WELLBEING

Arevolution has taken place in recent years in the treatment of type 1 diabetes, in part due to new wearable technology in the form of glucose-tracking body sensors.

‘These glucose sensors are part of a continuing revolution in diabetes care,’ says Sue Marshall, editor of an online diabetes journal (desang.net), who has type 1 diabetes. ‘All diabetics on insulin must take finger-prick blood tests throughout the day to check that their blood glucose levels are not dangerously high or low. These sensors take readings every five minutes, which is called continuous glucose monitoring (CGM). A blood test is a snapshot in time while CGM is like watching a video.

‘Because CGM gives you more information and records it, you can use the data to help control your blood glucose levels more effectively,’ Sue explains.

The small flat FreeStyle Libre sensor, the size of a €2 coin (freestylelibre.ie) is the simplest form of glucose sensor; it uses near-field communication (NFC, similar to Bluetooth). The wearer waves a separate small reader, or smartphone with an NFC chip, over the sensor to get the data.

More sophisticated models include a transmitter worn above the sensor, though these are less discreet. ‘In these, data is beamed directly from the sensor into a reader, which can be set so the user is alerted if their blood glucose level is rising or falling,’ says Sue.

Once glucose levels are assessed, a dose of insulin may be needed. The delivery of insulin took a leap forward around 2000 when, after long development, wearable insulin pumps were launched as an alternative to injecting insulin with a pen or syringe. The battery-operated pumps contain a cartridge, which provides regular insulin via a tiny flexible tube inserted under the skin. Sophisticated systems such as the MiniMed 640g by Medtronic team a sensor with an insulin pump that can, among other features, be set to turn off insulin delivery if glucose levels fall too low.

‘Compared to blood testing, this new technology is perceived as relatively expensive but it can help prevent high-cost complications and lead to significant improvements in blood glucose control and wellbeing,’ says Sue. It may be available free via the HSE for some patients.

Poor blood glucose control can lead to distressing short-term complications – I remember seeing my diabetic schoolfriend weak and dizzy from hypoglycaemia (low blood sugar) – as well as serious long-term consequences. Type 1 diabetes is the most common cause of vision loss and blindness in people of working age, and may lead to kidney failure, heart disease and stroke.