Christine H.M. Leong, Anand Velusamy, Pratik Choudhary
Self-monitoring of blood glucose (SMBG) is an integral part of diabetes care, allowing patients to identify patterns, calculate doses and identify hypoglycaemic or hyperglycaemic excursions. Structured education on interpretation of the results and algorithms to calculate insulin doses, structured and automated approaches to pattern recognition, and automation of data collection through these devices can contribute to improved glycaemic control.
Insulin delivery has not changed much since it was first used in 1921. Although therapy has moved from impure animal insulins to genetically modified rapid- and long-acting analogues, the mode of insulin delivery through subcutaneous injections remains the same. With the increasing use of continuous subcutaneous insulin infusions (CSII) or insulin pumps, greater precision in delivery is possible, but recent advances such as intraperitoneal insulin delivery and the combination of continuous glucose monitoring with insulin pumps, using algorithms to produce closed-loop systems, herald a new future for insulin delivery.
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