New Diabetes Monitors Require Fewer Pricks, Less Guessing
Coming Soon: Continuous Glucose Monitoring, With No Finger Pricks
This 'Smart Pen' Could Revolutionize Diabetes Treatment
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Rather, it’s the constant worry and mental calculations.\u003c/p>\n\u003caside class=\"pullquote alignright\">'In a perfect world, everybody with diabetes would benefit from some form of this technology.'\u003ccite>Kathleen Dungan, Ohio State University\u003c/cite>\u003c/aside>\n\u003cp>“You have to think about what did I eat last, how much insulin did I take for that, where is my blood sugar now, which direction is it trending, and then based on that, what am I going to eat?” she says. “You’re making these educated guesses about how much of a really volatile hormone [insulin] to take, and that is mentally exhausting.”\u003c/p>\n\u003cp>Lee, 38, who was diagnosed with Type 1 diabetes when she was 10, recounts ruined dates, missed flights and abandoned excursions, all because she was worried about her glucose level or forgot to bring a replacement for her insulin pump.\u003c/p>\n\u003cp>“You can go from being okay to being really not okay in a moment’s notice,” says Lee, who lives in Milpitas, California and works as the director of community relations at Bigfoot Biomedical.\u003c/p>\n\u003cp>To relieve some of the burden for the estimated 9.3 million people who use insulin to regulate diabetes, medical device makers have introduced new ways to monitor glucose and administer insulin.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Better Glucose Management\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_440097\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"wp-image-440097 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi.jpg\" alt=\"FreeStyle Libre\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Melissa Lee displays the components of the FreeStyle Libre, her blood glucose monitor. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Continuous glucose monitors, or CGMs, have been around for over a decade, but poor quality and high costs have been barriers to use, says Irl Hirsch, who holds the Diabetes Treatment and Teaching Chair at the University of Washington School of Medicine. But improvements on both fronts lead him to believe that CGMs will soon become the standard of care. At his own clinic, 60 percent of patients use one.\u003c/p>\n\u003cp>“The financial impact and the insurance coverage is not the barrier that it used to be,” Hirsch says. What’s more, “The quality and the accuracy of these things have just gotten better.”\u003c/p>\n\u003cp>CGMs measure glucose levels not in blood but in the interstitial fluid, which surrounds the cells just underneath the skin. A sensor sticks onto the body, typically on the upper arm or abdomen, with a small, flexible needle that penetrates the skin. The sensor takes a reading every 5 to 15 minutes and transmits that information to a separate receiver or a smartphone app, which patients can check at any time. The reading shows their current glucose level and a trend graph for the last eight hours. If the number is high and rising, the patient can bring their glucose down using insulin; if it’s low and dropping, they need to eat some sugar, fast.\u003c/p>\n\u003cp>“It's very exciting technology. I think it's really revolutionizing diabetes care,” says Kathleen Dungan, an associate professor of medicine at Ohio State University who runs the school’s endocrine clinical trials unit. “In a perfect world, everybody with diabetes would benefit from some form of this technology.”\u003c/p>\n\u003cp>\u003cstrong>Too Little Insulin\u003c/strong>\u003c/p>\n\u003cp>Every time you eat, your pancreas pumps out insulin to help your cells extract glucose from the blood and use it for fuel. In Type I diabetes, the pancreas stops producing insulin, while in Type II the cells can’t utilize the hormone properly. In either case, too little insulin causes excessive blood glucose levels. Chronic high blood sugar, or hyperglycemia, can lead to heart disease, kidney disease, stroke, nerve damage, blindness and loss of limbs.\u003c/p>\n\u003cfigure id=\"attachment_440099\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"size-full wp-image-440099\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi.jpg\" alt=\"Melissa Lee, who was diagnosed with type one diabetes at 10 years old, models the FreeStyle Libre in Hayward, Calif.\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Melissa Lee, who was diagnosed with Type 1 diabetes at 10 years old, models the FreeStyle Libre, \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In contrast, too much insulin results in low blood sugar, or hypoglycemia, which can cause weakness, dizzy spells, seizures, shaking, fainting and even death.\u003c/p>\n\u003cp>Patients typically use blood glucose meters that measure sugar levels in a drop of blood to determine if they need to take more insulin or not. However, having to prick your finger and draw blood to check your glucose level can be a major hurdle for maintaining normal blood sugar. Some patients may have aversions to needles, while others may have difficulty creating a sterile environment in which to take a reading.\u003c/p>\n\u003cp>\u003cstrong>Popular CGMs\u003c/strong>\u003c/p>\n\u003cp>CGMs aim to ease that pain and inconvenience. Dexcom and Abbott are two of the largest producers of CGMs, with Abbott’s FreeStyle Libre the newest device approved by the FDA, in September 2017.\u003c/p>\n\u003cp>The Libre sensors last for 10 days and cost $59 each. Sensors for Dexcom’s G4 or G5 system are $350 for a pack of four and have to be replaced every seven days. Patients also have to purchase a receiver, about $60 for the Libre versus $465 for the Dexcom G5. Finally, Dexcom requires a separate transmitter to send the glucose information to the receiver, another $595. Both companies’ devices are covered by major insurance providers and Medicare, so the actual cost to patients varies.\u003c/p>\n\u003cfigure id=\"attachment_440100\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-440100\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/IMG_0829-1020x680.jpg\" alt=\"Ken Reutell of Petaluma, Calif. displays his MiniMed 670G\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-520x347.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Ken Reutell of Petaluma, Calif. displays his MiniMed 670G. \u003ccite>(Danielle Venton/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Libre is the only monitor that doesn’t have to be calibrated daily with a traditional blood glucose reading, meaning patients never have to prick their fingers.