing a device on the skin can be irritating or inconvenient.  There may be occasional technical problems. The alarms & alerts, while customizable, can be an annoyance. And while the data is generally reliable, it is not quite as accurate as readings generated by fingersticks. For the vast majority of people, these drawbacks are far outweighed by the benefits that CGM has to offer.

Increased cost Device must be worn at all times Possibility for technical glitches does exist Various alarms can be annoying Data quality not (quite) as accurate

 

Automated Insulin Delivery

Now let’s turn our attention to an exciting new field of diabetes care and treatment: Automated Insulin Delivery, or A-I-D. AID consists of 3 components: An insulin delivery device (which is usually a pump), a CGM, and a computer program called an “algorithm” which automatically adjusts insulin delivery based on data provided by the CGM. 

3 Components Insulin delivery device CGM Computer algorithm

 

CGM Algorithm

For example, if the glucose level is elevated or rising, the algorithm would tell the pump to increase insulin delivery.  If the glucose level is falling or low, the algorithm would tell the pump to temporarily decrease or stop insulin delivery.  This way, the user can keep their blood sugar within a healthy range more of the time without having to do more work.

Automated responses to changing BG levels If BG is rising (or elevated), algorithm tells insulin pump to increase delivery If BG is falling (or low), algorithm tells insulin pump to decrease or stop delivery

 

Artificial Pancreas

Of course, the ultimate goal of A-I-D is to keep glucose levels within a normal range all the time without the user having to do any of the work. This is commonly referred to as an “artificial pancreas”. 

 

With our current state of technology, we do not have this capability. A true artificial pancreas would require insulin that is much faster-acting than what we have today. It would also require more-accurate sensors and an algorithm that has predictive capabilities. It may also require the use of other hormones in addition to insulin, such as glucagon for raising blood sugar and amylin for slowing down digestion. In short, we're not there yet.