After talking about diabetes technology in my last post How to stop worrying about diabetic complications!, it would be informative to explain what types of diabetes technology is out there, what they do and the differences between them!
So keep reading for your diabetes technology 101, and to find out everything you need to know to get started!
Flash Glucose Monitoring (intermittent glucose monitoring)
FGM’s are small sensors that you scan with a receiver to view your sugar levels. The receiver can either be a monitor that looks similar to a finger- prick monitor, or can you connect your sensor to your phone via an app.
FGM’s tend to be placed on the upper arm, and have to be removed and replaced every 2 weeks.
FGM’s take glucose readings from the interstitial fluid (fluid between cells), but can sometimes have a 10 minute lag. This means occasionally finger-prick tests might be needed, if you feel differently to what your sensor is telling you.
The FreeStyle Libre is a type of FGM, and is now widely used across the UK and being distributed by the NHS to individuals who fit ‘the criteria’.
The current criteria in the UK to get an FGM is:
1.T1D’s who check glucose levels more than 8x a day
2. T1D’s how have severe hypo’s or reduced awareness of hypo’s
3. Any individual with diabetes who also suffers from kidney problems
5. Cystic fibrosis induced diabetes with insulin therapy
FGM’s are fantastic for establishing what foods or factors could be causing glucose spikes.
For example for my FreeStyle Libre showed me what tends to happen to my sugar levels when I eat certain foods. I find that when I eat potatoes, I spike very quickly, and then drop into a hypo fairly soon after. In order to prevent this I always go for a walk after eating potatoes and then I have a little snack to keep my levels balanced.
CGM stands for Continuous Glucose Monitor, and it is a sensor that can be applied to a variety of places on the body.
For example the Dexcom can be placed on the lower stomach, upper arm or upper bottom.
CGM sensors have to be changed like FGM’s. How often they need to be changed depends on the brand. For example some models have to be changed every 7 days, while others don’t need to be changed for weeks.
CGM’s also take glucose readings from the interstitial fluid rather than the blood. The test reading is automatically sent to the connected device where you can see what your sugars are doing. This makes glucose testing much easier for people living with diabetes, because you can simply read the glucose results on your phone, rather than having to get your whole kit out and perform a finger-prick test.
The current criteria for getting a CGM in the UK is:
1.Having at least 2 hypo’s a week without being aware
2. Complete unawareness/ lack of feeling hypo’s
3. Having extreme fear of hypo’s
4. Consistently having a HbA1c of 75 mmol/mol despite testing glucose more than 10 times a day
CGM’s are fantastic for better glucose control and lowering HbA1c, because they allow you to identify factors causing your hyper or hypoglycaemia episodes.
CGM’s and FGM’s sound pretty similar right! The main difference between a CGM and FGM, is that CGM’s send updates on your sugar levels continuously (by Bluetooth) without you having to do anything. FGM’s however, only gives you information when you scan the sensor yourself. The CGM also has the ability to set an alarm off if your glucose is entering hyper or hypoglycaemia range, which can be pretty useful!
Pumps are devices that administer insulin into the body, rather than having to manually inject.
There are two types of pumps, Patch pumps and Tethered pumps.
Patch pumps are directly attached to the skin (like a CGM or FGM). Tethered pumps have a tube connected to a pump that can sit in the pocket, or can be attached to a belt.
Both pump types are connected to be body by a cannula, in general cannulas need be changed every couple of days. The individual living with diabetes will be taught how to change the cannula themselves.
The current pump criteria in the UK is:
1.T1D’s who cannot reach their target HbA1c without having severe hypo’s
2. An elevated HbA1c despite carefully trying to manage diabetes
If you’re living with diabetes and fit the criteria for getting a pump, I would recommend researching types of pumps more in-depth and of course talking to your diabetic team.
The information I have outlined on Insulin pumps is quite brief, so click here for some further information on pumps and how you can get started.
Making a decision
Also remember that technology does not suit everyone, try what you are comfortable and ready for! For example, I am more than happy just having an FGM, and I personally do not want a pump. I manage my diabetes and hit my HbA1c target with my FGM and manual injections.
If I’m being completely honest, I would absolutely ask your team and push to try some new tech if you want to try it out. Your team may not be fully willing to let you try the latest test tech, but you will not know how well it works until you try it! (And nor will your team).
If you do not fit the criteria for getting an FGM, CGM or Pump on the NHS (in the UK), you can purchase technology. Ask your diabetic team for more guidance on prices and options should you be interested.
And as I advised in my previous blog, I would recommend starting with an FGM if you’re interested. They are generally smaller and easier to get along with when transitioning to new technology.
Thank you so much for reading my Diabetes technology 101! I really hope you found this information useful, and it has inspired you to look into new types of diabetes technology. If you have any questions or need further guidance be sure to drop me a message! Please subscribe and give me a follow on Instagram!