In the next 3 to 5 years, we will have a new generation of control upon us providing continuous glucose monitoring. Some of these marvelous technologies will not require a drop of blood, while others will embody the tried-and-true stick-to-itiveness we all know and loathe.

Please join me as we browse the isles of things to come (and things now available) for continuous glucose monitoring.

The DexCom STS Continuous Glucose Monitoring System is a glucose sensor that reports glucose values every 5 minutes for up to 72 hours. The sensor is inserted in the abdomen. After a 2 hour start-up period, the STS System is calibrated with 2 fingerstick measurements taken by a traditional glucose meter. Checkout Amy Tenderich's review on Diabetes Mine of the DexCom Continuous Glucose Monitoring Sytem.

MiniMed Medtronic has 3 different versions: the Gold, the Guardian RT, and the Paradigm Real-Time Continuous Monitor.

Menarini GlucoDay S is a device worn by the patient for the continuous monitoring of glucose in the subcutaneous interstitial fluid. Monitoring is performed via insertion in the abdominal region of a microfibre for dialysis having the diameter of a human hair. Inside the microfibre a solution transports the patient's glucose to a biosensor within the instrument.

M-Biotech Glucose Biosensor is a minimally invasive implantation for painless and convenient monitoring. The key feature of our efficient Glucose Biosensor is the combination of a glucose-sensitive hydrogel and a miniature pressure sensor. Glucose-responsive hydrogels are biocompatible materials that either swell or contract when the glucose concentrations change in the body fluid surrounding the hydrogel.

The PreciSense System includes a microcapsule placement unit and a light detecting non-invasive reader unit. The microcapsule placement unit poses the right dose of glucose-responding microcapsules in the upper layer of the skin, painlessly. The glucose assay components in the microcapsules generate a fluorescence signal that corresponds to the glucose level. The non-invasive reader unit monitors this glucose binding event through FRET, Fluorescence Resonance Energy Transfer, which is directly related to the concentration of glucose.

Sensors for Medicine and Science glucose sensor is implanted under the skin in a short outpatient procedure. The sensor automatically measures interstitial glucose every few minutes, without any user intervention. The sensor implant will communicate wirelessly with a small external reader.

Synthetic Blood Implanted Glucose Biosensor claims to offer significantly more accurate glucose readings in a range of 30-500 mg/dl. The implanted Glucose Biosensor continuously monitors blood glucose without the need for finger sticks. The most accurate glucose monitor available, the implanted biosensor can be programmed to monitor blood glucose according to a predetermined schedule, thus eliminating problems of patient compliance. The sensor alarms for dangerous, life threatening conditions such as hypoglycemia.

GlucoLight Corporation is developing a low-cost non-invasive blood glucose monitor for home use by diabetic patents. GlucoLight's unique optical approach, microScatterTM (microscatter) technology, is based on patented technologies in the area of Optical Coherence Tomography (OCT) and Low Coherence Interferometry (LCI). There is a working prototype with published clinical data on healthy volunteers.

The GlucoWatch G2 Biographer was approved to detect glucose level trends and track patterns in people with diabetes. It must be used along with conventional blood glucose monitoring of blood samples. The device, which looks like a wristwatch, pulls body fluid from the skin using small electric currents. It can provide six measurements per hour for 13 hours. (See David Mendosa's review).

DexCom has developed a continuous glucose monitoring ("CGM") system that could be the next generation of aggressive control. The DexCom GCM is a device that measures glucose trends throughout the day, providing up to 288 glucose measurements every 24 hours.

A traditional glucose monitoring test -like finger sticks - leave gaps in time where you are uncertain as to your blood sugar reading. Continuous monitoring is different from traditional blood glucose monitoring because it affords a comprehensive picture of where your blood sugars are throughout the day and night. The trend reveals times throughout the day where your sugar may increase or decrease, as well as how fast it is happening. This trend information together with the glucose value shows you patterns and problems that traditional finger sticks cannot cover as thoroughly. CGM allows you to set a target range for your desired glucose. When your glucose goes above or below this range, an alert automatically lets you know.

A 2006 study showed that people who used this device were able to achieve a 23% decrease in time spent high and a 21% decrease in time spent low. After speaking with Dianne on the DexCom customer support line - she advised me that they are offering a $375 startup kit that has everything you need to get going. The Rechargeable STS Receiver has a sleek rounded design that can easily be carried with the carry case on both your belt or in a handbag. The STS Transmitter is lightweight and fits comfortably underneath clothing. The STS Sensor & Applicator is easy to insert and safe to use with no visible needles or exposed sharps. With this wireless system, no cables or wires will get in your way allowing you to Take Control and Live Uninterrupted.. Each sensor lasts for 3 days. A set of 5 sensors costs $175 and will last you approximately 15 days.

The annual cost of continuous glucose monitoring averages a ballpark figure of $4,258. Okay, sounds a little steep - but lean on Uncle Sam to offset the cost of the best control. Sounds like it might be time to open up a Flexible Spending Account and write-off the yearning for glucose precision.