Abstract
Healthcare professionals have focused on different ways that can be exercised to improve patient outcomes. One of the ways is by ensuring that technology is used in different practices. Home monitoring technology has been introduced to ensure that patients can track their progress when having a particular infection. Many patients with diabetes have used this technique to monitor their sugar levels. Continuous glucose monitoring has become easy for many patients due to advanced technology. Doctors have also revealed the outcomes of the approach, whereby they have stated that individuals can focus on temporal trends and glucose regulation patterns. Doctors have also analyzed professional and personal glucose monitoring to show how the practices can impact patient outcomes. The use of modern technology has also been encouraged in treating various diseases since it makes it easy for patients to learn about their infections and ways to limit further complications.
Introduction
The increasing occurrences of chronic diseases place an unprecedented strain on the healthcare systems in various countries. In America, many young people and adults live with one or more chronic conditions. These chronic diseases include hypertension, diabetes mellitus, kidney disease, asthma, hypertension, and heart failure. Moreover, most hospital beds in the United States are occupied by patients who suffer from chronic illness. Rapid advances in healthcare services and low-cost wireless connectivity have been implemented to meet this challenge. Home patient monitoring technologies have been proven to be operative in managing chronic disease and monitoring the older patient population’s safety. These technologies can help patients slow the progression of chronic illness and guarantee continued recovery after being discharged from the hospital. Additionally, the technologies are vigilant and alert health care practitioners if a patient is in danger. Therefore, one can discuss the current and emerging technologies for continuous glucose monitoring as a type of home monitoring technology.
Continuous Glucose Monitoring
A continuous glucose monitor is an approved device that gives real-time glucose readings at any given time, and it allows patients to know their glucose levels and trends with a touch of a button. About 400 million people are affected by diabetes mellitus, which is believed to be the seventh killer disease (Hirsch & Wright, 2019). If the blood glucose concentrations in individuals with diabetes rise, they will likely suffer from other chronic diseases like kidney failure and high blood pressure. Insulin can regulate these levels, and the loss of insulin secretion in Type Two Diabetes (T2D) and the absence of insulin secretion in Type One Diabetes (T1D) cause blood glucose levels to fluctuate (Hirsch & Wright, 2019). T2D and T1D patients should be tested at least twice a day and four times a day, respectively, to keep blood sugar levels in the euglycemic range. (Rodbard, 2016). Additionally, the patients are exposed to combined therapies like drugs, physical exercises, insulin supply, and diet.
The introduction of glucose sensors has enabled patients to monitor the BG levels and manage insulin levels. This approach has helped control the mortality of diabetes mellitus. The initially used method of glucose monitoring involved the urinalysis method back in 1941. This technique used a urine sample to measure sugar. Later in the 1960s, Ames developed the Dextrostix, the first glucose strip that used glucose oxidase (Hirsch & Wright, 2019). The method involved putting some blood on the meter and hold for fifty seconds. Drained blood was later washed off with warm water. Sugar level was determined by whatever color the blood residue is.
Easy-to-use home glucose meters were created due to the increased cases of chronic illnesses. It required test strips which patients complained that it was too expensive, painful, and inaccurate. All these challenges engineered the play to find the perfect glucometer. Many electronic glucometers need a finger prick to determine results. According to the researchers, blood is exposed to an enzyme that oxidizes and loses electrons, and then it is passed through an electrode that reads the currents (Battelino et al., 2018). There are various forms of continuous glucose monitoring systems. These are personal systems that enable patients to reflect continuous data in real-time at home or remotely, and specialist Continuous Glucose Monitoring systems, which patients wear without noting glucose values and which their practitioners download and check during their visits.
Personal CGM
In the United States, patients with diabetes can choose from various personal CGM programs for everyday use. The FDA approved the Abbott Freestyle Libre flash CGM device for stand-alone use in September 2017. The system has the Freestyle Libre sensor that individuals can wear for up to ten days. The machine also takes glucose readings every minute and tracks them every fifteen minutes. To scan the monitor’s current glucose level, the patient must place the reader over the sensor. A glucose level and a trend arrow showing direction and change rate are demonstrated with each sensor scan. Upon purchasing the sensor, it comes factory-calibrated, and the patient does not calibrate (Kudva et al., 2018). For the individual study, individuals can track their glucose information easily. The patient can also upload data from the reader for up to ninety days to the Freestyle Libre View app for evaluation at home or in the hospital during their doctor’s appointment.