\u003c/p>\n\u003cp>Studies show that patients who use a CGM have \u003ca href=\"http://care.diabetesjournals.org/content/40/Supplement_1/S48\" target=\"_blank\" rel=\"noopener\">better control over their diabetes\u003c/a> than patients who use traditional blood glucose tests. Doctors recommend patients check their glucose between \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/blood-sugar/art-20046628\" target=\"_blank\" rel=\"noopener\">4 and 10 times per day\u003c/a>, but in reality, only \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/14999899\" target=\"_blank\" rel=\"noopener\">one-third of patients\u003c/a> test themselves as often as they should. Abbott says patients using its device easily exceed this standard, checking on average 16 times a day.\u003c/p>\n\u003cp>Lee, who uses the FreeStyle Libre, says being able to easily check her blood glucose helps her know how it's affected by her diet. “You suddenly have this insight into how actions you took actually affected some kind of diabetes outcome,” she says.\u003c/p>\n\u003cp>Another Type 1 diabetes patient, Lisa Trahan, 33, yses the Dexcom G4 and says it’s “terrific.” Trahan, a clinical psychologist based in San Marcos, Texas, says the frequent readings provide her with more peace of mind, especially before exercising or eating. However, she still doesn’t trust the device enough to forego pricking her finger to double check the numbers.\u003c/p>\n\u003cfigure id=\"attachment_440101\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-440101\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/IMG_0816-800x533.jpg\" alt=\"A man's hand holds a small gaget.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ken Reutell's MiniMed 670G means he spends less time pricking himself to monitor his blood glucose levels. \u003ccite>(Danielle Venton/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I can trust the CGM reading of my Dexcom G4 to be within 20 percent in either direction of my actual blood sugar reading,” she explains. But, she says, that range can make a big difference when tinkering with blood sugar or insulin. “I use the alert as a suggestion to check my blood sugar and go from there.”\u003c/p>\n\u003cp>\u003cstrong>Smarter Insulin Pumps\u003c/strong>\u003c/p>\n\u003cp>Besides checking blood sugar, the other part of managing diabetes is taking insulin, either with an injection or an insulin pump.\u003c/p>\n\u003cp>Traditional insulin pumps are preset to deliver different doses at certain times of the day. However, it can be difficult to match the correct dose to fluctuations in glucose levels that occur naturally throughout the day or because of diet or exercise. A patient or doctor can adjust the levels manually, but it requires complex calculations and typically isn’t done every day.\u003c/p>\n\u003cp>Medtronic’s MiniMed 670G, the first integrated CGM-insulin pump system approved by the FDA in 2016, aims to solve that problem. The 670G can vary the amount of insulin it delivers as often as every five minutes, in response to input from an integrated glucose monitor.\u003c/p>\n\u003cp>The only calculation patients have to make is to manually deliver a boost of insulin every time they eat that is proportionate to the number of carbohydrates in the meal. They also need to prick their fingers three times a day to calibrate the system.\u003c/p>\n\u003cp>Despite the excitement over the 670G, the price can be prohibitive, running between $6,000 and $9,000. Medtronic says some of the cost is covered by insurance.\u003c/p>\n\u003cp>\u003cstrong>A Debate Over Alarms\u003c/strong>\u003c/p>\n\u003cp>Because low glucose levels can be so dangerous, most monitors have built-in alarms that go off when a patient’s glucose has dropped too low. However, Abbott’s FreeStyle Libre does not. Hirsch, the diabetes expert from the University of Washington, says because of this he recommends Dexcom’s CGM, even though the Libre is less expensive and easier to use.\u003c/p>\n\u003cp>The MiniMed 670G also has an alarm, and to patient Ken Reutell, 67, from Petaluma, California, this is a great feature. In the past he’s had to call 911 and has even passed out because his blood sugar had dropped so low. He's used the 670G for six months and says the alarm alerts him well before he gets to that point. Other users, however, have \u003ca href=\"https://www.reddit.com/r/diabetes_t1/comments/7sjpsi/just_placed_on_order_for_the_medtronic_790/dt5oh0l/\" target=\"_blank\" rel=\"noopener\">complained\u003c/a> that the 670G’s alarm is loud and goes off too frequently.\u003c/p>\n\u003cp>And while the device can alert a patient to a dangerously low glucose level, it can’t do anything about it because it doesn’t administer glucose.\u003c/p>\n\u003cp>“(W)hen you get too low, your liver starts pumping out more glucose. That’s something that insulin pumps don’t do yet,” Reutell laments.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Something for the next generation of devices, perhaps.\u003c/p>\n\n","blocks":[],"excerpt":"Continuous glucose monitors have been around for over a decade, but reductions in cost and improvements in quality have enticed more patients and doctors to try them out.","status":"publish","parent":0,"modified":1521487176,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":36,"wordCount":1621},"headData":{"title":"New Diabetes Monitors Require Fewer Pricks, Less Guessing | KQED","description":"Continuous glucose monitors have been around for over a decade, but reductions in cost and improvements in quality have enticed more patients and doctors to try them out.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"New Diabetes Monitors Require Fewer Pricks, Less Guessing","datePublished":"2018-03-19T14:30:06.000Z","dateModified":"2018-03-19T19:19:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440094 https://ww2.kqed.org/futureofyou/?p=440094","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/19/new-diabetes-monitors-require-fewer-pricks-less-guessing/","disqusTitle":"New Diabetes Monitors Require Fewer Pricks, Less Guessing","sourceUrl":"DIY Health","nprByline":"Dana Smith","path":"/futureofyou/440094/new-diabetes-monitors-require-fewer-pricks-less-guessing","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003ch3>\u003cem>Continuous glucose monitors have been around for over a decade, but reductions in cost and improvements in quality have enticed more patients and doctors to try them out.\u003c/em>\u003c/h3>\n\u003cp>For Melissa Lee, the worst part of diabetes isn’t pricking her finger to check her glucose level or changing her diet to keep her blood sugar in check. Rather, it’s the constant worry and mental calculations.\u003c/p>\n\u003caside class=\"pullquote alignright\">'In a perfect world, everybody with diabetes would benefit from some form of this technology.'\u003ccite>Kathleen Dungan, Ohio State University\u003c/cite>\u003c/aside>\n\u003cp>“You have to think about what did I eat last, how much insulin did I take for that, where is my blood sugar now, which direction is it trending, and then based on that, what am I going to eat?” she says. “You’re making these educated guesses about how much of a really volatile hormone [insulin] to take, and that is mentally exhausting.”