Self-monitoring blood sugar levels is one of the seven core behaviors of diabetes management. It’s important, very important.
Blood sugar monitoring offers a wealth of information to the person with diabetes giving them insight regarding how their blood sugar reacts to food, exercise, stress, lack of sleep, illness and really all the everyday stuff that we do. The traditional method is to use a blood glucose meter and lancing device to obtain a droplet of blood, generally from the finger, to check the blood sugar level. It’s a super useful tool for diabetes management.
The Importance of Monitoring Your Blood Sugar
Although there are times when your body will tell you if your readings are above or below target range, often you will have no idea unless you actually check your blood sugar with a device. People with diabetes don’t always experience symptoms of above or below target readings. For someone with diabetes, monitoring blood sugar is a key to diabetes management because it helps guide you about lifestyle decisions to keep your blood sugar in target. The number of blood sugar checks is individualized. Personally, I feel the more the merrier because there are many variables that can affect our blood sugar.
For problem solving, the recommendations are a minimum of twice a day. For instance, if you just check in the morning, this will simply give just the morning reading, but how does your body react to your breakfast after it’s been digested or after a morning walk? Having a before (eating or exercise or stressful situation or sleep) and an after can be helpful. If someone is checking before and after meals to see how their blood sugar reacts to certain meals, the blood sugar check should be done before eating and again two hours after the start of eating.
[READ: What Are the Causes of Diabetes? ]
Continuous Glucose Monitors Benefits
Continuous glucose monitors, or CGMs, have been a game changer in the world of diabetes. CGMs measure interstitial fluid and give you a reading every 5 minutes on the CGM monitor or via an app on your phone. The blood sugar reading is given on the CGM monitor is nearly real time — there’s a 5 to 25-minute lag time behind the actual blood sugar level. So, there is a delay in the actual reading, and it also depends on how fast the blood glucose level is moving. But it sure is helpful to have access to blood sugar readings every 5 minutes without poking your finger each and every time.
The CGM device is typically worn on the arm or stomach area attached with adhesive like a band aid. I say typically because these are the approved areas by FDA at the moment based on where they studied use of the CGM. Nonetheless, there are a lot of people with diabetes who “try the system” and will wear the CGM on other areas of the body.
CGMs were developed to make living with diabetes easier. I’m one of those people with diabetes that believes the more info I have on my readings the better I can trouble shoot. Before my CGM, I checked my blood sugar by poking my finger up to 10 to 12 times per day. So, when we do the math, the 10-day CGM saves me 120 pokes of my finger.
Another big advantage point of the CGM is the ability to see “time in range,” the percentage of time that your blood sugar is within the normal range. This is the new best practice. CGMs offer you information of the percentage of time that your blood sugar is within the normal range. We want our blood sugar to be in range (70-180 mg/dL) at least 70% of the time. A hemoglobin A1C reading, in contrast, doesn’t tell you that fine-tuned information.
There are several CGMs on the market today for people with diabetes: Freestyle Libre; Dexcom; and Senseonic (Eversense). Just a note here, Eversense is different than the others because the sensor needs to be inserted and removed by a health care professional and is worn for 3 or 6 months.
[READ: Best Snacks for Diabetics.]
Are There CGMs for People Without Diabetes?
There are also CGMs that have come to the market for people without diabetes. The question is …. do people who have not been diagnosed with diabetes require a CGM?
People who may have prediabetes or those who are pregnant and on the edge of a gestational diabetes diagnosis, can benefit from knowing how their blood sugar levels are trending. But for people who do not have diabetes, pre-diabetes or approaching gestational diabetes, the information on how your blood sugar is trending may just be knowledge overload without a purpose.
It’s important to know the physiology of blood sugar. People who have not been diagnosed with diabetes will have some modest rises in blood sugar after eating carbohydrates. This is considered normal. It’s that rise that stimulates your release of natural insulin. I can’t emphasize “modest” enough. Yes, there will be a rise, but not to the extent of being out of target range. People without diabetes have blood sugar levels at fasting that are 99 mg/dL or lower and less than 140 mg/dL two hours after eating. In contrast, blood sugar levels in the target range for a person with diabetes are 80-130 mg/dL before a meal and 180 mg/dL or less two hours after a meal.
Here’s an important message about CGMs for people without diabetes:
If you do not have diabetes, your CGM results will be a bit boring, and that’s a good thing. People without diabetes will have a rise in blood sugar but the blood sugar doesn’t rise out of target range. For people with diabetes, the concern is that their blood sugar rises above target levels and doesn’t come back down in a timely fashion. People with diabetes need to incorporate some type of treatment — eating changes, increase in physical activity or meds.
There are several companies selling CGMs that are marketed to people who are looking to improve their glucose patterns by “engaging with your blood sugar,” improving mental or physical performance or a device to provide motivation for healthy behavior change. But before you dip into your wallet, it’s good to know that this list of reasons for these devices I mentioned are not approved by the U.S. Food and Drug Administration and not covered by health insurance.
There are at least five companies that have devices available to consumers with a fee of anywhere from $150 to $450 per month to use their glucose monitoring device: Nutrisense, Signos, Veri, Levels and Supersapiens.
[READ: How Do You Know If You Have Diabetes? ]
Concerns With a CGM for People Without Diabetes
In addition to the monthly costs associated with wearing a CGM for people without diabetes, a bigger concern is about the data. A person without diabetes may be receiving misleading data.
There are limitations with the numbers, especially if you are looking at the glucose management indicator, a feature used by people with diabetes. For people without diabetes, this number may be an overestimate.
Currently, there isn’t enough evidence that a CGM can be beneficial or should be recommended to those without a diagnosis of diabetes. The metrics in a CGM are designed for levels related to a person living with diabetes.
As a population, many of us are intrigued to know what our bodies are doing. We have become digitally savvy with our new devices like cellular phones and fitness trackers that offer us constant health information on our heart rate, number of steps we take, blood oxygen levels and steadiness of our walking, to name a few. So, it makes sense that people may be driven to more biofeedback, like trends in blood sugar levels.
Bottom Line
If you have been diagnosed with diabetes, prediabetes or gestational diabetes, a CGM is a tool that can help make blood sugar management easier. If you do not have a medical diagnosis of diabetes and are interested in learning about your blood sugar trends, you can try a CGM for a one to two week period of time. Again, people without a diabetes diagnosis will see their blood sugar fluctuate with food and intense exercise but come back within a normal range. And those slight fluctuations don’t really offer information about changing your lifestyle. It’s normal to have some fluctuations.
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Should I Be Wearing a Continuous Glucose Monitor If I Have Diabetes, or Don’t Have Diabetes? originally appeared on usnews.com
