“To fight diabetes related health issues, glucose test in every five minutes, even when asleep, is essential,” says Dr Anoop Mishra, Chairman, Fortis C Doc Centre of Excellence in Diabetes, Obesity, Metabolic Diseases and Endocrinology, Fortis Hospital, New Delhi
Blood sugar of a person without diabetes is maintained by the body within a normal range irrespective of the amount of food that is consumed by a person. In patients having diabetes, blood sugar spikes within an hour after any meal. This process goes on throughout the day. So the blood sugar of a person with diabetes, is continuously changing every minute of the day throughout the person’s life. The risk of future complications of diabetes depends on how long and how often the blood sugar has gone above the normal range. Once complications like eye, kidney or nerve disease sets in, it is irreversible. So the whole idea of treating diabetes is to keep the patient’s blood sugar as close to the normal range as possible at all times.
Patients may use glucometers to check blood sugar, but this gives the value of blood sugar only at the particular time when the test is done. However, blood sugar level of a patient is changing from minute to minute. To understand how the blood sugar is changing throughout the day, at Fortis we have the newly developed state-of-the-art technology known as CGMS or Continuous Glucose Monitoring System.
CGMS is done with the iPro2 monitor which is attached to the abdominal wall. It reads the blood sugar of the person every 10 seconds and keeps a record every five minutes so that we can get 288 readings of blood sugar per day during the CGMS study period. This data is uploaded on a computer and the data is clearly visible in the form of a graph which any one can understand. The tremendous benefits are:
• The patient gets to see how his or her blood sugar has moved after each and every meal of the day. This gives the person a clear idea as to how much the blood sugar has risen after a particular meal. The patient can then take corrective measures regarding food intake.
• The doctor can make out how a particular patient’s blood sugar is changing throughout the day. There are plenty of patients who have high blood sugar at odd times of the day which is not detected by the routine tests like Fasting blood sugar and PPBS (blood sugar after food). With this information the doctor can modify the treatment to get better control of blood sugar throughout the day.
• If a patient with diabetes is planning pregnancy it is absolutely vital that the blood sugar is very tightly controlled throughout the pregnancy. The consequences of poor control can be grievous to the mother and fetus. So, in patients with diabetes who are planning pregnancy it is extremely useful to get a CGMS done and get a correct picture of the blood sugar pattern.
• Low blood sugar especially at night may go unnoticed and this is clearly picked up by a CGMS study. • HbA1c (Glycosylated Hemoglobin) is a very useful test to detect how well blood sugar is controlled over the previous three months. HbA1c indicates the average blood sugar and so it does not give a correct picture of how much fluctuation occur. In fact, if a patient has frequent low blood sugar, it could result in low HbA1c (because HbA1c denotes an average value) and a false sense of security to the patient and doctor, even when the blood sugar is often high and is actually poorly controlled. CGMS is a useful tool to detect this disease.