Explore innovative approaches and advancements in diabetes care shaping the future of health in Pakistan with expert insights from Meri Sehat.

Shaping The Future Of Diabetes Care In Pakistan

Continuous glucose monitoring (CGM) devices are cutting-edge gadgets designed to provide real-time insight into your blood glucose levels.

Introduction

Maintaining a balanced blood sugar level can feel like navigating a maze without a map. Whether you&#39;re newly diagnosed with diabetes or simply looking for better ways on how to manage diabetes, the struggle is real. With the FDA recently approving the over-the-counter sale of the Dexcom Stelo Glucose Biosensor System, let&rsquo;s see what this modern-day solution is all about.<a href="#accordion">[3]</a> 
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Understanding CGM

Unlike traditional glucose meters, which require manual testing multiple times a day, CGM systems offer a more seamless and convenient monitoring experience. 
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A CGM system typically consists of 3 main components:<a href="#accordion">[2]</a>

<ol>
	<li>Sensor &ndash; A small, single-use plastic device with a tiny electrode inserted under the skin. 
	Once properly inserted, the sensor can remain in place for 6 days or longer. The insertion process is swift and does not cause any discomfort. The electrode continuously collects glucose data by being in contact with the interstitial fluid in the body.</li>
	<li>Transmitter &ndash; A device attached to the sensor once it&#39;s placed on the body. 
	It receives the blood glucose data from the sensor and then sends this data via Bluetooth to the receiver and any connected devices. This will allow you to see your glucose levels in real-time.</li>
	<li>Receiver &ndash; Available in various forms, such as a handheld device, a smartphone app, or an insulin pump, it automatically receives glucose readings every 5 minutes. 
	This reduces the need for frequent finger pricks. However, the transmitter and receiver need to stay within 20 feet of each other to ensure uninterrupted data transmission. 
	&nbsp;</li>
</ol>

CGMs can be particularly useful for users who:

<ul>
	<li>Lack <a href="https://merisehat.pk/disease/diabetes-type-1-and-2">diabetes</a> awareness, particularly on what causes diabetes and diabetes complications</li>
	<li>Are young and unable to detect their lows reliably, or unable to communicate their lows to parents or carers</li>
	<li>Have type 1 or type 2 diabetes and are on multiple daily doses of insulin, including women with pregestational diabetes 
	&nbsp;</li>
</ul>

These include:<a href="#accordion">[1]</a>

<ul>
	<li>Real-Time Monitoring: The real-time feedback allows for more proactive management of diabetes, enabling timely interventions to prevent spikes or crashes in blood sugar. You can wear it under your clothes and while you bathe, exercise, or swim.</li>
	<li>Improved Accuracy: CGM devices are known for their accuracy in tracking blood glucose levels, offering a more reliable alternative to traditional fingerstick testing and ensuring more precise management of diabetes.</li>
	<li>Trend Analysis: CGM devices not only provide current glucose readings but also offer insights into glucose trends over time. By analyzing patterns and trends, users can better understand how their lifestyle choices and medication regimen impact their blood sugar levels, facilitating informed decision-making.</li>
	<li>Alerts And Alarms: They come equipped with customizable alerts and alarms that notify users of fluctuations in blood sugar levels. Hence, you can act timely, whether it&rsquo;s administering insulin, consuming carbohydrates, or seeking medical assistance to prevent hypo- or hyperglycemia. 
	&nbsp;</li>
</ul>

These include:<a href="#accordion">[1]</a>

<ul>
	<li>Cost: CGM devices can be prohibitively expensive. Besides the initial investment in the device, you would also need to consider the ongoing costs for sensors and accessories.</li>
	<li>Sensor Accuracy Issues: While CGM devices are generally accurate, factors such as sensor calibration, sensor placement, and environmental variables may affect the readings.</li>
	<li>Skin Irritation: Prolonged use of CGM sensors can sometimes cause skin irritation or allergic reactions at the insertion site. You would have to rotate sensor placement regularly, which can be a source of inconvenience.</li>
	<li>Technical Challenges: CGM devices rely on complex technology, and users may encounter technical issues such as sensor errors, signal loss, or device malfunctions. Moreover, it can be complicated to learn or confusing due to data overload. Dealing with these technical challenges can be frustrating if you don&rsquo;t have adequate support or troubleshooting resources. 
	&nbsp;</li>
</ul>

Understanding the availability of brands and their pricing is important when considering the purchase of a CGM device, not just in Pakistan but also around the world, as it directly impacts diabetes management.

The expenses associated with CGM devices vary between $100 and $300 monthly, depending on the brand. This cost typically encompasses both the sensors and the transmitters. Most CGM devices need to be replaced 2-3 times per month. Additionally, some CGM systems may require professional insertion by a healthcare provider, incurring additional costs.<a href="#accordion">[4]</a> 
 
Among the trio of conventional CGM devices presently available in the USA &mdash; Dexcom G6, Medtronic Minimed Guardian Connect, and Abbott FreeStyle Libre 2 &mdash; the Abbott Libre is considered to be the most budget-friendly option.

In Pakistan, too, the availability of CGM devices is gradually increasing, driven by growing awareness of diabetes management and advancements in healthcare technology.

Several international manufacturers now offer CGM devices in Pakistan, albeit at varying price points. For instance, FreeStyle Libre is available for Rs 12,000, whereas the Medtronic Guardian Connect CGM System Transmitter is available for Rs 200,000. 
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Conclusion

In conclusion, continuous glucose monitoring devices represent a significant advancement in diabetes management. They have certain drawbacks such as cost and technical challenges. However, the benefits they offer in terms of proactive monitoring and informed decision-making outweigh these limitations. 
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Key Takeaways

<ul>
	<li>CGM devices provide real-time glucose readings, allowing users to monitor their levels continuously.</li>
	<li>They also offer trend analysis, alarms for high or low glucose levels, and data storage for further analysis.</li>
	<li>Despite their advantages, CGM devices may pose challenges such as cost, sensor accuracy issues, skin irritation, and technical difficulties.</li>
	<li>Common CGM brands include Dexcom G6, Medtronic Guardian Connect, and Abbott FreeStyle Libre 2.</li>
	<li>CGM devices are becoming increasingly available in Pakistan, though access may vary depending on region and healthcare setting.</li>
</ul>

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