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Sunday, September 22, 2019 12:12:06 PM
Diabetes management entails administration of insulin in combination with careful blood glucose monitoring (Type 1) or involves the adjustment of diet and exercise level, the use of oral anti-diabetic drugs, and insulin administration to control blood sugar (Type 2).
Self-monitoring of blood sugars using a portable, personal device that takes a small blood sample obtained with a tiny finger lancet. Using such a device, tight glycemic control (TGC) becomes possible, as an adjunct to insulin therapy, either injected or delivered via a wearable insulin pump. This technology-enabled self-care model has been shown to reduce complications and improve the quality of life in T1DM. Replicating these results in T2DM has been challenging, largely reflecting the heterogeneous nature of the disease and the fact that it changes with increasing age and other factors. Implantable sensors that measure blood glucose continually have come into practice more recently.
The value of self-monitoring enablement using electronic devices, including the next generation of wearable health appliances, is aided by incorporating decision support algorithms and other intelligent information technology tools. The concept of the “artificial pancreas” combines glucose sensing technologies with automated insulin delivery by pump, with software based decision making interposed so that the former drives the latter (fully automated feedback loop). Such systems are under development but have not yet made their way to market.
In the absence of a cure, the goal of diabetes management is to alter the natural course of the disease by reducing the likelihood of complications by eliminating the wide fluctuations in blood sugar that define the disease. The toolset to do so is currently limited.
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Whoever is careless with the truth in small matters cannot be trusted with important matters.
– Albert Einstein
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