You might have seen me sporting a small machine on my higher arm in most of the images on this web site. That is my Steady Glucose Monitor (CGM), a software that helps me handle my diabetes on daily basis.
It is an important piece of apparatus and (for probably the most half) I actually prefer it.
What’s CGM?
With a CGM machine, you may see your blood sugar readings in (close to) actual time and monitor historic blood sugar information.
Most CGMs embody three fundamental elements:
- A small sensor inserted just below the pores and skin (the place it reads blood sugar ranges in interstitial fluid, or the fluid between physique cells)
- An connected transmitter (that is the half on my arm) sends measurements to a receiving machine.
- Receiver or smartphone that shows readings and blood glucose pattern information
There are at present a number of CGM programs accessible for private use in america.
My expertise with CGM
I received my first Medtronic CGM in December 2012 and wore it on daily basis for 18 months earlier than taking a break. I then ordered my first Dexcom system in August 2016 and it has been my go-to ever since.
All CGM programs have benefits and downsides. I’ve solely ever worn Medtronic and Dexcom units, so I will give my opinion based mostly on these so you may determine if CGM might help you handle your diabetes higher.
Benefits of CGM
information
If you happen to measure your blood sugar together with your finger and know your physique nicely, you’d most likely suppose you’ve a fairly good understanding of blood sugar ranges between measurements. Nonetheless, there is a good probability you are incorrect.
I used to be in for a giant shock once I began seeing how a lot my blood sugar ranges truly modified all through the day, not to mention through the evening, once I do not normally test them.
CGM is a vital software that gives this kind of steady info exhibiting developments and patterns over a 24-hour interval, versus snapshots at particular occasions of the day offered by conventional monitoring.
All of a sudden, you may see how sure meals and actions have an effect on your blood sugar ranges over a interval of a number of hours. That info is golden!
Plus, now that I can catch hypoglycemia earlier than it occurs (because of alerts I set for when my blood sugar begins to drop or reaches a sure level), it actually reduces the frequency of hypoglycemia.
It additionally means fewer glucose tablets and juices are taken to cope with low blood sugar ranges, as fewer interventions are wanted to carry blood sugar ranges again into the goal vary.
administration
So what do I do with all this new info? In my case, it not solely helped me cut back my possibilities of growing hypoglycemia (low blood sugar), however it additionally lowered my A1c degree (a measure of blood sugar management over the previous 2-3 months) to about 6.0%.
My blood sugar ranges have at all times been nicely regulated, however by no means earlier than have they been this secure.
Moreover, a few of in the present day’s CGM units might be built-in with insulin pumps, permitting each glucose and insulin ranges to be monitored concurrently.
Sure units additionally mix CGM and insulin pump expertise with algorithms that robotically modify insulin doses to maintain blood sugar ranges inside the goal vary (optimum ranges decided by your healthcare supplier) in an innovation generally known as hybrid closed-loop (HCL) expertise.
HCL units at present in the marketplace embody:
In fact, diabetes cannot be managed by merely hitting the CGM. Nonetheless, cautious interpretation and use of knowledge might be very useful.
For instance, I’ve discovered that if I am going to mattress after 8 a.m. earlier than my morning insulin dose, I will be battling excessive blood sugar ranges within the morning till not less than midday.
I additionally realized what actions decrease my blood sugar sooner (in my case, strolling), my precise insulin sensitivity degree all through the day, and that I at all times want not less than 0.5 items of energetic insulin onboard (IOB) earlier than coaching.
It took time and a few errors to realize this data, however that is life and studying. This info allowed me to optimize my coaching and made it simpler to take care of my desired vary of 90-144 mg/dL (5.0-8.0 mmol/L) throughout train.
Belief and peace of thoughts
CGM has helped me perceive extra about my diabetes. It has given me confidence in methods to handle my situation and helped me obtain seen outcomes.
It is also reassuring to know the developments in your blood sugar ranges. Typically you go on an journey with out taking all of your diabetes gear with you. I additionally stopped monitoring them 10-12 occasions a day. As a result of there isn’t any longer a necessity for that. Info is at all times displayed on the display screen in entrance of you.
With this machine, now you can go for a stroll or a severe health club session with out worry of low strain, serving to you attain each your health and diabetic well being targets extra effectively.
