INSULIN DEPENDENT DIABETES TRUST

OCTOBER 2008 NEWSLETTER

 

 

Justification for IDDT’s position on synthetic insulins

 

·         IDDT has always argued that animal insulins must remain available for people who are unable to tolerate synthetic insulins – both human and analogue insulins.

 

·         IDDT has always expressed concerns that the long-term safety of insulin analogues has never been established.

 

·         IDDT has openly criticised Novo Nordisk for their stated intention to discontinue all their other types of insulin and only supply insulins analogues. Apart from reducing insulin treatment choices, this leaves few alternative insulins for people who experience adverse effects with analogues. 

 

NEW warnings about NovoRapid justify all IDDT’s concerns!

 

Warnings in the US about NovoRapid

NovoRapid (insulin aspart) and called NovoLog in the US, is a rapid-onset, short-acting insulin analogue produced by GM technology by Novo Nordisk.

 

On March 14th 2008  the US Food and Drugs Administration (FDA) approved safety labelling revisions for NovoRapid to warn of the risk of systemic hypersensitivity reactions in patients receiving this and other insulin products.

 

On August 13th 2008 the FDA issued further warnings of the risk for severe, life-threatening, generalised allergic reactions in patients using insulin products, including post-marketing cases of anaphylaxis in those treated with NovoRapid. They also warn that generalised allergy to insulin may cause whole body rash, dyspnea (breathing difficulties), wheezing, hypotension (low blood pressure), tachycardia (rapid heart rate) or diaphoresis (sweating).

 

The evidence used by the FDA to issue these warnings was from controlled trials where allergic reactions were reported. Allergic reactions occurred In 3 of 735 people treated with regular human insulin and 10 of 1394 people treated with NovoRapid. Information from controlled and uncontrolled trials of NovoRapid also revealed 3 out of 2341 people discontinued using NovoRapid due to allergic reactions.

 

FDA now advise: that people using NovoRapid should be advised to obtain immediate medical assistance if a rash develops over their whole body, if they have trouble breathing or if they experience a fast heartbeat or sweating.

 

 

Is the UK issuing similar warnings about NovoRapid?

The Summary of Products Characteristics (SPC) documents for all synthetic GM insulins have always had warned about anaphylactic reactions:

“Symptoms of generalised hypersensitivity may include generalised skin rash, itching, sweating, gastrointestinal upset, angioneurotic oedema, difficulties in breathing, palpitation and reduction in blood pressure. Generalised hypersensitivity reactions are potentially life threatening.”

In the SPC for NovoRapid these reactions are classed as ‘very rare’ and by the standard SPC definition, ‘very rare’ means these adverse reactions occur in about 1 in 10,000 people. However, the evidence from controlled trials used by the FDA shows that they occur in 10 of 1394 people treated with NovoRapid which, by standard SPC definitions, shifts these adverse reactions from the category of ‘very rare’ to ‘uncommon’. ‘Uncommon’ adverse reactions affect between 1 in 100 and 1 in1000 people.

 

IDDT has asked questions of the UK drug regulatory authority (MHRA)

·         Is the MHRA going to take similar action to the FDA and issue warnings to patients and doctors about the severe allergic reactions to NovoRapid and the risks to people with diabetes? If not, why not?

·         Is the list of adverse reactions to NovoRapid going to be revised so that allergic reactions are moved from ‘very rare’ to ‘uncommon’? If not, why not?

 

 

GOVERNMENT REPORT – STILL A LONG WAY TO ACHIEVING GOOD QUALITY OF DIABETES CARE

Many readers will remember that in 2003 the National Service Framework for Diabetes [NSF] set targets for standards of care for people with diabetes which all have to be achieved by 2013. The idea behind the NSF is to ensure that everyone with diabetes should receive the same standard of care, no matter where they live. Local Primary Care Trusts [PCTs] are responsible for making sure that these targets are met.

 

Five years later, the Government has issued a report on the progress of meeting the NSF targets. 

·         Just half of patients are receiving the standard treatment.

·         Improvements are being made to reach all 12 NSF targets. The target that everyone with diabetes should receive screening for retinopathy [eye disease] by 2008 has not been achieved in all parts of the country. Progress is being made with the treatment of other complications but there is still a long way to go in terms of prevention.

·         There is a need to increase the number of diabetes specialists.

·         The report praised the work being done on involving people in their own care.

·         More needs to be done to improve the management of medical emergencies, specifically hypoglycaemia.