\u003c/p>\n\u003cp>Lee, 38, who was diagnosed with Type 1 diabetes when she was 10, recounts ruined dates, missed flights and abandoned excursions, all because she was worried about her glucose level or forgot to bring a replacement for her insulin pump.\u003c/p>\n\u003cp>“You can go from being okay to being really not okay in a moment’s notice,” says Lee, who lives in Milpitas, California and works as the director of community relations at Bigfoot Biomedical.\u003c/p>\n\u003cp>To relieve some of the burden for the estimated 9.3 million people who use insulin to regulate diabetes, medical device makers have introduced new ways to monitor glucose and administer insulin.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Better Glucose Management\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_440097\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"wp-image-440097 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi.jpg\" alt=\"FreeStyle Libre\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Melissa Lee displays the components of the FreeStyle Libre, her blood glucose monitor. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Continuous glucose monitors, or CGMs, have been around for over a decade, but poor quality and high costs have been barriers to use, says Irl Hirsch, who holds the Diabetes Treatment and Teaching Chair at the University of Washington School of Medicine. But improvements on both fronts lead him to believe that CGMs will soon become the standard of care. At his own clinic, 60 percent of patients use one.\u003c/p>\n\u003cp>“The financial impact and the insurance coverage is not the barrier that it used to be,” Hirsch says. What’s more, “The quality and the accuracy of these things have just gotten better.”\u003c/p>\n\u003cp>CGMs measure glucose levels not in blood but in the interstitial fluid, which surrounds the cells just underneath the skin. A sensor sticks onto the body, typically on the upper arm or abdomen, with a small, flexible needle that penetrates the skin. The sensor takes a reading every 5 to 15 minutes and transmits that information to a separate receiver or a smartphone app, which patients can check at any time. The reading shows their current glucose level and a trend graph for the last eight hours. If the number is high and rising, the patient can bring their glucose down using insulin; if it’s low and dropping, they need to eat some sugar, fast.\u003c/p>\n\u003cp>“It's very exciting technology. I think it's really revolutionizing diabetes care,” says Kathleen Dungan, an associate professor of medicine at Ohio State University who runs the school’s endocrine clinical trials unit. “In a perfect world, everybody with diabetes would benefit from some form of this technology.”\u003c/p>\n\u003cp>\u003cstrong>Too Little Insulin\u003c/strong>\u003c/p>\n\u003cp>Every time you eat, your pancreas pumps out insulin to help your cells extract glucose from the blood and use it for fuel. In Type I diabetes, the pancreas stops producing insulin, while in Type II the cells can’t utilize the hormone properly. In either case, too little insulin causes excessive blood glucose levels. Chronic high blood sugar, or hyperglycemia, can lead to heart disease, kidney disease, stroke, nerve damage, blindness and loss of limbs.\u003c/p>\n\u003cfigure id=\"attachment_440099\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"size-full wp-image-440099\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi.jpg\" alt=\"Melissa Lee, who was diagnosed with type one diabetes at 10 years old, models the FreeStyle Libre in Hayward, Calif.\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Melissa Lee, who was diagnosed with Type 1 diabetes at 10 years old, models the FreeStyle Libre, \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In contrast, too much insulin results in low blood sugar, or hypoglycemia, which can cause weakness, dizzy spells, seizures, shaking, fainting and even death.\u003c/p>\n\u003cp>Patients typically use blood glucose meters that measure sugar levels in a drop of blood to determine if they need to take more insulin or not. However, having to prick your finger and draw blood to check your glucose level can be a major hurdle for maintaining normal blood sugar. Some patients may have aversions to needles, while others may have difficulty creating a sterile environment in which to take a reading.\u003c/p>\n\u003cp>\u003cstrong>Popular CGMs\u003c/strong>\u003c/p>\n\u003cp>CGMs aim to ease that pain and inconvenience. Dexcom and Abbott are two of the largest producers of CGMs, with Abbott’s FreeStyle Libre the newest device approved by the FDA, in September 2017.\u003c/p>\n\u003cp>The Libre sensors last for 10 days and cost $59 each. Sensors for Dexcom’s G4 or G5 system are $350 for a pack of four and have to be replaced every seven days. Patients also have to purchase a receiver, about $60 for the Libre versus $465 for the Dexcom G5. Finally, Dexcom requires a separate transmitter to send the glucose information to the receiver, another $595. Both companies’ devices are covered by major insurance providers and Medicare, so the actual cost to patients varies.\u003c/p>\n\u003cfigure id=\"attachment_440100\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-440100\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/IMG_0829-1020x680.jpg\" alt=\"Ken Reutell of Petaluma, Calif. displays his MiniMed 670G\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-520x347.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Ken Reutell of Petaluma, Calif. displays his MiniMed 670G. \u003ccite>(Danielle Venton/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Libre is the only monitor that doesn’t have to be calibrated daily with a traditional blood glucose reading, meaning patients never have to prick their fingers.\u003c/p>\n\u003cp>Studies show that patients who use a CGM have \u003ca href=\"http://care.diabetesjournals.org/content/40/Supplement_1/S48\" target=\"_blank\" rel=\"noopener\">better control over their diabetes\u003c/a> than patients who use traditional blood glucose tests. Doctors recommend patients check their glucose between \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/blood-sugar/art-20046628\" target=\"_blank\" rel=\"noopener\">4 and 10 times per day\u003c/a>, but in reality, only \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/14999899\" target=\"_blank\" rel=\"noopener\">one-third of patients\u003c/a> test themselves as often as they should. Abbott says patients using its device easily exceed this standard, checking on average 16 times a day.\u003c/p>\n\u003cp>Lee, who uses the FreeStyle Libre, says being able to easily check her blood glucose helps her know how it's affected by her diet. “You suddenly have this insight into how actions you took actually affected some kind of diabetes outcome,” she says.