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Diabetes - Knowledge Saves Lives

Technology in diabetes

Jothydev Kesavadev, MD

In India diabetes prevalence has reached epidemic proportions resulting in enormous increase in the need for dialysis, coronary artery bypass grafts, treatment for eye diseases, neuropathy, sexual dysfunction, depression, leg ulcers etc. According to International Diabetes Federation(IDF), the prevalence of diabetes in India is 61.3 million in year 2011 and the number is estimated to reach 101.2 million by 2030. Diabetes is a complex metabolic disorder with a multitude of components where elevation or excursions in blood sugar is one among them. The complexity of the disease badly requires technological interventions to be part of day to day management in the absence of which the therapy miserably fails as it is happening with more than 80% of subjects on so called conventional diabetes treatment.

After the publication of Diabetes Control and Complications Trial(DCCT) with type 1 diabetes  and United Kingdom Prospective Diabetes Study (UKPDS) with type 2 diabetes  the management of diabetes has radically changed in the past decade. Now Self Monitoring of Blood Glucose (SMBG) with a glucometer has become indispensable whatever may be the type and stage of the illness .Technology in diabetes is linked to blood glucose monitoring and delivery devices. Blood glucose monitors and insulin pens have been popular since years .However recently, Continuous Glucose Monitoring (CGM) and Insulin pump therapy is also being gradually and strongly getting incorporated with routine diabetes therapy. The whole idea behind incorporating technology in diabetes care is to ensure success in maintaining the targets of HbA1c, Blood Pressure and LDL cholesterol   thereby preventing the onset of micro vascular complications and macro vascular complications of diabetes.

Diabetes being a progressive disease, one treatment regimen cannot be followed for long and diabetes being a complex disease with genetic predisposition, a  single therapeutic regimen is not applicable in all patients .Continuous Glucose Monitoring is a technology where by  pricking the finger tip to measure the blood glucose using a glucometer is replaced by a standalone tiny sensor needle which measures up to 288 blood glucose values over a period of 24 hours and can be insitu for  3 days up to 3 weeks. This device can be used as a blinded one or as a real time device where the patient will be able to visualize the change in the blood glucose and the trends, the lows, the highs, the excursions, the trend during the sleep etc.This series dealing with technological innovations in diabetes will discuss each one of them in detail in the future issues.


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