You have in all probability seen him carrying 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 amazing gear and I completely find it irresistible (largely).
What’s CGM?
The CGM machine permits you to view glucose measurements (virtually) in actual time and monitor historic glucose information.
Most CGMs include three essential parts:
- A small sensor inserted just under the pores and skin (studying glucose ranges in interstitial fluids, or fluids between somatic cells)
- The hooked up transmitter (that is what seems on my arm) sends the measurements to the receiving machine
- Receiver or smartphone that shows measurements and glucose development information
Presently, there are a number of CGM methods that you need to use personally within the US.
My expertise with CGM
I bought 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.
Each CGM system has its benefits and drawbacks. I’ve solely worn Medtronic and Dexcom units to this point, so I am going to give my opinions based mostly on them in order that I can decide whether or not CGM will show you how to handle your diabetes.
Advantages of CGM
information
In the event you do a blood sugar examine in your fingersticks and know your physique nicely, you will assume there is a fairly good thought of what sugar is doing in between measurements. However the chance that you just is likely to be unsuitable is nice.
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 any such ongoing data over a 24-hour interval, versus snapshots of particular occasions through the day supplied 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 data is golden!
Moreover, having the ability to discover low sugar earlier than a success (because of alerts you set when sugar ranges begin to drop or whenever you attain a sure level) really decreased 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 take care of its low ranges of low glucose tablets.
administration
So, what ought to we do with all this new data? 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 nicely regulated, but it surely has by no means been as steady as ever.
Moreover, some present CGM units may be built-in with insulin pumps, permitting for simultaneous monitoring of each glucose and insulin ranges.
Moreover, sure units mix CGM and insulin pump expertise 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 referred to as hybrid closed loop (HCL) expertise.
The present HCL units available on the market are:
After all, simply hitting CGM won’t management diabetes. Nonetheless, cautious interpretation and use of the info is extraordinarily useful.
For instance, in the event you sleep at 8am earlier than taking morning insulin, you have realized to combat high-morning blood sugar ranges till midday.
I additionally realized 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 a minimum of half of the energetic insulin (IOB) always earlier than coaching.
This information took time and concerned some missteps, but it surely was life, and it was studying. This data 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 usually. I generally journey with out bringing all my diabetic gear. Additionally, I ended monitoring 10-12 occasions a day as a result of I do not want it anymore. Data is at all times on the display in entrance of you.
Utilizing this machine allowed me to go for walks and hardcore fitness center classes with out concern of the bottom potential worth, and I used to be in a position to effectively attain each my health and diabetic well being objectives.
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 expertise will not be but good (though it’s continually 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)
Except for apparent points, it’s fully harmful in the event you rely solely on sensor measurements and fully 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 units are at the moment extremely correct and are authorised by the US Meals and Drug Administration (FDA) to make therapy choices, it’s at all times sensible 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 units available on the market, 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 expertise 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 primary motive I initially stopped carrying 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 suggestions just a little closely. For instance, if studying says my glucose is dropping shortly, I fully belief it in how I really really feel. In relation to diabetes administration, I believe that is an enormous no-no. On this state of affairs, it’s sensible to examine CGM data with fingerstick checks.
I’ve made administration companions a significantly better companion, not essentially as an entire fact, however relatively a significantly better companion.
inconvenience
Having the CGM sensor hooked up to my physique on a regular basis may be extraordinarily annoying. It is not that massive and may go away a tan mark that individuals actually do not discover, however relatively unattractive. I additionally are likely to get damage 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 fairly good learn with that association. (One downside although is that it’s kind of troublesome to show off a sweaty sports activities bra with out ripping the sensor.)
Carrying it on my higher arm has created some fairly cool interactions and conversations with curiosity and thriving folks. I do not care – I believe 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 embody higher arms, abdomen, hips, thighs and however relying on the actual machine you might be utilizing.
There are adhesives that assist to boost CGM’s physique compliance. See the directions that include your CGM and discuss to your diabetes care supplier concerning the strategy that may be just right for you.
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 definitely worth the information your machine provides.
Moreover, for units at the moment available on the market, 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 ideas that may clarify intimately how you can placed on the sensor (in video) and how you can maintain it.
worth
Relying in your medical health insurance, CGM units and their related provide may be costly. Examine together with your insurance coverage supplier to see what prices related together with your CGM.
Last Ideas
Do you suggest CGM to folks with diabetes utilizing insulin? The reply is sure, a minimum of till you perceive your physique and your diabetes higher.
CGM gives you with information about diabetes you have by no means had earlier than. If after a whilst 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 amazing machine, but it surely’s not an alternative choice to my very own ideas and experiences.
It is the right device to be present in my diabetes toolbox, but it surely can’t stand it by itself.
