Technological advances such as insulin pumps coupled with glucose monitoring system, which deliver insulin more accurately than daily injections, are making people with diabetes manage their sugar levels more easily. Among people benefiting the most are executives with erratic sleep and eating schedules because of work and travel, and pregnant women, for whom fluctuating sugar levels are a challenge to manage.
The insulin pump delivers rapid-acting insulin in programmable doses through a soft tube under the skin generally on abdomen. A continuous glucose monitoring system (CGMS) measures glucose levels 24X7, recording a new value every five minutes. It helps in keeping track of very high (hyperglycaemia) or too little (hypoglycaemia) blood sugar and other patterns that would be otherwise missed.
“This is the most effective physiological method of insulin delivery and more closely mimics the normal pancreas than injections,” says Dr Francine Kaufman, vice-president of global medical clinical and health affairs at Medtronic Diabetes, which makes these machines.
The insulin pump and the CGMS are more useful for children, pregnant women and patients who cannot control their food intake. Says Dr SK Wangnoo, senior endocrinologist from Apollo Hospitals, “Not just schoolchildren and pregnant women, the insulin pumps are of great use to people who are frequent flyers and those with long-standing history of diabetes.”
Different time zones and long flying hours can alter sugar levels for frequent flyers. Another category is formula one diabetic or for that matter, any diabetic athlete, who indulge in heavy activity at intervals. The insulin pump with automatic glucose level monitoring can help immensely.
“Those with long-standing diabetes history tend not to recognise the symptoms when their glucose levels dip (hence) use of pump is recommended,” says Dr Wangnoo, who installed Delhi’s first such device in 2004.
Newer versions of CGMS, set to hit the Indian market next month, have a recorder attached to the glucose sensor and a dock that uploads the data for three days. It helps web-based software to generate easy-to-use graphical reports. The graph helps the physician — and the patient too — to understand how glucose levels are affected by various activities.