New technology may help overcome challenges of blood sugar testing for diabetes in Thalidomide survivors
For thalidomide survivors living with Type 1 or Type 2 diabetes, testing blood sugar can present a unique challenge. As Dan Howarth, Head of Care at Diabetes UK, explains – while technology might be heading in the right direction, there are still some challenges those affected need to overcome.
For many millions of people across the world living with diabetes, blood sugar testing is part and parcel of life with the condition. While not everyone living with the condition needs to test their blood sugars as part of managing their diabetes, for those that do, there are a number of options.
For thalidomide survivors living with no arms or short arms, the practicalities of blood sugar testing can be more challenging, and these options may not be suitable for their needs.
Typical testing methods may not be practical
Finger prick testing is by far the most common, and involves pricking the finger with a short, fine needle – also known as a lancet – and then using a blood sugar testing strip, and a blood testing meter, to get your blood sugar reading. Finger prick testing is a snapshot; it tells you your blood sugar at that moment in time.
However, some thalidomide survivors with diabetes may find finger prick testing difficult or impossible. Reassuringly, while the fingertip is the most common site for this type of blood sugar testing, other sites on the body can be used. This is called alternate site testing, and other sites on the body that are suitable include the palm, forearm, upper arm, or the thigh.
For those with reduced mobility or reach, finger prick testing or alternate site testing may just not be practical, and a clinician will be able to advise the best method of testing in those circumstances.
Flash Glucose Monitoring technology can help with daily monitoring
Newer technologies are, for many people living with diabetes, making things that bit simpler. Flash Glucose Monitoring technology – which was made available to be prescribed through the NHS late last year – is a small sensor that is worn on the skin. We call it ‘Flash’ for short.
It records glucose (sugar) levels continuously throughout the day, and these levels are accessed by scanning the sensor with a reader that tells you both the blood sugar level, and the trend of those levels (whether they’re going up or down). It’s immediate, and can be done without the need to draw blood, freeing those who – for whatever reason – find blood testing challenging, from needing to do it so often during the day.
However, Flash doesn’t completely remove the need for blood testing. That’s because Flash doesn’t actually measure your blood sugar level; it measures the amount of glucose in the fluid that surrounds your body cells – called interstitial fluid. There can be a small delay when checking this fluid, especially after eating or if you're exercising.
That means a flash glucose monitor result isn't always exactly the same as a finger-prick result. This means you'll still need to do a finger-prick test if you’re thinking of changing your treatment at any point, like if you need to take more insulin or if you're treating a hypo, so you can get the most accurate result.
As with standard day-to-day finger prick testing, or alternate site testing, this may not be possible, and it might mean getting a carer or someone you trust to do this for you, if you are not able to do it for yourself. What it does mean, however, is that if you need someone to support you in monitoring your blood sugar throughout the day, scanning a Flash sensor and getting an instant reading is less invasive and more discreet than other methods.
While technology is taking us in the right direction, for those with diabetes and reduced mobility, no arms, shortened arms, or any disability that limits their range of motion, the support of a carer may be necessary to ensure they have the best idea of what their blood sugars are doing during the day.
Revolutionary Diabetes technology, 'artificial pancreas', is being developed
It’s not the end of the story, however. Diabetes technology continues to evolve. Work funded by Diabetes UK has advanced a revolutionary technology known as the ‘artificial pancreas’ which, we hope, will in the future be available to everyone who could benefit from it.
The artificial pancreas, or closed-loop insulin delivery system, continuously monitors blood glucose levels, calculates the amount of insulin required (through a device such as a tablet or mobile phone), and automatically delivers insulin through a pump.
It's known as the 'artificial pancreas' because it monitors and adjusts insulin levels just as the pancreas does in people without diabetes. However, the artificial pancreas isn’t available yet, and there's still work to be done to understand the full benefits of this technology.
As with every aspect of diabetes management, what’s right for the person with diabetes, and what helps them best stay on top of their condition day-to-day, is the right course of action. Technology might not give us all the answers we want just yet but, with the support of a carer, and the newer technologies available, Thalidomide survivors living with diabetes may find their condition that bit easier to deal with day-to-day.
The Thalidomide Trust’s Summary:
- We know thalidomide survivors with diabetes and short or no arms have difficulty testing their blood sugar.
- Though the finger is usually used to get a droplet of blood with a lancet, other areas of the body can be used.
- Thalidomide survivors may need carers to help them test their blood sugar.
- ‘Flash’ is a small sensor that is worn on the skin. It is available now on the NHS to measure the trend of whether the blood sugar level is going up or down. This means it doesn’t need a blood test.
- Though ‘Flash’ is very good and will greatly reduce the need for a lot of finger pricks, a finger prick test will still be needed for treatment changes, for example, if more insulin is needed or to treat a low blood sugar or “Hypo” when a more accurate result is required.
- In the future, the use of an ”artificial Pancreas” will be even better than Flash. This may mean no blood tests are needed and the device will measure and deliver the insulin by itself without any monitoring.