Star Trek Medicine--That's a Thing Now
Ever since the first diabetic pets were identified, their doctors have been fantasizing about squeezing more blood sugar measurements out of each patient. That’s what helps us create the best treatment strategy. We don’t, however, fantasize about being the actual person to collect extra blood samples for this. It’s every veterinarian’s dream to just divine a patient’s sugar levels by looking at him, like they do in science fiction movies. No sharp implements. No battle of wills. In a perfect world, he wouldn’t even have to wake up from his nap. That dream has recently come very close to reality.
The continuous blood glucose monitor, or CGM, is a miniature device that has changed the lives of some patients and veterinarians. Most seem to be using a product called the Free Style Libre from Abbott Laboratories. This machine, only about the size of a quarter, is situated in a sticker that adheres to the skin. In the center of the patch, on the sticky side, is a tiny sensor that can read sugar levels without any bloodshed at all. Readings are taken every minute, which is literally 10,000 times more frequently than our basic protocol of one measurement per week. The pet owner's entire role is to merely swipe a scanner over the device a couple of times a day—just like Star Trek! Really futuristic, yet far more user-friendly than most TV remotes. The Libre smartphone app consolidates this data into a series of graphs and summaries which your doctor will use in crafting a treatment plan.
The CGM can be a real godsend in certain situations. If a pet is hospitalized with any sort of blood sugar issue and needs to be sampled often, this device will allow her to sleep peacefully through the night and devote all of her energies to getting better. If a patient is suspected of suffering low sugar episodes, but has never been caught in the act, the machine is always watching (every minute!). However, the sensor is both costly and fragile, with a lifespan of only 14 days. If your pet scratches it off the first day, it can’t be reapplied. While the sensors can be somewhat prone to erroneous readings, technical support from the company is provided only for human patients. The amount of data harvested from one of these is massive, something like drinking from a fire hose; yet, those tens of thousands of data points would actually be much more valuable distributed over five to ten years. Because blood sugars don’t settle into a routine until about a week after any changes in the amount or type of insulin, a CGM is partially wasted on patients who are undergoing a dosage adjustment.
The CGM is not a magic wand for combating diabetes, but it is exactly what the doctor ordered for certain patients. This futuristic device will allow us to overcome some very specific challenges that were previously insurmountable. If you think your pet might be the one to benefit, check and see whether your clinic offers CGM services.
Dr. M.S. Regan