Continuous glucose monitoring (CGM) devices have made diabetes monitoring and management easier.
This is according to Dr Angela Murphy, a specialist physician and diabetologist at Sunward Park Hospital.
According to Murphy, the age of finger prick tests for diabetes is slowly coming to an end because of CGM devices.
“These devices are playing a pivotal role in reading glucose levels in real-time and transmitting the information to a smartphone. Diabetic people can see the patterns of their previous hour’s glucose levels, as well as the direction of their glucose.
“They help diabetic people in making decisions about their insulin doses and food choices.
“The only CGM devices that are available in South Africa are Freestyle Libre, Dexcom and Medtronic Guardian,” said Murphy.
She stated like any other innovative device, their prices are high. The cheapest device is costing R1 900 per month on average.
“Hopefully, this will change. People with Type 2 diabetes, especially if they are on insulin, can also benefit from CGM devices.
“Insulin pumps can work when linked with the CGM devices because insulin pumps deliver short-acting insulin 24 hours a day at a programmed rate. The user can produce extra insulin when eating the right type of food. This takes away the burden of multiple daily injections.
“This type of connection is good because the CGM device communicates the readings to the pump and the pump adjusts insulin according to the sugar readings.
“People must understand that these types of systems are expensive, but certain medical aids do cover the costs for people with Type 1 diabetes,” explained Murphy.
Murphy said there is a new ultra-fast insulin available. It can be used by diabetic patients during mealtimes and is more convenient than the current insulin that has to be taken 20 – 30 minutes before mealtimes.
“Type 2 diabetes medication has also been improved. In the same way that we expect our cellphones to do much more than be merely cellphones, we expect medications for diabetes to do so much more than just lower blood sugar levels. We want it to protect the heart and kidneys, assist with weight loss and protect us from higher blood glucose readings,” said Murphy.
She added there are currently two classes of medications to be used to treat type 2 diabetes that is effective.
“It is the Glucagon-like peptide 1 (GLP-1) receptor agonists and the sodium-glucose-like transporter 2 (SGLT-2) inhibitors.
“Glucagon-like peptide 1 (GLP-1) receptor agonists are injectable drugs that can be used daily (Victoza) or weekly (Trulicity and Ozempic) and have three major benefits.
“They lower glucose and stimulate the pancreas to increase insulin and decrease glucose production in the liver.
“They also help in weight loss by directly inhibiting the appetite centre in the brain and decreasing hunger, so a person feels full for longer. They also protect the heart by protecting heart muscle and blood vessels.
“Sodium-glucose-like transporter 2 (SGLT-2) inhibitors are drugs that act in the kidneys to decrease the reabsorption of glucose.
“More glucose gets excreted in the urine, thereby lowering blood glucose. Sodium is lost with glucose and this has a beneficial effect on both kidney and heart function. Forxiga and Jardiance are available as daily tablets,” stated Murphy.
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