·         The access to specialist care for children with diabetes and pregnant women with diabetes is very variable and needs to be improved.

·         The NHS has improved its record of early diagnosis of people who were unaware that they had Type 2 diabetes – over 600,000 have been diagnosed over the last 5 years. However the report adds that there are still a further 500,000 people undiagosed.

 

 

Still a long way to go

No doubt there have been improvements and we know from our members that some areas of the country provide excellent care but what about the rest? There is certainly no room for complacency as we still receive many calls from people who are certainly not receiving the care they should and many people, especially those with Type 2 diabetes, don’t seem to have received very much education about their condition, the food they should eat or generally how to manage it.

 

Was setting the NSF targets putting the cart before the horse?

The report comments on the increasing number of people with diabetes, Type 2 in particular, but this cannot be used as a reason [or excuse] for not meeting the targets as this increase has been predicted for many years. 

The principle of setting targets of standards of care to be achieved by Primary Care Trusts has many advantages. However, there was a shortage of specialist staff and education programmes etc prior to setting the NSF targets, so as the NSF also included diagnosing the undiagnosed, can the targets ever be met? Was setting targets without the necessary staff putting the cart before the horse? IDDT raised this question at the time.

 

What’s the state of play now with staffing levels?

From figures published in Clinical Medicine 2008;8,4:377-380

·         the number of diabetes consultants has increased but the time they spend on diabetes has fallen from 40% in 2000 to 26% in 2007. 75% of their job plans are spent on non-diabetes related activities.

·         94% of diabetes consultants are spending more time in acute-general medicine which means less time spent for training juniors in diabetes.

·         There is less time for developing community services with GPs and only 12.8% of consultants involved in diabetes community clinics.

Another survey carried out by Diabetes UK in 2007 showed:

·         only 38% of Primary Care Trusts [PCTs] provided psychological support for adults with diabetes compared with 64% in 2006. For children only 51% provided this care compared with 69% in 2006.

·         There is still a shortage of paediatric diabetes specialist nurses and in 41% of PCTs their case load has increased with an improvement in only 7%.

With figures like this, can the NSF targets be met? Greater investment in diabetes care is necessary but this seems unlikely.

So what can you do in the meantime? Don’t accept poor care, don’t accept delayed or no retinopathy screening, complain to your local Primary Care Trust as they are responsible for funding services in your area. 

 

 

PORK INSULIN AND PUMPS – CAN YOU HELP US?

IDDT receives a number of calls from people interested in using pork insulin in an insulin pump. We are gathering information that currently does not seem available to patients or professionals about this to try to assist in decision-making.

So we interested in making contact with people who are using pork insulin in pumps, people who would like to use an insulin pump with pork insulin and those who have talked to their health care team about doing so. We would like to know more about their views and experiences and what their diabetes health care team think about this as an option.

We believe that most people using animal insulin in pumps are using pork insulin but if you are using beef insulin, do get in touch as we would love to hear from you too.

If you fit into any of these categories and are prepared to help us by filling in a short questionnaire, please contact Jenny at IDDT on 01604 622837 or e-mail jenny@iddtinternational.org

We would very much appreciate your help.

 

 

INTRODUCING MARTIN

Hi Everyone,

As a newcomer to the staff of IDDT, I was very pleased when Jenny asked me to write this article for the newsletter so that I can introduce myself and tell you a bit about my background. As you know, IDDT prides itself on the fact that most of us involved have a connection in some way to a person with diabetes. I am no exception to that fact – my sister has lived with diabetes for 33 years being diagnosed when she was five and I was six. In my previous career I worked as a registered care home manager for adults with learning disabilities, several of whom had Type I or Type II diabetes and I often found myself going to Jenny for advice about management and care.

 

My memories of growing up with a sister with diabetes are very mixed, some very happy, others not so happy, but that’s just the same as anybody isn’t it? I don’t really remember the conversation I must have had with Mum and Dad, when I was told that my sister had been diagnosed but I do remember spending what seemed to be hours sitting outside the children’s ward at the hospital. I suppose I used to feel a bit jealous of the attention that she was getting but found it difficult to say this because I knew she was ill and that was selfish and then I’d feel guilty. I think I was a bit confused to say the least.

 

That said there was an upside – all this fascinating new stuff that came into the house, metal and glass syringes with screw on needles, urine testing kits with fizzing tablets, test tubes and colour charts. My sister and I discovered that if you put enough of these tablets in a test tube with some water then they could get so hot that the tube would crack – a bit like Mum’s temper when she found out what we had been doing!

