Newswise — Every person with diabetes knows that they can make themselves crazy self-testing their blood glucose levels. Continuous glucose monitors (CGMs) are an important tool that can make daily diabetes management a lot easier.
Originally designed for people with type 1 diabetes, CGMs track the amount of glucose in body fluid throughout the entire day. Composed of a sensor and a receiver, these devices reveal how invisible factors — such as exercise, stress, certain foods and sleep — impact blood glucose. Today, with rapidly changing technology, CGM use is becoming more common, including people with type 2 diabetes.
In the past, one of the main barriers to CGM use was that people thought the technology was too difficult to use. But today, CGMs have gotten much more user-friendly. “Even my patients in their 70s are doing a great job of using these devices,” says Elena Toschi, MD, Staff Physician in the Adult Diabetes Center at Joslin Diabetes Center.
The benefit? Better diabetes management.
Who should use a CGM?
CGMs are recommended for all people with type 1 diabetes, those who have hypoglycemia or hypoglycemia unawareness, and those who are not able to achieve an A1c below 7 percent. The device lets you see what your levels actually are, allowing for more accurate insulin adjustments.
“CGMs have an alarm, which will let you know if your blood glucose level is high, but more importantly, they can tell you if you blood sugar is dangerously low,” says Dr. Toschi. “Many people with type 1 develop hypoglycemia unawareness, meaning that they don’t have symptoms until they lose consciousness.”
In people with type 2 diabetes, specifically those who take multiple daily insulin injections, have unexplained highs or lows, or have hypoglycemia unawareness, CGMs may be recommended. Today, newer devices are becoming smaller and more accurate. For example, a new Dexcom G6 CGM was developed and launched in the summer of 2018. It doesn’t need finger sticks or interfere with Tylenol.
For women with gestational diabetes, a CGM is an important tool for keeping blood glucose in check. Pregnant women need to have very tight control and the CGM provides real-time feedback on different types of foods, helping mothers-to-be figure out what foods result in a poor glucose profile.
Here are a few things to consider before deciding if a CGM is right for you:
Privacy. While you can travel and swim with the device, some people do not like to wear any technology on their body, even if it’s not bulky or inconvenient. “The device may highlight the fact that you have diabetes, when you want to keep your condition private,” says Dr. Toschi. “It’s really about personal preference.”
Convenience. “Some people do not like being engaged with data constantly and may be overwhelmed by that,” says Dr. Toschi. “Getting data feedback every five minutes, 24/7 may raise anxiety and stress about diabetes management, making its use counterproductive.”
Affordability. Expanded Medicare coverage means that people with type 2 diabetes on intensive insulin therapy may be covered for a CGM. “And for people with type 2 diabetes whose insurance does not cover one, there are models on the market that are much more affordable,” says Dr. Toschi. Either way, you still need to factor in any out-of-pocket expenses and ongoing costs of the system such as supplies (the sensors and dressings to cover sensors).
To make the best decision for you, talk to your physician or certified diabetes educator.
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