\u003c/p>\n\u003cp>Another Type 1 diabetes patient, Lisa Trahan, 33, yses the Dexcom G4 and says it’s “terrific.” Trahan, a clinical psychologist based in San Marcos, Texas, says the frequent readings provide her with more peace of mind, especially before exercising or eating. However, she still doesn’t trust the device enough to forego pricking her finger to double check the numbers.\u003c/p>\n\u003cfigure id=\"attachment_440101\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-440101\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/IMG_0816-800x533.jpg\" alt=\"A man's hand holds a small gaget.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ken Reutell's MiniMed 670G means he spends less time pricking himself to monitor his blood glucose levels. \u003ccite>(Danielle Venton/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I can trust the CGM reading of my Dexcom G4 to be within 20 percent in either direction of my actual blood sugar reading,” she explains. But, she says, that range can make a big difference when tinkering with blood sugar or insulin. “I use the alert as a suggestion to check my blood sugar and go from there.”\u003c/p>\n\u003cp>\u003cstrong>Smarter Insulin Pumps\u003c/strong>\u003c/p>\n\u003cp>Besides checking blood sugar, the other part of managing diabetes is taking insulin, either with an injection or an insulin pump.\u003c/p>\n\u003cp>Traditional insulin pumps are preset to deliver different doses at certain times of the day. However, it can be difficult to match the correct dose to fluctuations in glucose levels that occur naturally throughout the day or because of diet or exercise. A patient or doctor can adjust the levels manually, but it requires complex calculations and typically isn’t done every day.\u003c/p>\n\u003cp>Medtronic’s MiniMed 670G, the first integrated CGM-insulin pump system approved by the FDA in 2016, aims to solve that problem. The 670G can vary the amount of insulin it delivers as often as every five minutes, in response to input from an integrated glucose monitor.\u003c/p>\n\u003cp>The only calculation patients have to make is to manually deliver a boost of insulin every time they eat that is proportionate to the number of carbohydrates in the meal. They also need to prick their fingers three times a day to calibrate the system.\u003c/p>\n\u003cp>Despite the excitement over the 670G, the price can be prohibitive, running between $6,000 and $9,000. Medtronic says some of the cost is covered by insurance.\u003c/p>\n\u003cp>\u003cstrong>A Debate Over Alarms\u003c/strong>\u003c/p>\n\u003cp>Because low glucose levels can be so dangerous, most monitors have built-in alarms that go off when a patient’s glucose has dropped too low. However, Abbott’s FreeStyle Libre does not. Hirsch, the diabetes expert from the University of Washington, says because of this he recommends Dexcom’s CGM, even though the Libre is less expensive and easier to use.\u003c/p>\n\u003cp>The MiniMed 670G also has an alarm, and to patient Ken Reutell, 67, from Petaluma, California, this is a great feature. In the past he’s had to call 911 and has even passed out because his blood sugar had dropped so low. He's used the 670G for six months and says the alarm alerts him well before he gets to that point. Other users, however, have \u003ca href=\"https://www.reddit.com/r/diabetes_t1/comments/7sjpsi/just_placed_on_order_for_the_medtronic_790/dt5oh0l/\" target=\"_blank\" rel=\"noopener\">complained\u003c/a> that the 670G’s alarm is loud and goes off too frequently.\u003c/p>\n\u003cp>And while the device can alert a patient to a dangerously low glucose level, it can’t do anything about it because it doesn’t administer glucose.\u003c/p>\n\u003cp>“(W)hen you get too low, your liver starts pumping out more glucose. That’s something that insulin pumps don’t do yet,” Reutell laments.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Something for the next generation of devices, perhaps.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440094/new-diabetes-monitors-require-fewer-pricks-less-guessing","authors":["byline_futureofyou_440094"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_309","futureofyou_26","futureofyou_128","futureofyou_80"],"featImg":"futureofyou_440096","label":"futureofyou"},"futureofyou_435719":{"type":"posts","id":"futureofyou_435719","meta":{"index":"posts_1591205157","site":"futureofyou","id":"435719","score":null,"sort":[1506702749000]},"guestAuthors":[],"slug":"coming-soon-continuous-glucose-monitoring-and-no-finger-pricks","title":"Coming Soon: Continuous Glucose Monitoring, With No Finger Pricks","publishDate":1506702749,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>U.S. regulators have approved the first continuous blood sugar monitor for diabetics that doesn't need backup finger prick tests.\u003c/p>\n\u003cp>Current models require users to test a drop of blood twice daily to calibrate, or adjust, the monitor.\u003c/p>\n\u003cp>The pain of finger sticks and the cost of testing supplies discourage many people from keeping close tabs on their blood sugar, which is needed to manage insulin use and adjust what they eat.\u003c/p>\n\u003cp>Abbott's new FreeStyle Libre Flash Glucose Monitoring System, approved Wednesday by the Food and Drug Administration, uses a small sensor attached to the upper arm. Patients wave a reader device over it to see the current blood sugar level and changes over the past eight hours.\u003c/p>\n\u003cp>Most of the 30 million Americans with diabetes use standard glucose meters, which require multiple finger pricks each day and only show current sugar level. More-accurate continuous glucose monitoring devices are used by about 345,000 Americans.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But most don't do the finger pricks to calibrate them and may get inaccurate readings, said Dr. Timothy Bailey, who helped test FreeStyle Libre.\u003c/p>\n\u003cp>\"We're able to lower blood sugar safely\" with this technology, said Bailey, director of the Advanced Metabolic Care and Research Institute in California. He receives consulting fees from various diabetes device makers.\u003c/p>\n\u003cp>Too-high blood sugar levels can damage organs and lead to heart attacks, strokes, blindness and amputations. Very low blood sugar can cause seizures, confusion and loss of consciousness.\u003c/p>\n\u003cp>Abbott's device was approved for adults with Type 1 or Type 2 diabetes and should be available in pharmacies within months. The company, based near Chicago, did not disclose the price of the reader or the sensors.\u003c/p>\n\u003cp>Abbott's system can't be used with an insulin pump, a device worn against the skin that allows users to inject insulin as needed, but the company is planning improvements to eventually enable that.\u003c/p>\n\u003cp>Rival Medtronic this spring launched a device in which the insulin pump automatically responds to blood sugar changes recorded by the sensor and either withholds or injects insulin as needed.\u003c/p>\n\u003cp>The pain of finger sticks and the cost of testing supplies discourage many people from keeping close tabs on their blood sugar, which is needed to manage insulin use and adjust what they eat.