Diabetes is a condition marked by the inability of the body to properly manage the level of glucose (sugar) in the blood. In type 1 diabetes, the body does not make insulin, the hormone that regulates the body's use of sugar. Individuals with type 1 diabetes need insulin to keep blood sugar levels stable at all times. People with the disorder must therefore monitor their glucose levels frequently, usually by pricking their fingers many times a day to obtain blood and using a glucose monitor and test strips to detect blood sugar amounts.
The new study reviewed and re-analyzed data from 33 randomized controlled trials that compared the newer technologies to conventional methods of monitoring and controlling blood sugar levels. The new technologies looked at were primarily real-time continuous glucose monitoring devices and insulin pumps.
The continuous monitoring devices track blood sugar levels day and night, as often as every five minutes, using a sensor that is attached to the abdomen with a small needle held in place by tape. The sensor sends the results to a display that is worn on the belt.
Diabetic individuals can make decisions about adjusting insulin therapy and/or activity levels based on the readouts. Patients still need to prick their fingers two to four times a day to make sure the device is working properly, but that is down from as many as eight to 10 times a day for patients trying to strictly control blood sugar. These devices also sound alarms if the blood sugar level is dangerously high or low.
"Our study was designed to help patients and physicians better understand the effectiveness of insulin pumps and blood sugar sensors that provide constant glucose monitoring compared to conventional approaches," Sherita Hill Golden, M.D., M.H.S., an associate professor in the division of endocrinology and metabolism at the Johns Hopkins University School of Medicine was quoted saying.
The researchers found that children, teens and adults with type 1 diabetes who used continuous monitoring had lower blood glucose levels than those who used finger stick testing alone. They also spent less overall time with too much blood sugar (hyperglycemia).
While there was little difference in blood sugar control in those who give themselves multiple insulin shots a day versus those who used insulin pumps, those with type 1 diabetes who used the sensor-augmented pumps, pumps that include real-time continuous glucose monitoring devices, did much better controlling blood sugar than those who used finger stick testing and shots.
"Those who use the devices as prescribed, do the best at maintaining blood sugar control, adherence is the key to effectiveness," added Golden.