If you have diabetes, it can be mentally taxing to remember to check your blood sugar several times a day. Then there’s the worry of whether or not your numbers are going up or down at any given time. That’s where a continuous glucose monitor, or CGM, can come in handy.
More and more people with diabetes are using CGMs, particularly those with Type 1 diabetes who use an insulin pump or multiple injections of insulin daily, says registered nurse and certified diabetes educator Linda Parks, director of clinical development and research for Glooko in Mountain View, California.
“It gives the user an understanding of their glucose levels at any given time, including the direction their glucose levels are heading,” Parks says. If you wear a CGM and your blood sugar is heading dangerously low or high — in other words, hypoglycemia or hyperglycemia — the CGM will alert you with beeps so you can take action accordingly. Little arrows pointing up or down can indicate trends in your blood sugar readings.
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“A CGM can give you and your health care team a more complete look at your diabetes. It helps you fine tune,” says certified diabetes educator Anna Simos, a diabetes education and prevention program manager at Stanford Health Care in Stanford, California. You’ll be able to see how your blood sugar changes after eating specific foods or after certain kinds of exercise. Just knowing you have the monitor on often forces you to make better health choices, Simos has observed.
How does a CGM work? “A small electrode or ‘glucose sensor’ is inserted under the skin to measure glucose levels in tissue fluid,” says pharmacist Norman P. Tomaka, a media liaison for the American Pharmacists Association in Melbourne, Florida. “It is connected to a transmitter that sends the information via wireless radio frequency to a monitoring and display device.” The sensor is most commonly attached to the abdomen, and the transmitter can be placed under your clothing, in a pocket or attached to a belt. The transmitter is about the size of a credit card, although it’s thicker than that.
In addition to someone with Type 1 diabetes, another ideal patient for a CGM is someone who tends to have glucose readings with very abnormally high or low values but no symptoms, Tomaka says. The devices are also handy for women with gestational diabetes, who must keep their blood sugar numbers under tight control, Simos says.
Although health insurance coverage for CGMs varies, the devices often are covered for someone who takes insulin or who has a lot of variability in their blood sugar, Parks says. Coverage is also common for a child with unpredictable blood sugar lows and highs. Medicare, the government insurance program for those over age 65, does not yet cover CGMs, but diabetes experts interviewed for this story believe it will eventually.
Parks would like to see the devices covered more frequently. “It’s a great device for both treating diabetes as well as preventing high-cost care, such as ER visits for high or low blood sugars,” she says.
There are also CGMs that a doctor’s office can use temporarily with a patient to see if adjustments are needed in that person’s treatment plan.
[See: Got Diabetes? Why You Must Protect Your Feet.]
Research studies show that patients with CGMs experience better quality of life and can better manage their blood sugar. Lucille Hughes, a certified diabetes educator and director of diabetes education at South Nassau Communities Hospital in Oceanside, New York, has seen patients who previously stayed at home frequently now feel confident going out more because their CGM has given them a better understanding of their blood sugar trends at any given time.
As helpful as CGMs are, there are a few drawbacks to consider, diabetes experts say:
— The monitor is always on your body (unless you remove it), so there’s more “stuff” to keep track of, maintain and purchase, Parks says.
— You still have to check your blood sugar. So much for getting rid of those daily skin pokes, right? The act of checking your blood sugar with a traditional device helps the CGM to calibrate properly. “A CGM is used in addition to finger sticks and is not a complete replacement,” Tomaka says. You’ll enter your blood sugar reading into the device so it can adjust and process your blood sugar readings accurately.
— Your skin may have an allergic reaction to the adhesives used to hold it in place.
— Some users get annoyed by the beeps from the device and feel technical overload.
— The monitors can be excellent for children, but you’ll want to think about the impact it has on their routine and social life to wear it all the time.
— Without insurance, it can be expensive to maintain — to the tune of $400 to $500 a month, Simos says.
Of course, the device is only as good as your decision to take action on its findings. In other words, if your CGM alerts you to a lower or higher than normal blood sugar and you don’t act on it, you could still experience effects on your health, Simos says.
Here are a few tips to better manage your use of a continuous glucose monitor:
Use technology to your advantage. Connect your CGM data to a diabetes management app to help track insulin, other medications, diet, exercise and other information, Parks advises. “This will help [patients] to help understand the impact of their daily decisions and the medication doses,” she says.
Work with your care team to get a full understanding of the technology. Certified diabetes educators, nurses and pharmacists are great resources for this. “Be educated to use it to its fullest potential,” Hughes recommends. If you use an insulin pump and you’re concerned about having another device on your body and where to place it, that’s another good reason to consult a health educator like the ones previously mentioned. “We’ll help you find uncharted territory,” Hughes says.
[See: The 12 Best Diets to Prevent and Manage Diabetes.]
Make a commitment to better blood sugar control with the help of your CGM. Still, don’t overreact — or underreact — to a few off readings, Tomaka cautions.
Don’t rely on your readings if they seem off. “If you feel great and the numbers say 500 or 30, check your blood sugar,” Simos advises. “The monitors are great tools, but they’re not infallible.” And other factors, such as use of certain medications, can affect the readings you’ll get.
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What Is a Continuous Glucose Monitoring Device — and Can It Help Me? originally appeared on usnews.com