Many patients have also used the Medtronic Enlite sensor, which encompasses the insulin pumps from Medtronic. However, every 12 hours, the Enlite sensor must be calibrated. The Dexcom G4 Platinum, Dexcom G6 systems (Dexcom, San Diego, and CA), and the Dexcom G5 Mobile are stand-alone real-time CGM systems that have been licensed for use in the United States (Kudva et al., 2018). The Dexcom G4 Platinum and Dexcom G5 Mobile both have a patient-placed Dexcom Platinum G4 and G5 sensor that can be used for seven days. Individuals must change these devices with fingerstick blood glucose tests at least twice a day. The glucose data is transmitted using radio-wave technology, and trend arrows can be seen on a Dexcom receiver in real-time. The Dexcom G5 receiver and Apple and Android smartphone apps will monitor glucose data from the G5 transmitter, which uses Bluetooth technology.
Professional CGM
Professional CGM has been analyzed in healthcare, where the Freestyle Libre Pro sensor and a single reader device are primarily used in the physician’s office. The sensor must be triggered for two minutes after being placed on the back of a patient’s upper arm in the doctor’s office. After that, for the next two weeks, the machine will record glucose levels every fifteen minutes. During the fourteen days, the patient is not in contact with the sensor and cannot view the glucose data. The sensor is scanned at the doctor’s office at the end of the cycle, and the data is sent to the freestyle Libre View app. The mean absolute relative difference precision is 12.3 percent (Blum, 2018). The MARD is the fundamental error between all CGM values and the synchronized reference value.
The Medtronic iPro2 scheme has an Enlite glucose sensor that can be used for six days. The readings are recorded after every five minutes. Moreover, fingerstick blood glucose measurements are not required unlike personal CGMs. Nonetheless, blood glucose entry is considered to ensure that the correct number of blood glucose entry is achieved. The device also allows patients to use the iPro2 my Log software on their phones to record incidents and upload them to the Medtronic Care Link website.
Outcomes
The systems are based on improving the quality of life for patients with chronic diseases. The most notable benefit is the time-series glucose information the technology provides. Patients can detect asymptomatic hypoglycemia. CGMs can also monitor and report up to 288 glucose values in a single day, resulting in data that reveals temporal trends and glucose regulation patterns. Patients may also set the alarm to sound if glucose levels are detected above or below a certain threshold, helping them to treat these rising values potentially. Despite all the positive sides of CGM, the monitoring technology has its limitations. Some patients reported that continuous monitoring produces lots of data. Similarly, the system comes with some tech frustrations, whereby inaccurate results can be encountered. For example, patients are forced to stay awake in the middle of the night as their systems fail to display their results. Although these approaches are essential, one disadvantage is that they lead to anxiety about one’s blood sugar control and state of health. Many patients are afraid that the glucometer might have negative results. Another drawback is that glucose levels in the interstitial space and capillary blood levels will differ. As a result, the CGM readings can vary from a fingerstick glucose reading.
Conclusion
In conclusion, home patient monitoring technologies are put in place to fight the rising chronic disease cases and monitor the older patient’s population’s safety. Diabetes is the seventh most chronic disease, with over four hundred million patients globally. Glucose sensors were introduced to help individuals monitor their BG levels at the comfort of their homes. There are two types of continuous glucose monitoring systems. The personal systems afford real-time observation and the professional approach that patients wear, and only the healthcare provider can review the data upon a visit. Furthermore, the plans are based on improving the quality of life for patients with chronic diseases like diabetes.
References
Battelino, T., Peters, A. L., Chamberlain, J. J., Aleppo, G., & Bergenstal, R. M. (2018). Continuous glucose monitoring. American Diabetes Association. Web.
Blum, A. (2018). Freestyle libre glucose monitoring system. Clinical Diabetes, 36(2), 203-204. Web.
Hirsch, I. B., & Wright, E. E. (2019). Using flash continuous glucose monitoring in primary practice. Clinical Diabetes, 37(2), 150-161. Web.
Kudva, Y. C., Ahmann, A. J., Bergenstal, R. M., Gavin III, J. R., Kruger, D. F., Midyett, L. K., & Harris, D. R. (2018). Approach to using trend arrows in the FreeStyle Libre flash glucose monitoring systems in adults. Journal of the Endocrine Society, 2(12), 1320-1337. Web.
Rodbard, D. (2016). Continuous glucose monitoring: A review of successes, challenges, and opportunities. Diabetes Technology & Therapeutics, 18(S2), S2-3. Web.