\u003c/p>\n\u003cp>Abbott's new FreeStyle Libre Flash Glucose Monitoring System, approved Wednesday by the Food and Drug Administration, uses a small sensor attached to the upper arm. Patients wave a reader device over it to see the current blood sugar level and changes over the past eight hours.\u003c/p>\n\u003cp>Most of the 30 million Americans with diabetes use standard glucose meters, which require multiple finger pricks each day and only show current sugar level. More-accurate continuous glucose monitoring devices are used by about 345,000 Americans.\u003c/p>\n\u003cp>But most don't do the finger pricks to calibrate them and may get inaccurate readings, said\u003cbr>\nDr. Timothy Bailey, who helped test FreeStyle Libre.\u003c/p>\n\u003cp>\"We're able to lower blood sugar safely\" with this technology, said Bailey, director of the Advanced Metabolic Care and Research Institute in California. He receives consulting fees from various diabetes device makers.\u003c/p>\n\u003cp>Too-high blood sugar levels can damage organs and lead to heart attacks, strokes, blindness and amputations. Very low blood sugar can cause seizures, confusion and loss of consciousness.\u003c/p>\n\u003cp>Abbott's device was approved for adults with Type 1 or Type 2 diabetes and should be available in pharmacies within months. The company, based near Chicago, did not disclose the price of the reader or the sensors.\u003c/p>\n\u003cp>Abbott's system can't be used with an insulin pump, a device worn against the skin that allows users to inject insulin as needed, but the company is planning improvements to eventually enable that.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Rival Medtronic this spring launched a device in which the insulin pump automatically responds to blood sugar changes recorded by the sensor and either withholds or injects insulin as needed.\u003c/p>\n\n","blocks":[],"excerpt":"U.S. regulators have approved the first continuous blood sugar monitor for diabetics that doesn't need backup finger prick tests.\r\n","status":"publish","parent":0,"modified":1506714872,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":659},"headData":{"title":"Coming Soon: Continuous Glucose Monitoring, With No Finger Pricks | KQED","description":"U.S. regulators have approved the first continuous blood sugar monitor for diabetics that doesn't need backup finger prick tests.\r\n","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Coming Soon: Continuous Glucose Monitoring, With No Finger Pricks","datePublished":"2017-09-29T16:32:29.000Z","dateModified":"2017-09-29T19:54:32.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"435719 https://ww2.kqed.org/futureofyou/?p=435719","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/09/29/coming-soon-continuous-glucose-monitoring-and-no-finger-pricks/","disqusTitle":"Coming Soon: Continuous Glucose Monitoring, With No Finger Pricks","nprByline":"Linda A. Johnson\u003cbr />Associated Press","path":"/futureofyou/435719/coming-soon-continuous-glucose-monitoring-and-no-finger-pricks","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>U.S. regulators have approved the first continuous blood sugar monitor for diabetics that doesn't need backup finger prick tests.\u003c/p>\n\u003cp>Current models require users to test a drop of blood twice daily to calibrate, or adjust, the monitor.\u003c/p>\n\u003cp>The pain of finger sticks and the cost of testing supplies discourage many people from keeping close tabs on their blood sugar, which is needed to manage insulin use and adjust what they eat.\u003c/p>\n\u003cp>Abbott's new FreeStyle Libre Flash Glucose Monitoring System, approved Wednesday by the Food and Drug Administration, uses a small sensor attached to the upper arm. Patients wave a reader device over it to see the current blood sugar level and changes over the past eight hours.\u003c/p>\n\u003cp>Most of the 30 million Americans with diabetes use standard glucose meters, which require multiple finger pricks each day and only show current sugar level. More-accurate continuous glucose monitoring devices are used by about 345,000 Americans.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But most don't do the finger pricks to calibrate them and may get inaccurate readings, said Dr. Timothy Bailey, who helped test FreeStyle Libre.\u003c/p>\n\u003cp>\"We're able to lower blood sugar safely\" with this technology, said Bailey, director of the Advanced Metabolic Care and Research Institute in California. He receives consulting fees from various diabetes device makers.\u003c/p>\n\u003cp>Too-high blood sugar levels can damage organs and lead to heart attacks, strokes, blindness and amputations. Very low blood sugar can cause seizures, confusion and loss of consciousness.\u003c/p>\n\u003cp>Abbott's device was approved for adults with Type 1 or Type 2 diabetes and should be available in pharmacies within months. The company, based near Chicago, did not disclose the price of the reader or the sensors.\u003c/p>\n\u003cp>Abbott's system can't be used with an insulin pump, a device worn against the skin that allows users to inject insulin as needed, but the company is planning improvements to eventually enable that.\u003c/p>\n\u003cp>Rival Medtronic this spring launched a device in which the insulin pump automatically responds to blood sugar changes recorded by the sensor and either withholds or injects insulin as needed.\u003c/p>\n\u003cp>The pain of finger sticks and the cost of testing supplies discourage many people from keeping close tabs on their blood sugar, which is needed to manage insulin use and adjust what they eat.\u003c/p>\n\u003cp>Abbott's new FreeStyle Libre Flash Glucose Monitoring System, approved Wednesday by the Food and Drug Administration, uses a small sensor attached to the upper arm. Patients wave a reader device over it to see the current blood sugar level and changes over the past eight hours.\u003c/p>\n\u003cp>Most of the 30 million Americans with diabetes use standard glucose meters, which require multiple finger pricks each day and only show current sugar level. More-accurate continuous glucose monitoring devices are used by about 345,000 Americans.\u003c/p>\n\u003cp>But most don't do the finger pricks to calibrate them and may get inaccurate readings, said\u003cbr>\nDr. Timothy Bailey, who helped test FreeStyle Libre.\u003c/p>\n\u003cp>\"We're able to lower blood sugar safely\" with this technology, said Bailey, director of the Advanced Metabolic Care and Research Institute in California. He receives consulting fees from various diabetes device makers.\u003c/p>\n\u003cp>Too-high blood sugar levels can damage organs and lead to heart attacks, strokes, blindness and amputations. Very low blood sugar can cause seizures, confusion and loss of consciousness.