Diabetes Nurse Educator and Nurse Clinician, Ms Lim Pei Kwee, guides a paediatric patient on obtaining a glucose level reading using the flash glucose monitoring system.

Self-monitoring of blood glucose is essential for people living with diabetes to manage their condition and remain healthy. Leveraging on technological advances in glucose monitoring, KK Women's and Children's Hospital (KKH) has started to incorporate a flash glucose monitoring system (FGMS) to help children with diabetes monitor their glucose levels in a more convenient and painless way.

Approved by the Health Sciences Authority for use in Singapore since mid-2017, the FGMS comprises a small, flat, circular sensor which is discreetly inserted in the upper arm for up to two weeks and an electronic reader which is light, pocket-size and portable. Once the sensor is inserted, it continuously measures and records the glucose level in the interstitial fluid under the skin of the arm.

​The flash glucose monitoring system, comprising a sensor (left) which is worn on the arm, and portable electronic reader (right).

The patient and caregivers can wave the reader over the sensor at any time to obtain a reading of their prevailing glucose level, as well as a chart of their recent glucose levels, displayed on the screen of the reader.

“Patients with diabetes typically need to monitor their blood glucose levels using the finger-prick test at least four times a day. The FGMS is a useful adjuvant to finger-prick blood glucose testing, as it can keep track of glucose readings more frequently round-the-clock in between the finger-prick blood tests,” shares Diabetes Nurse Educator Ms Hui Yuen Ching Angela, Nurse Clinician, Division of Nursing, KKH.

The ambulatory glucose profile that is displayed on the reader enables patients to conveniently observe in real-time the changes and fluctuations in their glucose levels on a daily basis. “Using this glucose monitoring technology, patients can respond faster to fluctuations in their glucose levels through well-timed insulin doses and food intake to keep their glucose levels within a healthy range,” explains Ms Hui.

Managing diabetes better with individualised ambulatory glucose profile

Since July 2017, the Endocrinology Service team has been guiding paediatric patients with diabetes and their caregivers to make full use of the FGMS' capabilities to manage their diabetes better.

“Over six months, more than 70 paediatric patients and their caregivers have learnt how to use the FGMS technology and review their daily glucose readings and profile,” adds Diabetes Nurse Educator Ms Lim Pei Kwee, Nurse Clinician, Division of Nursing, KKH.

“We have also found that children and their caregivers are now more motivated to self-monitor their glucose levels due to the convenience and painlessness that the FGMS provides.”

The reader also stores a patient’s glucose readings for up to three months. Detailed reports of the stored glucose readings can be generated retrospectively by downloading the data from the reader to a computer via a USB cable.

Using reports of individual patient’s unique ambulatory glucose profile, the KKH Diabetes Nurse Educators are able to provide targeted advice to patients on fi ne-tuning their dietary choices, meal times and lifestyle activities, as well their insulin treatment, to achieve optimal diabetes management.

“We are constantly exploring better and simpler ways for patients to self-monitor their condition, so as to mitigate the risk of developing diabetes-related complications.

“With the introduction of FGMS being one of such ways, we hope to continue to engage and motivate patients in their on-going journey of managing the chronic condition, and remove the barriers towards optimal diabetes management so that they can experience an active and fulfilling life,” adds Ms Lim.