 

Like any brother and sister we also used to argue and sometimes these were because she was hypo and thus bad tempered but what then used to happen was that she would have something to eat and wonder what the fuss was about and why I was still cross. These days I’ve just realised that she doesn’t have to be hypo - sometimes she is just plain bad tempered.

 

Anyway there are loads of different feelings and emotions and memories that go along with living with someone who has diabetes and they are far too numerous and complex for me to write about them all here but if I can be of help to anyone, then please don’t hesitate to get in touch.

 

Things have certainly changed since my sister was diagnosed. I can remember Mum fundraising for the local branch of then British Diabetic Association and raising enough money to buy the first blood monitor for the children’s ward at the general hospital – it was the size of a house brick.

 

Coming back into the loop, starting to work for IDDT has made me realise how much there is to know and how mind-boggling the choice of treatments can be, so even though I have quite a lot of experience of living with someone with diabetes I can only start to imagine what it is like to be someone who is newly diagnosed or a member of their family.

 

Martin is employed to help to both raise funds and raise the profile of IDDT but he has the added ‘advantage’ of having a sister with Type 1 diabetes! Sometimes parents are worried about how their children without diabetes are feeling, so if you would like to talk to Martin, give him a call on 01604 622837 or e-mail martin@iddtinternational.org  or write to him at IDDT, PO Box 294, Northampton NN1 4XS

 

 

IDDT NEWS

Thanks to Sue Morris

Sue has been a Trustee of IDDT from the formation in 1994 and treasurer for many years. Due to pressure at work, Sue has had to resign as a Trustee of IDDT so we would like to thank her for all the work and support she has given to IDDT over the last 14 years.

 

IDDT’s Annual Report for 2007

The Annual Report for 2007 will be approved at our Annual General Meeting on October 11th 2008. To save funds we are not sending the Annual Report to all our members but will give a summary in the January 2009 Newsletter but copies are freely available to anyone who wants one – just contact IDDT on 01604 622837, e-mail enquiries@iddtinternational.org or write to IDDT, PO Box 294, Northampton NN1 4XS.

 

And congratulations are in order!

To Ruth Rigby who is 14 years old and has Type 1 diabetes

Ruth contacted IDDT because she wants to help children and young people with diabetes in developing countries. Ruth put the idea of sponsoring a child with Type 1 diabetes in India to her school year group and they decided to have a ‘Mufti-Day’ and a cake sale. They raised the excellent sum of £225.84 which will pay for the insulin and medical care for a child at Dream Trust in India for year. Ruth and her year group now have a photo of Aarti and information about her family and schooling so that they can all see how they are helping to take care of her and her diabetes.

IDDT would like to say her huge thank you to Ruth and her year group for helping Aarti whose family is too poor to be able to afford the vital insulin that she needs. A special thank you must go to Ruth for her initiative and for thinking about other children with diabetes.

 

To Jackie Banks for fighting the DVLA

As we reported in the July 2008 Newsletter, the DVLA has finally accepted that retinopathy is not always progressive and some people are now receiving their driving licences back after several years of being refused a licence. We all have Jackie Banks to thank for this as she has worked tirelessly to achieve this situation. We are pleased to report that the DVLA form sent to people who state that they have had retinopathy treatment now has boxes included to cover this situation. Jackie, whose retinopathy has remained stable for over 25 years, recently received her new form, filled in the boxes and received her driving licence without the usual battle! So we congratulate Jackie and thank her for all her hard work and persistence.

 

 

Nationwide Community and Heritage Award to Jenny Hirst

IDDT’s Co-Chairman, Jenny was a winner in the Community – Individual category of the East Midlands region. This was for the work she has done for people with diabetes through IDDT. She accepted the Award at a lunch in Nottingham and never known to knock, she handed out IDDT cards to several people with diabetes also attending!

 

To Brenda Smith and The Greene King Summer Charity Darts League

We must thank Brenda Smith and her family for choosing to hold their Summer Charity Darts League in aid of IDDT. Over £1400 was raised and a presentation made at the finals at the Tally Ho public house in Lewes. Brenda’s friend and IDDT member, Kathryn Millbank received the cheque on behalf of IDDT and made a short speech about diabetes and IDDT. Our thanks go to Brenda, Kathryn and all those who helped to raise this wonderful amount for IDDT and enjoyed themselves at the same time!

