Posted by on Monday, 24 October 2011

The holy grail? HG1-c a CGM without consumables

I had a comment posted over the weekend that drew my attention to a new CGM (continuous glucose monitor) technology. It's so new that it's not even available yet, anywhere in the world, and while I suspect that the commenter ('Bob Slack') may possibly be part of the 'marketing machine' it is, nevertheless, interesting enough for me to want to post about it.

I've been banging on about CGMs for ages. As far as I can see they are perhaps THE most significant step forward in diabetes care in the past 10 years. For my money a full-time CGM would have at least as much benefit to many MDI patients as a pump. The ability to know at any given moment, not just my BG level but also the direction it is heading and the rate of change would be a complete revelation to me. Suddenly you would have three times the amount of information on which to base your decisions. Managing diabetes often feels like steering an ocean liner through a tricky maze of sand bars and reefs. Blood glucose levels can change so rapidly with food or exercise, but the insulin 'steering mechanism' we are using has a frustrating time-lag of a few hours before its effects are truly felt. Dodging highs and lows before they happen is often a case of informed guesswork based on years of experience combined with living as many days as possible the same way to try to reduce the ridiculous number of variables involved. Reducing spikes after meals can involve injecting early to give the insulin 'a bit of a head start', while simultaneously trying not to overdo it and risk a post-meal dip. Sometimes it works, quite often it doesn't.

A CGM takes a reading from 'interstitial fluid' around every 10 minutes and gives an idea of what the BG level was perhaps 10-15 minutes ago. Up till now the readings have been taken via a sensor placed under the skin. Every few days this sensor had to be replaced, and they are not cheap. Running a fulltime CGM in the UK is likely to set you back thousands of pounds a year and currently NICE does not recognise them as a stand-alone treatment method. There are only a handful of people who have managed to secure NHS funding for CGM therapy in the UK, mostly children. Either their clinical circumstances are unusual enough to swing the extra expense, or they are very very skilled and determined negotiators.

The HG1-c by C8 Medisensors is based on what appears to be completely new technology. It uses non-invasive optical measurement so that no expensive under-skin sensor is required. In theory you just strap it to you for as little or as much time as you want. Of course since it is not yet available there is no way of knowing (apart from reading the marketing promises) how well, if at all, it might actually work, how much the unit will cost and even whether it will ever be licensed for use in the EU or UK.

Still... This could be one to watch.

Posted by on Wednesday, 19 October 2011

Beating Diabetes... anyone fancy a cure?

I'm just coming to the point in my life where I've lived longer with diabetes than I lived without it. Ever since diagnosis I have read about, or been told about exciting research which could have profound effects on those living with diabetes. I have witnessed the release and gradual acceptance of amazing new technologies and treatment options which make diabetes more controllable than ever before. Every year I've heard of breakthroughs that bring that elusive prevention or cure one step closer.

But anyone who has more than a passing experience of this condition will know that it can be an infuriatingly complex and difficult business. Most reports of dramatic research developments usually end with caveats about 'very exciting, but early days' and 'further research' being needed. Typically the timeline suggested before things come to fruition is 10 years. I don't know why they pick that number, but they always seem to. Long enough, perhaps, for everyone to have forgotten the promise.

So you might think by now I'd be all cynical and downhearted? Nope.

Before diagnosis I had never really had much to do with the medical profession. I'd not broken any limbs as a child, or needed to go to the doctor much. I had a brief stay in hospital when I was around 8 after being hit by a car crossing a road, but on the whole medics, hospitals and GPs weren't really in my frame of reference. Suddenly, in my early 20s there I was. Right in the middle of multiple appointments and practitioners, a hospital stay, armfuls of blood tests and with an on-going connection to all these people stretching out in front of me. Not only that but I became very aware of others diligently working away in quiet labs prodding and poking at diabetes, turning it over and over with a stick and trying to figure out how to make it easier to live with, and if possible disappear completely.

There has never been a better time in history to be a diabetic (and given the numbers of us around, that's quite a good thing). And tomorrow, or the day after, or the day after that, someone, somewhere will have a thought, or observe some happy accident, then test it and tweak it and suddenly BAM!

No more diabetes. Ever.

That would be great, right? If you live with D, I'm pretty sure you'd like that. Quite a bit. And the fact that there were lots of thoughts and ideas earlier that didn't come to anything will not be important. The dead ends and diversions will be of no consequence because the beast will be slain, or the perfect treatment option to control it will be right there in our hands. If not 'no more diabetes', I'll settle for 'no more diabetic complications'.

If only we could speed the process. If only we could, in our own small way, play a part in that amazing story.

Well we can.

I was contacted a week or so ago by someone who asked if I could raise the profile of a campaign to help beat diabetes. The NHS's National Institute for Health Research 'Diabetes Research Network' has launched the Help Diabeates campaign to encourage people to get involved in the search for a cure or better treatment for diabetes. Because of the nature of the teaching hospital I attend for my diabetes care I have been able to take part in various research projects in the past. But this, I think, is part of the difficulty... Any researcher with a brilliant new idea to try needs to be able to make observations and test things with suitable candidates to develop their knowledge, explore their idea and push it further. If they are attached to a clinic they might be able to ask around and see if there any volunteers, but I suspect they are going to be scratching around with only a handful of people who fit the criteria.

And if they can't get their research done we can't get our cure.

In simple terms the Help Diabeates campaign offers you an easy way of offering to be involved at some point, and only if you want to for any particular project. It's a way of throwing the research net a little wider. You add your name to the database, they ask you a handful of questions. Then if there's a research project that might benefit from your involvement you get contacted and are given the chance to take part. Even if you decide you want to and then change your mind, you can back out at any stage.

What are you waiting for?

Find out more about Help Diabeates here, then sign up to take part here.

And if you dont live in the UK? Well just look around. In a lab somewhere in your country there's a clinical trial with your name on it.

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Diabetes explained. Search for diabetes treatments at a private hospital in Nottingham.