\u003c/p>\n\u003cp>Abbott's device was approved for adults with Type 1 or Type 2 diabetes and should be available in pharmacies within months. The company, based near Chicago, did not disclose the price of the reader or the sensors.\u003c/p>\n\u003cp>Abbott's system can't be used with an insulin pump, a device worn against the skin that allows users to inject insulin as needed, but the company is planning improvements to eventually enable that.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Rival Medtronic this spring launched a device in which the insulin pump automatically responds to blood sugar changes recorded by the sensor and either withholds or injects insulin as needed.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/435719/coming-soon-continuous-glucose-monitoring-and-no-finger-pricks","authors":["byline_futureofyou_435719"],"categories":["futureofyou_1062"],"tags":["futureofyou_309","futureofyou_1366","futureofyou_128"],"featImg":"futureofyou_435721","label":"futureofyou"},"futureofyou_7146":{"type":"posts","id":"futureofyou_7146","meta":{"index":"posts_1591205157","site":"futureofyou","id":"7146","score":null,"sort":[1435683491000]},"guestAuthors":[],"slug":"this-smart-pen-could-revolutionize-diabetes-treatment","title":"This 'Smart Pen' Could Revolutionize Diabetes Treatment","publishDate":1435683491,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Diabetes runs in Amay Bandodkar’s family. He remembers watching his grandmother, who suffered from Type 2 diabetes, draw blood from her finger every few hours for glucose tests. The process got harder as she grew older, and in her final years Bandodkar says it hurt to watch.\u003c/p>\n\u003cp>“She was really skinny, and sometimes she would have to prick over and over to find a vein,” he recalls. “I could see the pain she was in.”\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Now a graduate student in the engineering department at \u003ca href=\"https://ucsd.edu/\">\u003cspan class=\"s2\">UC San Diego\u003c/span>\u003c/a>, Bandodkar and his adviser, Professor Joseph Wang, have developed products that could have spared her pain: \u003c/span>\u003cspan class=\"s3\">glucose sensors that are cheap, non-invasive, and renewable, applied using a regular ballpoint pen or stuck on like a temporary tattoo.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">These new sensors make testing blood sugar as easy as signing your name, and \u003c/span>\u003cspan class=\"s2\">have\u003c/span>\u003cspan class=\"s1\"> the potential to revolutionize a multibillion dollar industry. \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>The Glucose Gold Rush\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8616\" class=\"wp-caption alignright\" style=\"max-width: 290px\">\u003cimg class=\" wp-image-8616\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/06/Glucose-1-400x600.jpg\" alt=\"The renewable glucose sensor that looks like a temporary tattoo, and is just as easy to apply and remove\" width=\"290\" height=\"435\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/06/Glucose-1-400x600.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/Glucose-1.jpg 600w\" sizes=\"(max-width: 290px) 100vw, 290px\">\u003cfigcaption class=\"wp-caption-text\">The renewable glucose sensor that looks like a temporary tattoo, and is just as easy to apply and remove \u003ccite>(Amay Bandodkar)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The glucose self-monitoring industry has exploded as Type 2 diabetes proliferated over the past thirty years. Diabetes diagnoses \u003ca href=\"http://www.cdc.gov/diabetes/statistics/prev/national/figage.htm\">doubled between 1980 and 2011\u003c/a>\u003ca href=\"#_ftn1\" name=\"_ftnref1\">\u003c/a>, while sales of glucose monitoring products grew by over 12 percent annually from 1994 to 2006. Today, the industry is \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769893/\">worth over $8 billion\u003c/a>\u003ca href=\"#_ftn2\" name=\"_ftnref2\">. \u003c/a>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The disease isn’t going anywhere — \u003ca href=\"http://www.cdc.gov/diabetes/data/statistics/2014statisticsreport.html\">one in eleven Americans has it\u003c/a>, and the Centers for Disease Control and Prevention projects this number will climb to \u003ca href=\"http://www.cdc.gov/media/pressrel/2010/r101022.html\">one in three by 2050\u003c/a>\u003ca href=\"#_ftn4\" name=\"_ftnref4\"> \u003c/a>— as a result of poor nutrition and a lack of exercise.\u003c/p>\n\u003cp>“The worst thing about diabetes is that it has no cure,” Bandodkar says. “You can only manage it.” But for patients, keeping a close eye on blood sugar levels is key.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/05/12/everyone-should-track-their-blood-sugar-not-just-people-with-diabetes-like-me/\">\u003cem>[Related: Everyone Should Track Their Blood Sugar -- Not Just People With Diabetes Like Me]\u003c/em>\u003c/a>\u003c/p>\n\u003cp>Type II diabetics are encouraged to test their glucose levels regularly, as often as every few hours, like Bandodkar’s grandmother had to.\u003c/p>\n\u003cp>The standard tool for these tests is a disposable sensor strip. The strips are plated with gold film, can only be used once, and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22235952\">cost about a dollar each\u003c/a>. Surveys of patients with diabetes have shown that the cost of the strips, and the inconvenience of replacing them, is a \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S1499267110410084;%20http://care.diabetesjournals.org/content/26/8/2294.short\">significant barrier to responsible monitoring\u003c/a>\u003ca href=\"#_ftn6\" name=\"_ftnref6\">.\u003c/a>\u003c/p>\n\u003cp>“You have to throw [the strips] away,” Bandodkar says. “If we could make a reusable sensor that would be one way to reduce the cost.”\u003c/p>\n\u003cp>So, he and Wang set out to find a renewable sensor. The bio-catalytic enzymatic roller pens they came up with (“biocatalytic pens” for short) could be the next generation of glucose testing for the masses: reusable, customizable, and cheap.\u003c/p>\n\u003cp>\u003cstrong>Smart Ink\u003c/strong>\u003c/p>\n\u003cp>The biocatalytic pen uses ink with glucose-oxidase, an enzyme that reacts selectively with glucose.\u003c/p>\n\u003caside class=\"pullquote alignright\">““The worst thing about diabetes is that it has no cure. You can only manage it.\"\u003cbr>\n\u003ccite>Amay Bandodkar, a graduate student at UC San Diego\u003cbr>\n\u003c/cite>\u003c/aside>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A sensor can be applied right onto a patient’s skin using a temporary tattoo, and the glucose oxidase will react with glucose just under their skin\u003c/span>\u003cspan class=\"s2\">. The reaction generates an electric current that a chip, stuck onto their skin, reads and transmits to a laptop via Bluetooth. \u003c/span>\u003cspan class=\"s1\">Or, a pen can be used to draw a renewable sensor onto an electrode. In this case the patient would still supply a drop of blood for testing on the electrode.