You have in all probability seen him sporting a small gadget on his higher arm in lots of images on this web site. That is my steady glucose monitor (CGM) and a device that helps me with my each day diabetes administration.
It is an awesome tools and I completely find it irresistible (principally).
What’s CGM?
The CGM gadget lets you view glucose measurements (virtually) in actual time and monitor historic glucose knowledge.
Most CGMs include three important parts:
- A small sensor inserted just under the pores and skin (studying glucose ranges in interstitial fluids, or fluids between somatic cells)
- The connected transmitter (that is what seems on my arm) sends the measurements to the receiving gadget
- Receiver or smartphone that shows measurements and glucose pattern knowledge
At the moment, there are a number of CGM programs that you should use personally within the US.
My expertise with CGM
I acquired my first Medtronic CGM in December 2012 and wore it day-after-day for 18 months earlier than taking a break. I then ordered my first Dexcom system in August 2016.
Each CGM system has its benefits and downsides. I’ve solely worn Medtronic and Dexcom units up to now, so I am going to give my opinions based mostly on them in order that I can decide whether or not CGM will assist you to handle your diabetes.
Advantages of CGM
knowledge
For those who do a blood sugar test in your fingersticks and know your physique properly, you will suppose there is a fairly good thought of what sugar is doing in between measurements. However the chance that you just is perhaps flawed is sweet.
I used to be an enormous shock once I started to see how a lot my blood sugar ranges really modified, to not point out the nights I usually do not test.
CGM is a vital device for offering such a ongoing info over a 24-hour interval, versus snapshots of particular occasions in the course of the day offered by conventional monitoring.
Abruptly, I used to be capable of see how sure meals and actions affected glucose ranges over the following few hours. That info is golden!
Moreover, with the ability to discover low sugar earlier than successful (because of alerts you set when sugar ranges begin to drop or whenever you attain a sure level) really diminished the frequency of hypoglycemic episodes.
Additionally they catch the much less interventions wanted to return blood sugar to the goal vary, so there are fewer glucose tablets and fewer juices to cope with its low ranges of low glucose tablets.
administration
So, what ought to we do with all this new info? In my case, it helped me restrict the episodes of hypoglycemia (hypoglycemia), but it surely additionally helped me cut back my A1C ranges (a measure of glucose management over the previous 2-3 months) to about 6.0%.
My blood sugar stage is at all times pretty properly regulated, but it surely has by no means been as secure as ever.
Moreover, some present CGM units will be built-in with insulin pumps, permitting for simultaneous monitoring of each glucose and insulin ranges.
Moreover, sure units mix CGM and insulin pump know-how with an algorithm that routinely adjusts insulin administration, which helps preserve glucose inside goal vary (optimum ranges decided by a human healthcare supplier), in an innovation referred to as hybrid closed loop (HCL) know-how.
The present HCL units in the marketplace are:
After all, simply hitting CGM won’t management diabetes. Nevertheless, cautious interpretation and use of the info is extraordinarily useful.
For instance, for those who sleep at 8am earlier than taking morning insulin, you’ve got discovered to battle high-morning blood sugar ranges till midday.
I additionally discovered what actions will shortly drop my sugar (in my case it is strolling), and that I would like my true stage of insulin sensitivity all through the day and not less than half of the lively insulin (IOB) always earlier than coaching.
This information took time and concerned some missteps, but it surely was life, and it was studying. This info permits for optimizing coaching and makes it simpler to remain inside the desired vary of 90-144 mg/dL (5.0-8.0 mmol/L) throughout train.
Confidence and safety
My CGM has helped me to raised perceive diabetes. It has given me extra confidence in the best way I handle my situation and helped me obtain concrete outcomes.
It is also good to know the way my sugar ranges are typically. I generally journey with out bringing all my diabetic gear. Additionally, I finished monitoring 10-12 occasions a day as a result of I do not want it anymore. Info is at all times on the display in entrance of you.
Utilizing this gadget allowed me to go for walks and hardcore gymnasium classes with out worry of the bottom doable value, and I used to be capable of effectively attain each my health and diabetic well being targets.
