Understanding the Dynamics of the Continuous Glucose Monitoring

Continuous glucose monitoring devices are smart, tiny automated machines that provide a wide range of information about a patient’s fluctuating blood glucose levels  such as the frequency, magnitude, direction, duration and causes of the glucose fluctuation in the patient’s body and help in taking optimal treatment decisions well before the outburst of an emergency situation. 

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Conventional glucose mentoring systems, which require obtaining a speck of blood on a lancing device and analyzing the glucose level in the blood sample thus obtained by using a glucose meter, are generally used once a day by most patients. Continuous glucose monitoring systems, on the other hand, allow for a continuous monitoring of blood glucose levels per day. As such a close inspection of trends in a patient’s glucose level fluctuation is possible, allowing the identification and prevention of emergencies.  

The difference between a conventional glucose mentoring system and a continuous glucose monitoring system is similar to the difference between a conventional camera and a security video surveillance camera. The camera takes accurate snapshots at discrete moments, specifically at the moments when it is manually operated. The small set of pictures thus taken can be carefully studied to analyze any given situation but no specific data about trends in the situation under-cover can be gathered from the pictures. 

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The security surveillance camera, on the other hand, records video streams of multiple frames, albeit poorly focused, and displays a sequential array of these recorded frames. The trend observable from the array of frames can be used to predict future. But, too much information is captured on each frame, making it quite difficult to study each frame carefully. Also, no manual interaction is required for it to record something, except for the initial set-up efforts to turn it on. 

The two types of glucose monitors essentially have the similar kind of differences: 
A conventional glucose monitor can measure glucose levels at discrete intervals almost accurately, whereas a continuous glucose monitor can measure glucose levels at multiple moments with fair accuracy. A conventional glucose monitor cannot predict future glucose levels as it does not study or analyze trends from past results. With a continuous glucose monitor, however, this is possible as a result of its capability of capturing and analyzing trends by making use of past results.  Also, conventional glucose monitors require manual efforts to operate whereas continuous glucose monitors are automated. 

Looking back at the camera analogy, we know that a security surveillance camera is often more useful than a regular camera in cases when the outcome is more important than just the momentary frames. Correspondingly, the best way to monitor blood glucose levels often may be a continuous glucose monitor rather than a conventional glucose monitor. 

The technology used in the currently available continuous glucose monitors is either the continuous measurement of the interstitial fluid (ISF) that involves minimal invasiveness or by applying electromagnetic currents through the skin to the blood vessels of the body that involves no invasion in the body.   

The most common method of these two methods is the one that measures the ISF through minimal invasion in the body. It involves fixing a sensor into the abdominal wall or the arm so that it comes in contact with the ISF of one’s body. The ISF is harvested by using various methods and is then delivered to an external sensor that monitors the glucose levels. 

This technique is called minimally invasive as the sensor is pricked on the skin only as deep as to compromise the barrier of skin and not puncturing any blood vessel. 

Continuous glucose monitors are basically simple-looking devices that produce complex-looking data and this can, especially at times when the user is not well educated about the correct meaning of these data-pieces, can disguise the patient in taking erroneous corrective measures. Also, it should be understood that the glucose levels are prone to rise at times such as right after eating something or after a period of exercise. Such conditions should not prompt the patient in taking doses of insulin or eating something, to manage the sudden fluctuation. Instead the patient should be prompted to check the glucose level by finger-sticking a blood sample through a conventional glucose monitor. 

It is obvious that continuous glucose monitoring techniques are currently less accurate than the conventional glucose monitors. But they are more beneficial as they provide data every frequent interval and keep feeding data throughout the day and night. Most systems also incorporate alarms for extreme results that may indicate cases of hyper and hypoglycemia. Also, when these systems are in use almost continuously over extensive time periods, there is huge possibility that significant improvements in controlling glucose levels can be easily achieved. 

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