 

 

WARNINGS ABOUT BYETTA

Byetta [exenatide] is a relatively new injectable drug for the treatment of Type 2 diabetes.

In the UK acute pancreatitis associated with taking Byetta is not listed as an adverse reaction but the information document [SPC] does say there have been ‘rare spontaneously reported events of it and warns that patients should be informed of its symptoms: persistent, severe abdominal pain.’

In October 2007 the US FDA [the drugs regulatory body] announced that it was investigating 30 reports of acute pancreatitis in people taking Byetta, Since then it has received reports of 6 cases, two of which were fatal.

In August 2008 the FDA reported that anyone using Byetta who experiences persistent abdominal pain should seek immediate help from their doctor. A few days after this latest announcement Amylin reported a further 4 deaths from pancreatitis and the share price in the company dropped by nearly 25%. The FDA is working with Amylin and Lilly, the manufacturers, to add stronger and more prominent warnings to the labelling of Byetta. Apparently as a defence, the manufacturers pointed out that people with Type 2 diabetes have a 3 times increased risk of pancreatitis than those without diabetes anyway. But this begs the questions of whether or not it is advisable to take a drug that appears to increase this risk even further.

 

And while we are on the subject, you should also know ………

Avandia and Avandamet – after these Type 2 diabetes drugs were linked with heart failure and death, the debate about their use rumbles on but Australia seems to have made its mind up! Changes have been ordered by the Therapeutic Goods Administration and under new guidelines, no patients with any degree of cardiac failure should take them, they must not be taken with insulin and no new Type 2 patients should be started on triple therapy [3 drugs in combination].  The manufacturer, GSK, says ALL patients using Avandia or Avandamet need to see their doctor as soon as possible.

 

Regranex [becaplermin] – is a prescription gel made by Johnson & Johnson used to treat diabetic leg and foot ulcers caused by neuropathy. A long-term study completed in 2001 found that there were more deaths from all types of cancer in people using Regranex than in those who did not. This prompted a further study which showed that these deaths were higher for people who were given three or more prescriptions for treatment with Regranex.

In the US, the FDA now recommends that Regranex is only used where the benefits can be expected to outweigh the risks. In the UK the SPC does not include the risk of cancer as an adverse reaction but warns that in view of the lack of data, Regranex should be used with caution in patients with known malignancies – not the same thing.

 

Champix [Varenicline] – it has been known for some time that this non-nicotine, anti-smoking drug can have adverse effects. In the US during the last 3 months of 2007, Champix was linked to 988 serious reported injuries  – far more than any other drug in this time period. After analysis of all reported adverse events since marketing approval in 2006 the FDA found Champix linked to a wide range of problem Including serious accidents and falls, serious cardiac rhythm disturbances, severe skin reactions, seizures, diabetes, psychosis, aggression and suicide. They have issued a Public Health Advisory about the most marked adverse effects – behavioural changes, agitation and attempted or completed suicides and with the recommendation that caution is exercised about its use and that alternative methods are used to stopping smoking.

 

 

DISCRIMINATION OR JUST DOWNRIGHT IGNORANCE?

In our July 2008 Newsletter we discussed discrimination at work and that although we don’t generally consider diabetes to be a ‘disability’, it does come under the Disability Discrimination Act. However, one of our members encountered discrimination on holiday, although it is debatable whether it is discrimination, ignorance or just a total lack of care for fellow human beings! Here is Christine’s experience.

I was booked in to a B&B in Combe Martin for 5 days in August. It took me 6 hours to get there and when I arrived I filled my car up with petrol so that I could travel around Devon, checked into the B&B and paid in advance for my 5 day stay.

On the second day, I had lunch, went for a wander on the beach and then went back to the B&B about 2.30pm. I felt a bit tired so laid in bed watching TV. I must have had a hypo because I came round at about 7.30 lying between the two beds surrounded by a paramedic and two ambulance staff. It took a while to come round properly as the paramedic did not give me Glucagon - I cant remember if she said she didn't use them or didn't have one. I declined going to hospital as I felt there was no point – I have had diabetes for 38 years now and have had a few episodes of severe hypoglycaemia like this before and once pumped full of sugar or glucose I am fine. The paramedic stayed until about 9pm and then left.
The owners of the B&B were in and out of the room, when the wife said I would have to leave "as they were not running a care home". I was so angry I wanted to leave there and then but had to wait until the next morning.   
The next morning I woke up and asked if the owner would help me with my boxes of dialysis fluid because they were too heavy for me to carry to the car. They said they could not do this until after breakfast. As I was getting into the car to drive off, the husband said "I was welcome to come back but next time bring a carer". I pointed out I did not have special needs and did not need a carer, and was so annoyed I just drove off. To add to all this, they did not give me any money back!

