Continuous tissue glucose measurement (CGM) to drive the therapy of diabetes mellitus

For the conventional insulin pump therapy the patient have to take blood glucose measurements five to ten time a day. That procedure is an ugly and painful thing and sometimes during activity not practicable.

To improve this problem CGM-systems are taken to replace the multiple blood glucose measurements during the day. The basal program of the insulin pump can built exact with the multiple glucose values over the day and the hence daily graph.

On this way the patient receive an individual designed basal program and it is possible to create different levelled basal rate in the pump. The patient need variable insulin amounts from day to day and because of this reason we designed graduated basal programs from a low level up to a high insulin dose. For example the needed insulin amount is much higher during an infection than normal. After physical activity the requirement of insulin from the body is for the next 10 hours smaler than usual.

The CGM values are put in the bolus calculator of the pump to charge the insulin amount for the carbohydrates of the meal. The bolus calculator of the insulin pump consider the active insulin amount in the body to avoid over correction. This important function is also used to correct higher glucose values.

It is much easier to achieve changes in the insulin dose from day to day with an AID system (Automated Insulin Delivery System). With the AID system, an algorithm is used to redefine the insulin dosage with the insulin pump every 5 minutes based on the CGM values. AID systems are also called loop or artificial pancreas.