Newfangled devices make it easier than ever to monitor blood sugar, but an analysis of more than 30 studies suggests that newer isn't necessarily better in terms of blood sugar control.
At issue are continuous glucose monitors and insulin pumps. A continuous glucose monitor is placed under the skin to help someone with type 1 or type 2 diabetes track blood sugar levels throughout the day. Insulin pumps are also placed under the skin and replace the need for daily insulin injections.
People with diabetes who take insulin must track their blood sugar to ensure that their body maintains a healthy blood sugar level. Too much or too little insulin can cause unhealthy blood sugar levels and result in complications such as dizziness or kidney and heart disease.
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Daily monitoring
To manage their blood sugar, people with diabetes must monitor it several times a day. Usually, this means pricking a finger to draw blood. The drop of blood is then placed on a test strip and inserted into a blood glucose monitor. Continuous glucose monitors don't replace traditional finger-stick blood testing, but they do cut the number of tests needed.
But the devices - in combination or alone - don't seem to give any better control over blood sugar than more traditional methods. Researchers came to that conclusion after comparing A1C levels of people with diabetes. A1C levels provide a two- to three-month snapshot of blood sugar control.
"We found similar levels of glycemic control and hypoglycemia [low blood sugar] when we compared insulin pumps versus multiple daily injections," says study author Sherita Hill Golden, M.D., at Johns Hopkins University School of Medicine.
Pumps do help
Dr. Golden says that people who use an insulin pump did report a somewhat better quality of life. She also says that people with type 1 diabetes who used a pump did slightly better than people who used other methods.
Results showed only a 0.10 percent drop in hemoglobin A1C levels among children and adolescents who used a pump compared with multiple shots. This difference is so slight as to be insignificant.
In adults, the researchers found the drop in A1C was 0.30 percent for those on a pump compared with those on shots. They didn't find any significant difference in the risk for severe hypoglycemia between the two.
Comparable numbers
When continuous glucose monitors were compared with individual blood-glucose monitoring, A1C levels were lowered by 0.26 percent without increasing the risk for severe hypoglycemia. And, the sensor-augmented pump - a device that combines the two technologies - reduced A1C levels by 0.68 percent in people with type 1 diabetes.
Dr. Golden says the main factor in whether the new technology helped was how consistent the person was in using it.
The analysis had some limitations. The studies looked at were small, and some of the insulin pump studies used a different type of insulin from what is now commonly prescribed.
The study was published in the Annals of Internal Medicine.
Always talk with your health care provider to find out more information.
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