Disadvantages of CGM
accuracy
Anybody who has ever worn a CGM is aware of how irritating it may be to carry out a standard finger prick test and discover that the sensor studying is off.
The rationale behind that is that the expertise just isn’t but good (though it’s enhancing on a regular basis) and the sensor measures blood sugar ranges in interstitial fluid reasonably than blood. (Sometimes there’s a lag of a number of minutes between interstitial blood glucose and blood glucose ranges)
Other than the plain issues, relying solely on sensor readings and utterly ignoring your physique’s alerts might be downright harmful. For instance, in case your CGM alarm sounds indicating a focus of 250 mg/dL (13.9 mmol/L), it may be tough to not react instantly.
I’ve additionally needed to cease a exercise as a result of the sensor falsely advised me my blood sugar was low or about to drop. It is at all times an annoying state of affairs in the midst of session on the health club.
Though some CGM units at the moment are extremely correct and authorised by the U.S. Meals and Drug Administration (FDA) to find out therapy, it’s at all times sensible to test for sudden readings or readings that do not match your physique’s sensations with a standard finger prick earlier than taking motion.
(Additionally, some units in the marketplace, such because the Medtronic Guardian and Ascensia Eversense E3, require roughly two finger stick checks per day for calibration.)
That being mentioned, it is price noting that expertise has improved considerably over time. A 2023 examine confirmed that the accuracy of CGM in a real-world hospital setting was 96.5%.
overdependence
That is truly the primary cause I ended sporting CGM within the first place, and why I nonetheless take breaks every now and then.
This might not be true for everybody, however I are inclined to rely an excessive amount of on studying and proposals. For instance, if it says my blood sugar is dropping quickly, I will belief that utterly over how I truly really feel. In terms of diabetes administration, I feel that is one thing you must by no means do. On this state of affairs, it’s sensible to tactile the CGM info.
I’ve grow to be significantly better at utilizing CGM as an information level, not essentially the entire fact, and I’ve grow to be a greater accomplice in administration.
inconvenience
Having a CGM sensor in your physique on a regular basis might be very annoying. It is not that massive of a deal, so it is not usually seen, however it might go away behind some unpleasant sunburn marks. I additionally are inclined to get scratched simply.
I normally put on it on my higher arm as a result of it tends to get in the way in which once I train if I put on it on my abdomen. I discovered that this association gave fairly good measurements. (One downside, nevertheless, is that it is somewhat tough to take off a sweaty sports activities bra with out tearing the sensor.)
Carrying this on my higher arm has led to some nice interactions and conversations with curious individuals. I do not care. I see this as a chance to teach and advocate.
Nonetheless, if that bothers you, there are a lot of different locations you may place sensors out of sight. Widespread places beneficial by producers for sensor placement embody the higher arm, stomach, decrease again, thigh, and buttocks, relying on the particular machine you’re utilizing.
There’s an adhesive that helps the CGM adhere to your physique. See the directions that include your CGM and speak to your diabetes care supplier concerning the method that works for you.
On a associated subject, many individuals surprise if CGM might be dangerous. In my expertise, there’s solely a slight tightening sensation when inserting the sensor, and this momentary discomfort is nicely definitely worth the information the machine offers.
Moreover, for units at present in the marketplace, sensors solely have to be changed each 7 to fifteen days (except for the implantable Eversense E3, which healthcare suppliers sometimes want to switch each 90 to 180 days).
Associated: This can be a submit outlining my greatest CGM ideas, with particulars on methods to put on the sensor (with video) and methods to maintain the sensor in place.
worth
Relying in your medical insurance protection, CGM units and associated provides might be costly. Test together with your insurance coverage firm concerning the prices related to CGM.
closing ideas
Would you suggest CGM to a diabetic who makes use of insulin? The reply is a convincing sure, not less than till you perceive your physique and diabetes higher.
CGM offers you with data about diabetes that you’ve by no means skilled earlier than. If after a when you really feel you now not want it, speak to your diabetes care supplier about different choices.
For me, the important thing to utilizing CGM is studying to pay attention higher to each the CGM and my physique. It is an important machine, however it would not exchange my very own ideas and expertise.
This can be a useful gizmo to have in your diabetes toolbox, however it would not work by itself.
