The holy grail? HG1-c a CGM without consumables

I had a comment posted over the weekend that drew my attention to a new CGM (continuous glucose monitor) technology. It's so new that it's not even available yet, anywhere in the world, and while I suspect that the commenter ('Bob Slack') may possibly be part of the 'marketing machine' it is, nevertheless, interesting enough for me to want to post about it.

I've been banging on about CGMs for ages. As far as I can see they are perhaps THE most significant step forward in diabetes care in the past 10 years. For my money a full-time CGM would have at least as much benefit to many MDI patients as a pump. The ability to know at any given moment, not just my BG level but also the direction it is heading and the rate of change would be a complete revelation to me. Suddenly you would have three times the amount of information on which to base your decisions. Managing diabetes often feels like steering an ocean liner through a tricky maze of sand bars and reefs. Blood glucose levels can change so rapidly with food or exercise, but the insulin 'steering mechanism' we are using has a frustrating time-lag of a few hours before its effects are truly felt. Dodging highs and lows before they happen is often a case of informed guesswork based on years of experience combined with living as many days as possible the same way to try to reduce the ridiculous number of variables involved. Reducing spikes after meals can involve injecting early to give the insulin 'a bit of a head start', while simultaneously trying not to overdo it and risk a post-meal dip. Sometimes it works, quite often it doesn't.

A CGM takes a reading from 'interstitial fluid' around every 10 minutes and gives an idea of what the BG level was perhaps 10-15 minutes ago. Up till now the readings have been taken via a sensor placed under the skin. Every few days this sensor had to be replaced, and they are not cheap. Running a fulltime CGM in the UK is likely to set you back thousands of pounds a year and currently NICE does not recognise them as a stand-alone treatment method. There are only a handful of people who have managed to secure NHS funding for CGM therapy in the UK, mostly children. Either their clinical circumstances are unusual enough to swing the extra expense, or they are very very skilled and determined negotiators.

The HG1-c by C8 Medisensors is based on what appears to be completely new technology. It uses non-invasive optical measurement so that no expensive under-skin sensor is required. In theory you just strap it to you for as little or as much time as you want. Of course since it is not yet available there is no way of knowing (apart from reading the marketing promises) how well, if at all, it might actually work, how much the unit will cost and even whether it will ever be licensed for use in the EU or UK.

Still... This could be one to watch.