When Christine rang IDDT about this, words failed us! Here is someone maintaining her independence, unfortunate enough to have a hypo while on holiday. It can happen to anyone with Type 1 diabetes but to be treated with such ignorance is unbelievable!

 

 

CAN YOU HELP IDDT?

eBay Weekend

Almost all of us who have access to the internet have heard of eBay, the on-line auction site, and quite a few of us have used it to buy and sell items - over 20 million people at the last count!

What a lot of people don’t realise is that every time they sell an item on eBay they can raise money for charity – including IDDT.

 

How to donate to IDDT by selling stuff on eBay – it’s really quite simple

1.    Log on to www.e-bay.co.uk

2.    Once you’re ready to sell your item, go to the Sell hub and select ‘Advanced Sell’. If you’re stuck you can get some tips on how to list.

3.    As you are filling out the details, look out for the charity box just below where you set your price. Select IDDT and the percentage of your final selling price that you would like to donate [10% - 100%].

4.    A week after your item sells, Missionfish [eBay’s charity partner] will automatically collect the donation from you. You can also manage your donations through the ‘My donations’ section of My eBay, under the ‘My Account’ tab. Any fee credits will appear on your next invoice.

 

Everyone’s a Winner!

You Win - every time you list an item for charity, you’ll get a fee credit on your basic insertion and final value fees equal to the percentage you donate. So if you donate 50% of your selling price to a charity, eBay will waive 50% of your fees.

We Win – every time you sell an item, Missionfish will collect your donation and after deducting a small fee to cover administration, pass your donation on to IDDT.

We know it works, thanks to Jean

Jean from Darlington has been donating to IDDT through eBay in memory of her husband who sadly passed away in April last year. Jean has listed 139 items over the last few weeks with every one raising money for IDDT. Jean has not only shown that donating by selling on eBay really does work but she has also raised much needed funds for IDDT. We are really grateful to her for her kindness and generosity. So a huge thank-you to Jean!

 

IDDT’s eBay weekend, January 17th and 18th 2009

Of course you can start selling items on eBay to donate a percentage to IDDT anytime and we are always grateful for your help. But we are making January 17th and 18th 2009 ‘IDDT’s eBay Weekend’ by asking everyone with internet access, to get involved. It’s a good opportunity to sell any unwanted items, especially any Christmas presents that maybe you don’t really want! If we all list our unwanted items, however small, and donate a percentage to IDDT, not only can we have some fun but we can raise a tidy sum – the old saying of look after the pennies and the pounds take care of themselves.

Other ways to use eBay to help IDDT

If you run a business that uses eBay, you can help too!

If your business uses eBay to sell then you can also register to donate to IDDT, again with benefits:

·         your listings are highlighted with a yellow and blue ribbon,

·         your business is associated with a good cause and

·         there are significant tax benefits.

For more information go to www.ebay.co.uk/ebayforcharity/sell.html and click on the link to businesses.

Special Auctions

The final way you can help IDDT is by holding a special auction. A special auction is hard to define but they tend to have one or more of the following features:

·         ‘money can’t buy’, one of a kind items or experiences,

·         items with celebrity status,

·         unique or extraordinary items,

·         extremely valuable or rare items.

If you need any help or have any ideas or items for a special auction, then please contact Martin at IDDT tel 01604 622837 or e-mail martin@iddtinternational.org

 

 

NICE GUIDANCE ON INSULIN PUMP THERAPY, JULY 2008

NICE issues guidance is about the use of medicines, devices and treatment in the NHS in England and Wales. The new final NICE guidance for insulin pump therapy has resulted in changes to the 2003 recommendations. Here are the main points:

 

1.    Pump therapy is recommended as a treatment option for adults and children 12 years and older with Type 1 diabetes provided that:

·         attempts to achieve target HbA1cs levels with multi daily injections [MDIs] result in the person experiencing disabling hypoglycaemia. [This is defined as repeated and unpredictable hypoglycaemia that results in persistent anxiety about recurrence and is associated with a significant adverse effect on quality of life.]

or

·         HbA1cs have remained high [8.5% or above] on MDI despite a high level of care.