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">One pen can generate 500 sensors, and the accuracy of the glucose measurements in the \u003c/span>\u003cspan class=\"s2\">pen and tattoo methods \u003c/span>\u003cspan class=\"s1\">are already comparable to the glucose strips in use today.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">There are still some challenges to overcome, mostly in the stability and storage of the ink (which so far only keeps for three weeks in an extra-cold refrigerator), but Bandodkar will begin working with doctors in the next few months on a large-scale human trial.\u003c/p>\n\u003cp>He’s not the only one looking to shake up the glucose monitoring status quo.\u003c/p>\n\u003cp>\u003ca href=\"http://www.dexcom.com/\">Dexcom\u003c/a>, also based in San Diego, has a system using a tiny wire inserted under a patient’s skin that make continuous glucose measurements. Google is even getting in on the game, with a\u003ca href=\"http://www.technologyreview.com/news/529196/what-else-could-smart-contact-lenses-do/\"> smart contact lens\u003c/a> it’s developing with pharma giant Novartis that would take and transmit continuous glucose measurements.\u003c/p>\n\u003cp>But the comparatively low-tech pens and tattoos are much cheaper than these methods, which Bandodkar hopes will help make life easier for diabetes patients who now rely on glucose testing strips.\u003c/p>\n\u003cp>The bio-ink technology also has a host of other applications, because ink could be made for almost any chemical that reacts with an enzyme, and drawn on any surface. Bandodkar and Wang have formulated an ink to measure levels of common air pollutants that can be drawn onto tree leaves, or other natural surfaces, to cheaply monitor local pollution.\u003c/p>\n\u003cp>The sneakiness of a sensor hidden in a ballpoint pen also has military utility.\u003c/p>\n\u003cp>“For defense, you wouldn’t want your enemy to know you [deployed] a chemical sensor,” Bandodkar says. An armed person could take the pen and draw a sensor onto any surface to stealthily detect chemical weapons.\u003c/p>\n\u003cp>\u003cstrong>Some Science is Personal\u003c/strong>\u003c/p>\n\u003cp>But among all the exciting applications of the pens, glucose-sensing remains Bandodkar’s priority, and not for the potential commercial gains. His grandmother wasn’t the only one in his family to suffer from diabetes: his mom also suffers from Type 2 diabetes.\u003c/p>\n\u003cp>“When I told my mom I was working on this, she was so happy,” he says. The potential to help her and millions of others keeps him motivated, but he doesn’t let personal investment cloud his scientific rigor.\u003c/p>\n\u003cp>“You have your emotional attachment, and on the other side you have your scientific yes or no, is it working or not,” he says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>So far, the answer seems to be a definitive ‘yes.’ More work needs to be done, but glucose-sensing pens may be only two or three years away from commercial availability. It’s too late to help Bandodkar’s grandmother, who passed away several years ago, but he can still help his mother — \u003ca href=\"https://www.idf.org/worlddiabetesday/toolkit/gp/facts-figures\">and 400 million others \u003c/a>\u003ca href=\"#_ftn7\" name=\"_ftnref7\">\u003c/a>— save their blood and money.\u003c/p>\n\n","blocks":[],"excerpt":"Graduate students at UC San Diego developed a 'bio ink-pen,' which makes testing blood sugar as easy as signing your name. ","status":"publish","parent":0,"modified":1477281281,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":1079},"headData":{"title":"This 'Smart Pen' Could Revolutionize Diabetes Treatment | KQED","description":"Graduate students at UC San Diego developed a 'bio ink-pen,' which makes testing blood sugar as easy as signing your name. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"This 'Smart Pen' Could Revolutionize Diabetes Treatment","datePublished":"2015-06-30T16:58:11.000Z","dateModified":"2016-10-24T03:54:41.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"7146 http://ww2.kqed.org/futureofyou/?p=7146","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/06/30/this-smart-pen-could-revolutionize-diabetes-treatment/","disqusTitle":"This 'Smart Pen' Could Revolutionize Diabetes Treatment","path":"/futureofyou/7146/this-smart-pen-could-revolutionize-diabetes-treatment","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Diabetes runs in Amay Bandodkar’s family. He remembers watching his grandmother, who suffered from Type 2 diabetes, draw blood from her finger every few hours for glucose tests. The process got harder as she grew older, and in her final years Bandodkar says it hurt to watch.\u003c/p>\n\u003cp>“She was really skinny, and sometimes she would have to prick over and over to find a vein,” he recalls. “I could see the pain she was in.”\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Now a graduate student in the engineering department at \u003ca href=\"https://ucsd.edu/\">\u003cspan class=\"s2\">UC San Diego\u003c/span>\u003c/a>, Bandodkar and his adviser, Professor Joseph Wang, have developed products that could have spared her pain: \u003c/span>\u003cspan class=\"s3\">glucose sensors that are cheap, non-invasive, and renewable, applied using a regular ballpoint pen or stuck on like a temporary tattoo.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">These new sensors make testing blood sugar as easy as signing your name, and \u003c/span>\u003cspan class=\"s2\">have\u003c/span>\u003cspan class=\"s1\"> the potential to revolutionize a multibillion dollar industry. \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>The Glucose Gold Rush\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8616\" class=\"wp-caption alignright\" style=\"max-width: 290px\">\u003cimg class=\" wp-image-8616\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/06/Glucose-1-400x600.jpg\" alt=\"The renewable glucose sensor that looks like a temporary tattoo, and is just as easy to apply and remove\" width=\"290\" height=\"435\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/06/Glucose-1-400x600.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/06/Glucose-1.jpg 600w\" sizes=\"(max-width: 290px) 100vw, 290px\">\u003cfigcaption class=\"wp-caption-text\">The renewable glucose sensor that looks like a temporary tattoo, and is just as easy to apply and remove \u003ccite>(Amay Bandodkar)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The glucose self-monitoring industry has exploded as Type 2 diabetes proliferated over the past thirty years. Diabetes diagnoses \u003ca href=\"http://www.cdc.gov/diabetes/statistics/prev/national/figage.htm\">doubled between 1980 and 2011\u003c/a>\u003ca href=\"#_ftn1\" name=\"_ftnref1\">\u003c/a>, while sales of glucose monitoring products grew by over 12 percent annually from 1994 to 2006. Today, the industry is \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769893/\">worth over $8 billion\u003c/a>\u003ca href=\"#_ftn2\" name=\"_ftnref2\">. \u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The disease isn’t going anywhere — \u003ca href=\"http://www.cdc.gov/diabetes/data/statistics/2014statisticsreport.html\">one in eleven Americans has it\u003c/a>, and the Centers for Disease Control and Prevention projects this number will climb to \u003ca href=\"http://www.cdc.gov/media/pressrel/2010/r101022.html\">one in three by 2050\u003c/a>\u003ca href=\"#_ftn4\" name=\"_ftnref4\"> \u003c/a>— as a result of poor nutrition and a lack of exercise.