The most recent advance in sensor technology is the addition of a near closed loop system from Medtronic and Animas (the latter having just received a EU license). The STAR 3 study (NEJM 2010) shows that sensor augmented insulin pump therapy achieves long-term improvement in glycaemic control.
New generation CGM sensors are smaller, have longer lifespan and in laboratory settings at least appear to offer good accuracy.
De-noising CGM data by removing spikes and artefacts yields about 30 greater accuracy. It is then important to recalibrate CGM senors as they are prone to drift during their lifespan in-situ – doing this improves accuracy by about 26%. Dual sensor arrays’ using more than 1 sensor yields a synergistic benefit which increase accuracy of glucose estimation. Dual sensor arrays also offer real time detection of failure of one unit and may thus improve safety and reduce the impact of patient/human factors in using CGM.
The future holds integrated pump & CGM systems. This closure of the loop requires a control system with a built in algorithm. It also requires that the closed loop devices are small, portable and safe.
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