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.

British researchers have found that tight glucose control during hospitalization for a stroke may not improve survival.

The study involved 933 patients enrolled within 24 hours of a stroke who had glucose in the range of 6.0 to 17 mmol/l. Participants received saline solution or continuous glucose, potassium, insulin infusions to reduce their blood glucose. Patients were monitored every two hours with glucose adjusted if needed every eight hours. The researchers found that both treatment and placebo groups had improvement in glucose levels. The treatment group had an overall mean 0.57 mmol/l reduction in glucose over 24 hours while glucose levels also fell spontaneously with simple saline hydration. There was also no difference in the secondary outcome of disability. There was a significant reduction in systolic blood pressure in the treatment group. A researcher noted, "In the majority of patients, treatment with a simple saline infusion will correct mild to moderate hyperglycemia."

The saline and glucose relationship is similar to the way the noninvasive glucose monitors measure blood sugar (aka Glucowatch)., This relationship between sodium and glucose in the blood moves inverse. When your sugar levels are elevated, your sodium is down. When you force sodium into your blood, your sugar is suppressed. Doctors must proceed with caution in light of this study. When it comes to aggressively lowering glucose, especially after a trauma, it could be more harmful than helpful.

Solianis Holding AG is a Swiss Medical device company developing a non-invasive, continuous glucose monitoring device for diabetic patients. This prototype was inspired by the realization that diabetics need a way to more effectively manage their blood glucose throughout the day, without the bloodshed. Mario Stark is revitalizing a concept in diabetes control that many have tried and few have succeeded.

The design of Solianis' non-invasive device includes monitoring as often as once a minute. Although there have been previous generations of non-invasive continuous glucose monitoring devices, they have been more adequately deemed minimally invasive. Even the Glucowatch extracted fluid from the skin, which constitutes it being minimally invasive. Perhaps the failure of true success has been due to the technology chosen not being adequate to measure glucose throughout the day in a variety of circumstances. The Solianis device is truly non-invasive. Solianis realizes the real issue is to develop a non-invasive glucose monitor that works under daily life conditions, uninterrupted. Under these conditions a lot of things happen. Factors that can affect the glucose measure include: changes in blood flow, micro-vascular circulation, sweat, the humidity and temperature fluctuations, and the thickness of the skin. All these physiological changes induce changes in the sensor that may affect the measurement of glucose. Solianis has developed a multi-sensor approach that will measure these perturbing factors and include them into the calculation of glucose for more accuracy than previous non-invasive glucose monitoring sensors.

If somebody could please bring a device like this to fruition that will accurately, continuously and conveniently measure the fluctuations in blood sugar without drawing blood - that somebody will mitigate the frustration of millions of diabetics. If that somebody happens to enjoy investing - I'd venture to say this is a potential ten bagger. A biomedical position like this in your portfolio is worth its weight in the convenience it will give diabetics. Now I'm going to sound like Jim Cramer -- I don't own the stock, but I will own the device for my charitable trust: ME!

Blood sugar testing is part of the daily grind when it comes to diabetes management. Albeit important, it is also the main frustration of my diabetic control. Yes, it only takes all of thirty seconds, start to finish. But I tend to think, each and every time, that's thirty seconds I'll never get back. And then I do the mental math for recreational torture: 4 tests a day, 30 seconds each, 365 days a year, 20 years...you get the idea. I'd like to review two options that might offer some remedy from the inconvenience of glucose testing: the glucowatch, and the artificial pancreas.

The glucowatch is intended for detecting trends and tracking patterns in glucose levels in adults and children with diabetes. It's available by prescription, only. The site disclaims, The G2 Biographer is intended to supplement, not replace, conventional blood glucose monitoring. Several years ago I journeyed west into NYC to guinea pig myself in the clinical testing of the watch. Does anybody use this thing?

The artificial pancreas is a man-made organ that has three parts, all of which have to work perfectly in synch: a sensor that continually monitors blood or tissue sugar levels, an insulin infusion pump, and a computer algorithm that controls the delivery of insulin minute by minute based on measured blood sugar. The brilliance of artificial intelligence might be our remedy while we patiently await the cure.

If anybody knows of other options to mitigate the annoyance of blood glucose testing-blog it back!