Abstract
Patients with type 1 diabetes often face decisions regarding correct insulin dosage and they risk hypoglycaemia or hyperglycaemia daily. Patients who measure their glucose levels more frequently tend to achieve better diabetes compensation - 4 measurements per day are considered to be the standard.
From available literature we know that HbA1c levels will be decreasing thanks to more frequent self-monitoring up to the frequency of 7-8 measurement per day - but this is unmanageable for most patients. For successful type 1 diabetes treatment, precise insulin dosage is required, but unfortunately even frequent measurements using a glucometer are always sufficient to enable the patients to adequately predict the risks of hypoglycaemia or hyperglycaemia.
Even though the availability of personal glucometers and diabetes self-monitoring starting in the 1980's have meant a huge advance for managing diabetes. nowadays systems for continuous glycaemia monitoring are becoming the standard of care for patients with type 1 diabetes. Patients can be offered common glucometers, continuous glucose monitoring systems (CCM) and newly also the so-called flash glucose monitoring systems (FGM).
Both continuous and flash monitoring are based on subcutaneous sensors. CGM systems typically informs the patient about the glycaemia trends every 5 minutes and gives of warnings in case of risky levels or trends.
CGM systems thus give the patient the data about current glycaemia in real time and they can be linked to an insulin pump to launch the pump's automatic functions - especially for protecting the patient from hypoglycaemia. In case of FGM systems, the patient is informed only after actively putting the receiver near the sensor.
At that point, the data is transferred, and the patient has the chance to see the current glycaemia levels, its 8-hour history and predicted trend. The accuracy of CGM and FGM measurements has drastically improved and recently has become comparable to high quality glucometers.
Improved quality of the sensors brings higher or total independence of CGM and FGM systems on glucometers and CGM accuracy is no longer and obstacle for creating self-contained systems for automatic insulin dosage. The obstacles which still prevent their wider use include a relatively high price and insufficient access to quality patient education.