\u003c/p>\n\u003cp>“The worst thing about diabetes is that it has no cure,” Bandodkar says. “You can only manage it.” But for patients, keeping a close eye on blood sugar levels is key.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/05/12/everyone-should-track-their-blood-sugar-not-just-people-with-diabetes-like-me/\">\u003cem>[Related: Everyone Should Track Their Blood Sugar -- Not Just People With Diabetes Like Me]\u003c/em>\u003c/a>\u003c/p>\n\u003cp>Type II diabetics are encouraged to test their glucose levels regularly, as often as every few hours, like Bandodkar’s grandmother had to.\u003c/p>\n\u003cp>The standard tool for these tests is a disposable sensor strip. The strips are plated with gold film, can only be used once, and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22235952\">cost about a dollar each\u003c/a>. Surveys of patients with diabetes have shown that the cost of the strips, and the inconvenience of replacing them, is a \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S1499267110410084;%20http://care.diabetesjournals.org/content/26/8/2294.short\">significant barrier to responsible monitoring\u003c/a>\u003ca href=\"#_ftn6\" name=\"_ftnref6\">.\u003c/a>\u003c/p>\n\u003cp>“You have to throw [the strips] away,” Bandodkar says. “If we could make a reusable sensor that would be one way to reduce the cost.”\u003c/p>\n\u003cp>So, he and Wang set out to find a renewable sensor. The bio-catalytic enzymatic roller pens they came up with (“biocatalytic pens” for short) could be the next generation of glucose testing for the masses: reusable, customizable, and cheap.\u003c/p>\n\u003cp>\u003cstrong>Smart Ink\u003c/strong>\u003c/p>\n\u003cp>The biocatalytic pen uses ink with glucose-oxidase, an enzyme that reacts selectively with glucose.\u003c/p>\n\u003caside class=\"pullquote alignright\">““The worst thing about diabetes is that it has no cure. You can only manage it.\"\u003cbr>\n\u003ccite>Amay Bandodkar, a graduate student at UC San Diego\u003cbr>\n\u003c/cite>\u003c/aside>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A sensor can be applied right onto a patient’s skin using a temporary tattoo, and the glucose oxidase will react with glucose just under their skin\u003c/span>\u003cspan class=\"s2\">. The reaction generates an electric current that a chip, stuck onto their skin, reads and transmits to a laptop via Bluetooth. \u003c/span>\u003cspan class=\"s1\">Or, a pen can be used to draw a renewable sensor onto an electrode. In this case the patient would still supply a drop of blood for testing on the electrode.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">One pen can generate 500 sensors, and the accuracy of the glucose measurements in the \u003c/span>\u003cspan class=\"s2\">pen and tattoo methods \u003c/span>\u003cspan class=\"s1\">are already comparable to the glucose strips in use today.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">There are still some challenges to overcome, mostly in the stability and storage of the ink (which so far only keeps for three weeks in an extra-cold refrigerator), but Bandodkar will begin working with doctors in the next few months on a large-scale human trial.\u003c/p>\n\u003cp>He’s not the only one looking to shake up the glucose monitoring status quo.\u003c/p>\n\u003cp>\u003ca href=\"http://www.dexcom.com/\">Dexcom\u003c/a>, also based in San Diego, has a system using a tiny wire inserted under a patient’s skin that make continuous glucose measurements. Google is even getting in on the game, with a\u003ca href=\"http://www.technologyreview.com/news/529196/what-else-could-smart-contact-lenses-do/\"> smart contact lens\u003c/a> it’s developing with pharma giant Novartis that would take and transmit continuous glucose measurements.\u003c/p>\n\u003cp>But the comparatively low-tech pens and tattoos are much cheaper than these methods, which Bandodkar hopes will help make life easier for diabetes patients who now rely on glucose testing strips.\u003c/p>\n\u003cp>The bio-ink technology also has a host of other applications, because ink could be made for almost any chemical that reacts with an enzyme, and drawn on any surface. Bandodkar and Wang have formulated an ink to measure levels of common air pollutants that can be drawn onto tree leaves, or other natural surfaces, to cheaply monitor local pollution.\u003c/p>\n\u003cp>The sneakiness of a sensor hidden in a ballpoint pen also has military utility.\u003c/p>\n\u003cp>“For defense, you wouldn’t want your enemy to know you [deployed] a chemical sensor,” Bandodkar says. An armed person could take the pen and draw a sensor onto any surface to stealthily detect chemical weapons.\u003c/p>\n\u003cp>\u003cstrong>Some Science is Personal\u003c/strong>\u003c/p>\n\u003cp>But among all the exciting applications of the pens, glucose-sensing remains Bandodkar’s priority, and not for the potential commercial gains. His grandmother wasn’t the only one in his family to suffer from diabetes: his mom also suffers from Type 2 diabetes.\u003c/p>\n\u003cp>“When I told my mom I was working on this, she was so happy,” he says. The potential to help her and millions of others keeps him motivated, but he doesn’t let personal investment cloud his scientific rigor.\u003c/p>\n\u003cp>“You have your emotional attachment, and on the other side you have your scientific yes or no, is it working or not,” he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So far, the answer seems to be a definitive ‘yes.’ More work needs to be done, but glucose-sensing pens may be only two or three years away from commercial availability. It’s too late to help Bandodkar’s grandmother, who passed away several years ago, but he can still help his mother — \u003ca href=\"https://www.idf.org/worlddiabetesday/toolkit/gp/facts-figures\">and 400 million others \u003c/a>\u003ca href=\"#_ftn7\" name=\"_ftnref7\">\u003c/a>— save their blood and money.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/7146/this-smart-pen-could-revolutionize-diabetes-treatment","authors":["6616"],"categories":["futureofyou_1060","futureofyou_1062"],"tags":["futureofyou_138","futureofyou_477","futureofyou_128","futureofyou_453","futureofyou_80","futureofyou_480","futureofyou_479","futureofyou_478"],"featImg":"futureofyou_8615","label":"futureofyou"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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