58 DI A BETIC LI V ING / SPR ING 2019
your target range several models also
sound an alarm when you veer outside
of it.
Health care providers benefi t from
the technology too. “Now, I can see a
patient’s tracings over a few weeks and
make adjustments to his or her insulin
pump sett ings much more accurately
than if I’m looking at just a few dozen
blood sugar levels over a one- or two-
week period,” says Sasan Mirfakhraee,
M.D., medical director of the Diabetes
Management Center at University of
Texas Southwestern Medical Center. For
PWDs type 2, even temporary use of a
CGM can help with lifestyle and medi-
cation adjustments.
Th ere are currently fi ve CGMs on
the market, each with diff erent features
to consider. Medtronic’s Guardian Con-
nect system requires fi nger-stick calibra-
tion to ensure accurate readings and has
a 7-day wear time, but can be combined
with innovative smartphone technology.
Abbott ’s newest version of the FreeStyle
Libre now has the longest approved
wear time 14 days and takes read-
ings when the sensor is scanned by
either the handheld reader or an iPhone
using the FreeStyle LibreLink app. Plus,
just like the Dexcom G6, the FreeStyle
Libre does not need fi nger sticks to
calibrate. Dexcom G6 has a 10-day wear
time and allows you to automatically see
glucose readings on a smart device and
share that data with others. With the
newest CGM on the market, the Ever-
sense long-term CGM system, a phy-
sician implants a sensor under the skin
where it can stay for up to 3 months.
INSULIN PUMPS
Pumps have been around for decades,
but new technology is making insulin
delivery safer, sleeker, and more hands-
off. Pumps mimic a healthy pancreas
by delivering a small, steady trickle of
rapid-acting insulin 24 hours a day. Th is
keeps blood sugar stable between meals
and during the night without the need
for long-acting insulin. Wearers also
use the pump to deliver bolus doses at
mealtimes and when blood sugar is ele-
vated. Delivering insulin in this way can
make dosing more precise and easier to
adjust in real time, and reduce the risk of
ABBOT
experiencing low or high blood sugar.
Traditional pumps deliver a preset
amount of insulin regularly throughout
the day, but the latest pumps can tailor
insulin delivery to the amount of glu-
cose in the blood, just like a pancreas.
In 2017, Claire, who is also one of
Sherr’s patients, became the fi rst pedi-
atric patient to go on the fi rst FDA-ap-
proved “artifi cial pancreas,” Medtronic’s
MiniMed 670G hybrid closed-loop
Claire Bickel uses her
Medtronic MiniMed 670G
(also on p. 54) to dose
mealtime insulin.
