You have most likely seen him sporting a small machine 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 (largely).
What’s CGM?
The CGM machine lets you view glucose measurements (nearly) in actual time and observe historic glucose knowledge.
Most CGMs include three predominant 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 machine
- Receiver or smartphone that shows measurements and glucose development knowledge
Presently, there are a number of CGM programs that you need to use personally within the US.
My expertise with CGM
I obtained my first Medtronic CGM in December 2012 and wore it daily 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 drawbacks. I’ve solely worn Medtronic and Dexcom gadgets to date, so I am going to give my opinions primarily based on them in order that I can decide whether or not CGM will enable you to handle your diabetes.
Advantages of CGM
knowledge
If you happen to do a blood sugar examine in your fingersticks and know your physique effectively, you will assume there is a fairly good thought of what sugar is doing in between measurements. However the chance that you just could be fallacious 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 examine.
CGM is a crucial device for offering the sort of ongoing info over a 24-hour interval, versus snapshots of particular instances in the course of the day offered by conventional monitoring.
All of the sudden, I used to be in a position to 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 a success (due to alerts you set when sugar ranges begin to drop or once you attain a sure level) really diminished the frequency of hypoglycemic episodes.
In addition 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), however it additionally helped me scale back my A1C ranges (a measure of glucose management over the previous 2-3 months) to about 6.0%.
My blood sugar stage is all the time pretty effectively regulated, however it has by no means been as secure as ever.
Moreover, some present CGM gadgets will be built-in with insulin pumps, permitting for simultaneous monitoring of each glucose and insulin ranges.
Moreover, sure gadgets mix CGM and insulin pump know-how with an algorithm that mechanically adjusts insulin administration, which helps keep glucose inside goal vary (optimum ranges decided by a human healthcare supplier), in an innovation often called hybrid closed loop (HCL) know-how.
The present HCL gadgets in the marketplace are:
In fact, simply hitting CGM won’t management diabetes. Nevertheless, cautious interpretation and use of the info is extraordinarily useful.
For instance, if you happen to sleep at 8am earlier than taking morning insulin, you have realized to struggle high-morning blood sugar ranges till midday.
I additionally realized what actions will rapidly 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 energetic insulin (IOB) always earlier than coaching.
This information took time and concerned some missteps, however it was life, and it was studying. This info permits for optimizing coaching and makes it simpler to remain throughout 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 way in which I handle my situation and helped me obtain concrete outcomes.
It is also good to understand how my sugar ranges are usually. I typically journey with out bringing all my diabetic gear. Additionally, I finished monitoring 10-12 instances a day as a result of I do not want it anymore. Info is all the time on the display screen in entrance of you.
Utilizing this machine allowed me to go for walks and hardcore health club periods with out worry of the bottom doable worth, and I used to be in a position to 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 rationale behind that is that the know-how shouldn’t be but excellent (though it’s consistently enhancing), so sensors measure glucose ranges in interstitial fluids, not blood. (There’s normally a couple of minutes delay between interstitial glucose ranges and blood glucose ranges)
Other than apparent points, it’s utterly harmful if you happen to rely solely on sensor measurements and utterly ignore what your physique is telling you. For instance, if you’re telling a CGM alarm to be 250 mg/dl (13.9 mmol/l), it’s troublesome 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 gadgets are at the moment extremely correct and are permitted by the US Meals and Drug Administration (FDA) to make therapy selections, it’s all the time clever to examine for surprising readings and readings that don’t match what your physique is feeling with a conventional finger stick earlier than taking motion.
(And a few gadgets 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 will likely not apply to everybody, however I are likely to depend on measurements and proposals just a little closely. For instance, if studying says my glucose is dropping rapidly, I utterly belief it in how I really really feel. Relating to diabetes administration, I feel that is a giant no-no. On this state of affairs, it’s clever to examine CGM info with fingerstick checks.
I’ve made administration companions a a lot better companion, not essentially as an entire reality, however reasonably a a lot better companion.
inconvenience
Having the CGM sensor connected to my physique on a regular basis will be extraordinarily annoying. It isn’t that massive and might depart a tan mark that folks actually do not discover, however reasonably unattractive. I additionally are likely to get harm simply.
When worn on the abdomen, it tends to get in the way in which throughout exercises, so it normally wears in your higher arm. I get a reasonably good learn with that association. (One drawback although is that it is a bit troublesome 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 feel it is a chance to coach 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 machine you’re 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 in regards to the method that may give you the results you want.
On associated subjects, many individuals marvel if CGM hurts. In my expertise, once I insert the sensor, I solely get a slight boring feeling. This instantaneous discomfort is well worth the knowledge your machine affords.
Moreover, for gadgets at the moment in the marketplace, the sensors should be modified each 7-15 days (aside from the embedded Eversense E3, which normally requires that the healthcare supplier change each 90-180 days).
Associated: Under is an summary of my greatest CGM suggestions that can clarify intimately the right way to placed on the sensor (in video) and the right way to maintain it.
worth
Relying in your medical insurance, CGM gadgets and their related provide will be costly. Examine together with your insurance coverage supplier to see what prices related together with your CGM.
Closing 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 information about diabetes you have 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 hearken to each my CGM and my physique. It is an awesome machine, however it’s not an alternative to my very own ideas and experiences.
It is the right device to be present in my diabetes toolbox, however it can’t stand it by itself.