 

2.    Pump therapy is recommended as an option for children younger than 12 years  provided that:

·         MDI is considered to be impractical or inappropriate, and

·         Children on insulin pumps would be expected to undergo a trial of MDI between the ages of 12 and 18 years.

 

3.    Pump therapy should only be started by a trained specialist team who should provide structured education programmes and advice on diet, lifestyle and exercise appropriate for people using pumps.

 

4.    After adults and children have started pump therapy, it should only be continued if it results in a sustained improvement  in glycaemia control [a fall in HbA1cs] or a sustained decrease in the numbers of hypos. Appropriate targets for these improvements should be set by the responsible physician in discussion with the person or their carer.

 

5.    Pump therapy is not recommended for the treatment of Type 2 diabetes.

 

More information and the full NICE Guidance for insulin pump therapy is available from: www.nice.org.uk/TA151 or phone on 08454 003 7783 or e-mail publications@nice.org.uk 

 

INTERESTING COMMENTS ON CONTINUOUS GLUCOSE MONITORING SYSTEMS BY A USER

We all place high hopes on the development of continuous glucose monitoring systems. These are now available but are only to be used to pick up trends in blood glucose levels and cannot be relied on for making dose adjustments.

There was an interesting letter in Diabetes Health [22 May 2008] from a medical student who has had Type 1 diabetes for over 10 years. He is using a Medtronic insulin pump and continuous glucose monitoring system [Paradigm Real-time]. He warns people not to have unrealistic expectations of the current generation of continuous glucose systems as both the Dexcom and Paradigm Real-Time systems are good to monitor trends in blood sugars but they are inherently limited in several ways. He suggests that perhaps the drawbacks are not emphasised sufficiently by the manufacturers selling these expensive systems. The drawbacks he describes are as follows.

·         The readings are delayed in time and can lag behind the actual blood sugar concentration by as much as 20 minutes. This is because they sample interstitial fluid [fluid in the cells] which may take up to 20 minutes to change in the same direction as blood glucose. Standard finger-prick monitors use capillary blood which represents the current blood glucose levels. This time lag means that they cannot reliably protect against hypoglycaemia as 20 minutes can be too long before treating the hypo. This is not helped by the sensors being inaccurate at both high and low blood glucose levels.

·         Both manufacturers warn that continuous monitoring systems are not a substitute for finger-prick testing and decisions about insulin dose must be made on the basis of finger-prick tests. So using continuous monitoring does not reduce the number of daily finger-prick tests. A further drawback is that the continuous monitors must be calibrated multiple times a day.

·         These devices and the sensors are very expensive costing between £400 and £500 in the UK and the disposable sensors cost £15 to £20 each. Added to this, the Medtronic system is only lasts for a year until the transmitter ceases to hold a charge and then a new transmitter has to be purchased.

·         People using a pump need two subcutaneous insertions and for slim people this can be a problem as the abdomen fat they use for the pump insertion site may not be large enough for two insertion sites. Unlike the pump infusion set, the sensor probe of the continuous monitoring system bends more easily and therefore any area of the body that is continuously being flexed or that bears weight is not a good choice for the sensor probe to be inserted.

Undoubtedly continuous glucose monitoring systems are useful for people who wish to monitor trends in their glucose levels but as this user points out, people need to be aware of the drawbacks too – informed choice again!

 

What does research say?

Trials have mostly failed to find a significant improvement in control with continuous glucose monitoring [CGM] compared to finger prick tests. Several studies have shown that CGM may help to detect night hypos and one study showed that CGM helped to motivate people with Type 2 diabetes to take more exercise.

A recently published study investigated the safety and clinical effectiveness of a new device with a combined insulin pump and continuous monitoring system compared to a pump with standard finger prick testing. [Diabetes Technology and Therapeutic, Vol 10, No 5 2008] 146 participants between the ages of 12 and 72 were randomised to receive the two different methods of measuring blood glucose levels.

The results showed that HbA1cs reduced in both groups but with no significant difference between the groups. Greater than 60% use of the continuous monitoring system did result in a reduction in HbA1cs. However, the finger prick testing group showed no increase in hypoglycaemia [3 severe hypos] but the continuous monitoring group showed a significant increase [14 severe hypos].

Another report ‘Continuous blood glucose monitoring: does it really affect diabetic c