Continuous glucose monitors (sensors)
Sensors (or continuous glucose monitors) are devices that measure the sugar/glucose in body water (known medically as “interstitial fluid”). A small teflon needle is inserted into the skin and is usually changed every 7-14 days. The needle is connected to a sensor which either
- automatically sends/pushes the Interstitial fluid glucose level via bluetooth to a receiver every 5 minutes 24/7 (Dexcom G5 stand-alone sensor, and packaged with the Animus Vibe & Minimed Veo pumps) or
- has data “pulled” from it by the waving of the receiver over the sensor/flash glucometer (Freestyle Libre, see below).
Interstitial fluid glucose is reliably within 20% of blood glucose unless the blood sugar is rising or falling rapidly and with this exception is accurate enough to allow for insulin adjustment. Trending information is very useful. In addition high and low alarms can be set.
There is only one stand-alone sensor on the Canadian market, the Dexcom G5. It is a simply outstanding device and comes with the highest recommendation from BCDiabetes.
Sensors combined with an Insulin pump
Sensors also come built-in as part of two excellent insulin pumps on the Canadian market – both cost around $7500: Both offer the setting of alarms for both high and low glucose values. The low alarm offers an extra level of reassurance of safe sleep and operation of machinery (but is not foolproof). BCDiabetes recommends the low alarm be set no lower than 4.5. The high alarm helps with the use of boluses and meal-planning. For pumps with built-in sensors below are the preferred contacts:
A third excellent stand-alone insulin pump, though without a built-in sensor, is the tubeless Omnipod. It is particularly easy to use. Combining the Omnipod with a stand-alone sensor makes perfect sense. Contact Amrit Malkin firstname.lastname@example.org
The Freestyle Libre represents the first of new technology similar to sensors, termed “flash” glucose monitoring. The Libre is the expected on the Canadian market sometime in 2017 & to retail at around $100 for the hardware & $7/day for the consumables. Separate blood glucose calibration is not required. Interstitial glucose values are stored in the sensor but not pushed to the monitor (as with “sensors”); rather the monitor is swiped over the sensor to pull the values which are then displayed. High and low alarms are not offered. See here the recent BCDiabetes blog on the Libre.
BC Pharmacare will cover the purchase price of all three pumps described above plus the cost of pump tubing for individuals with Type 1 diabetes under the age of 26. Most third party insurers will cover the cost of an insulin pump regardless of age. At the time of writing (2017-Feb-08) Dexcom G5 sensors are covered by only a minority of insurers.