Cons of CGM
Accuracy
Anybody who has worn CGM is aware of they’re sad with doing conventional finger staining checks and ensuring the sensor studying is off.
The explanation behind that is that the know-how is just not but excellent (though it’s continuously enhancing), so sensors measure glucose ranges in interstitial fluids, not blood. (There’s often a couple of minutes delay between interstitial glucose ranges and blood glucose ranges)
Apart from apparent points, it’s utterly harmful for those who rely solely on sensor measurements and utterly ignore what your physique is telling you. For instance, in case you are telling a CGM alarm to be 250 mg/dl (13.9 mmol/l), it’s tough to not reply instantly.
I additionally needed to cease coaching as a result of the sensor incorrectly mentioned my blood sugar was both low or about to go low.
Whereas some CGM units are at present extremely correct and are accepted by the US Meals and Drug Administration (FDA) to make remedy selections, it’s at all times smart to test for sudden readings and readings that don’t match what your physique is feeling with a conventional finger stick earlier than taking motion.
(And a few units in the marketplace, together with the Medtronic Guardian and Ascensia Eversense E3, require roughly two finger staining checks per day for calibration.)
That mentioned, it’s price noting that the know-how has been considerably improved through the years. A 2023 survey confirmed that CGM was 96.5% correct in real-world hospital settings.
Overdependence
That is really the principle motive I initially stopped sporting CGM and why I take breaks every so often.
This may occasionally not apply to everybody, however I are inclined to depend on measurements and proposals a little bit closely. For instance, if studying says my glucose is dropping shortly, I utterly belief it in how I really really feel. In the case of diabetes administration, I believe that is a giant no-no. On this situation, it’s smart to test CGM info with fingerstick checks.
I’ve made administration companions a significantly better associate, not essentially as an entire fact, however quite a significantly better associate.
inconvenience
Having the CGM sensor connected to my physique on a regular basis will be extraordinarily annoying. It isn’t that large and may depart a tan mark that individuals actually do not discover, however quite unattractive. I additionally are inclined to get harm simply.
When worn on the abdomen, it tends to get in the best way when exercising, so it often wears in your higher arm. I get a reasonably good learn with that association. (One drawback although is that it’s kind of tough to show off a sweaty sports activities bra with out ripping the sensor.)
Sporting it on my higher arm has created some fairly cool interactions and conversations with curiosity and thriving individuals. I do not care – I believe it is a chance to teach and advocate for it.
But when that bothers you, there are many different areas the place you place the sensor the place it’s invisible. Typical producer suggestions for sensor placement embrace higher arms, abdomen, hips, thighs and however relying on the actual gadget you might be utilizing.
There are adhesives that assist to reinforce CGM’s physique compliance. See the directions that include your CGM and discuss to your diabetes care supplier concerning the method that may give you the results you want.
On associated subjects, many individuals surprise if CGM hurts. In my expertise, once I insert the sensor, I solely get a slight boring feeling. This instantaneous discomfort is definitely worth the knowledge your gadget affords.
Moreover, for units at present in the marketplace, the sensors should be modified each 7-15 days (apart from the embedded Eversense E3, which often requires that the healthcare supplier change each 90-180 days).
Associated: Beneath is an outline of my greatest CGM suggestions that may clarify intimately easy methods to placed on the sensor (in video) and easy methods to hold it.
value
Relying in your medical health insurance, CGM units and their related provide will be costly. Verify along with your insurance coverage supplier to see what prices related along with your CGM.
Last Ideas
Do you suggest CGM to individuals with diabetes utilizing insulin? The reply is sure, not less than till you perceive your physique and your diabetes higher.
CGM supplies you with data about diabetes you’ve got by no means had earlier than. If after a when you really feel you do not want it anymore, discuss to your diabetes care supplier about different choices.
The important thing when utilizing my CGM is to make it higher to take heed to each my CGM and my physique. It is an awesome gadget, but it surely’s not an alternative choice to my very own ideas and experiences.
It is the proper device to be present in my diabetes toolbox, but it surely can not stand it by itself.
