Beware of buying online noninvasive continuous glucose monitoring devices: danger is just around the corner!

Excerpt

Since the introduction into clinical practice of glucometer for self-monitoring, technological devices have had enormous evolution, becoming faster and smaller with consequent higher patient’s acceptability, and showed increasing accuracy. Furthermore, the most important revolution in this field was represented by the introduction on 2000 of devices for continuous or on-demand subcutaneous glucose monitoring (CGM). CGM can measure automatically and frequently the glucose concentration in the interstitial fluid avoiding to patients pain and inconvenience of finger pricks [1]. The mini-invasiveness, convenience and duration of these sensors explain why in short time they have almost replaced capillary monitoring in both type 1 and insulin-treated type 2 patients, becoming an invaluable ally for both the patient and for the clinician. Evidence also supports their use for educational purposes, allowing the patient to observe glucose fluctuations in real time and correlate them with lifestyle aspects, otherwise hardly observed [2]. However, some disadvantages of CGM devices have to be taken into account: (1) the need for insertion using a guide needle with potential local irritation and haematomas, (2) skin reactions linked to allergy to the glue, (3) the lag time between the interstitial compartment in which the glucose is measured versus blood sugar (which can be considerable in some circumstances in which blood sugar is rapidly changing or in some particular settings such as the patient in intensive care), (4) a huge quantity of consumable material constituting plastic waste. Researches on novel noninvasive painless glucose monitor devices using alternative body fluid such as saliva, sweat and tears, which could at least partially solve the critical points of current CGMs, are promising, but still requires further development in order to substantially improve the accuracy before it could be used [3, 4]. Despite the lack of necessary requirements for routine clinical use, new devices have anyway appeared on the market. These devices offer to eliminate completely the invasiveness of the needle and other inconveniences with CGM. However, their analytical and clinical accuracy is neither declared nor certified, thus representing a potentially dangerous smokescreen, as we illustrate in this case report. …