Continuous Glucose Monitors

By Tracey Neithercott

 

A continuous glucose monitor uses a sensor and transmitter attached to the body (left) that communicate with a handheld receiver (right) or an insulin pump.

Product Listings

 

To get a complete sense of how your blood glucose behaves throughout the day, you could test every minute, 1,440 times a day. (Ouch.) Or, you can wear a continuous glucose monitor and let the device do the work for you. Continuous glucose monitors (CGMs) use an under-the-skin sensor to measure glucose levels and transmit the results to a handheld receiver or insulin pump every one to five minutes, depending on the brand. The benefit of using a CGM is, of course, understanding exactly what your glucose is doing at all hours—especially overnight. Equipped with this knowledge, you can better adjust your treatment plan.

Compared with blood glucose testing, continuous glucose monitoring is still a relatively new technology, so there are only three models on the market. Their basic functions are similar—all provide at-a-glance readings and make it easy to track trends—but each stands out in its own way. You may be able to get a feel for how the brands differ by experimenting with sample products at your doctor’s office. (For starters, one has a built-in blood glucose meter; another is a pump-CGM combo. Both cut down on the number of devices you have to carry around daily.) Check with your insurer to see whether a specific device is covered before you start shopping around. Once you choose a CGM, the medical device company’s experts will walk you through the insurance approval process.

Before you decide on a product, you can learn about CGMs’ basic functions, explained below. Then look at the side-by-side comparison of the three available models.

Nonstop Testing 
How often a sensor sends glucose readings to a receiver differs among devices—one transmits every minute, others every five—but the difference is so slight that it shouldn’t affect your decision making, says Howard Wolpert, MD, a physician in the Joslin Clinic Section on Adult Diabetes and the director of the Insulin Pump and CGM Program at Joslin Diabetes Center. The bottom line: Your CGM will record glucose levels much more often than you would on your own.

Necessary Adjustments
To keep your CGM working properly, you’ll have to calibrate it on a regular basis by testing your blood glucose with a standard meter and entering the result into your CGM receiver. How often you’re required to calibrate—say, every 12 hours—varies somewhat among devices.

Data at a Glance
Take a quick look at your CGM’s home screen, and you’ll see your current glucose level and if it’s changing. All models feature arrows that indicate whether your glucose is rising or falling—and how fast.

Trend Tracker 
How have your glucose levels behaved during the past three hours? How about over the past day? If you use a CGM, you can graph glucose trends with a few button pushes. Though each model computes a different set of hourly trends—one averages the past two hours, another averages the past three—all make it easy to see the spikes and dips you’ve experienced throughout the day.

Event Markers 
Knowing how your glucose behaves can help you alter your diabetes treatment plan. Recognizing why your glucose acts in a certain way makes an even bigger difference. That’s why all CGMs allow you to note when you eat, exercise, get sick, and inject insulin.

Warning Bells
So that you don’t have to spend the day staring at your CGM’s screen, each device lets you program high- or low-glucose alarms. A couple of models will alert you if your glucose is moving very quickly in either direction, and others will sound an alarm if your glucose is drawing near to your customized upper or lower limit.

Continuous glucose monitors can help keep your glucose in line, but the devices aren’t for everyone. Many insurance plans don’t cover CGMs for people with type 2 diabetes, so it’s important to talk to your insurer about your options. Certain people find the extra handheld device inconvenient to carry. Those on insulin pumps already wear an under-the-skin cannula and may find it bothersome to maintain a second site for the CGM sensor. Plus, plenty of people with type 1 are happy enough with finger sticks, thank you very much. “The big issue, particularly among women, is the extra hardware,” says Wolpert. “It may make diabetes management easier in some ways, but it does present other demands.” In the end, whether you find the device fussy or functional is a matter of personal choice. 

Comments

Comments are subject to review and will not be posted immediately. If you have an urgent medical question, please consult a health care professional. If you have a question for the staff of Diabetes Forecast, please send it to replyall@diabetes.org.

The intellect vs. the emotion

Today I started a CGM and am not psyched. Intillectually, I get it. Great idea. Emotionally, however, not good. Tough to swallow.

intellect vs emotion

Thanks for being honest. I was considering one, but as the article says it is yet another under the skin device and site to keep up with. I also noted with my particular pump that the CGM device partner is sensitive to many things such as other electronic devices that are being used in its vicinity and that the distance from the pump site itself must be right. Now when they come up with an all in one, I will be happy to try that.

Wow! Can I relate.

Wow! Can I relate.

insurance coverage

Most insurance companies won't cover a CGM for Type 1 unless the person is already using an insulin pump. (I don't think that makes sense at all.) Knowing your sugar level at any point in time is key to control. Hopefully insurers will eventually come to figure this out.

I so agree. I am an

I so agree. I am an extremely unstable diabetic although I test 4-5 times a day. In days gone by I would have been termed a brittle diabetic. I do not feel my lows and have been in a diabetic coma about 8 times - never mind the lows which leave me feeling shattered. I have actually started to fear going to sleep at night and for me the only answer can be the CGM

insurance coverage

Most insurance companies won't cover a CGM for Type 2 diabetics is what was stated in the article.

CGM

Started pump 6 months ago. Added CGM 3 months ago. Love ability to work together. A1C lowering rapidly. Losing weight to enhance efforts. Instant feedback on progress. Advise everyone to consider CGM.

My daughter has been using

My daughter has been using the CGM system since October 15th. I love the alarms especially at night but sometimes the numbers are way off. Calabration is necessary more than every twelve hours if you want to stay more accurate. Always test with finger checks before treating.

Just started the Minimed

Just started the Minimed pump a month or so ago. Takes some getting used to, but overall it isn't too bad. My only complaint is that it is relatively easy to 'lose' a sensor. They are not very secure to your body. All of the pictures you see only show the sensor and transmitter....what you don't see is the layer of IV Prep tape you have to put over it. Seems like some work on a better adhesive for the back of the transmitter would have been a good idea.

That said....it is nice to see where I am at anytime in the day. If I see a quickly rising trend I can take action before my BG heads into the stratosphere. The technology is getting so much better! I can't wait to see what is available in 2-5 years! I just hope I can either (a) afford it out of pocket, or (b) have insurance that will approve it.

My son is 14 and has had the

My son is 14 and has had the CGM for nearly 3 years now. He didn't like the fact he was wearing "another" set, however, he recently lost his device and spent 3 weeks in a panic over not having it. It may not be 100% accuarate, but it certainly alerts us to problems before they are a crisis. This was never meant to REPLACE finger pokes, but alert to potential problems so that a finger poke was warranted. It may not be accurate when there is a significant rise or drop in glucose levels, but it has alerted us to the fact that the movement is significant. If his glucose is stable, 20 points off isn't a crisis to us. This has avoided many lows because we were alerted in a timely manner. It's a tool for better health and management.

Post new comment

  • Web page addresses and e-mail addresses turn into links automatically.
  • Allowed HTML tags: <a> <em> <strong> <cite> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Lines and paragraphs break automatically.

More information about formatting options

Advertisement