Continuous glucose monitors (CGM) offer some of the most exciting advances in blood glucose monitoring on the market. Nonetheless, is monitoring right for you? What are the advantages and disadvantages? What are the best (only) systems that offer the features you need? We discuss all this and more below.
WHAT IS CGM?
CGM systems record your blood glucose levels 24 hours a day for three to four days at a time. Testing occurs every 1 to 5 minutes, depending upon which monitor is being used. Thus, in a 24 hour period there are 288 to 1,440 blood glucose test being done.
How does it do this? A small sensor, usually about the size of a quarter, is attached to your skin with a piece of tape. The sensor has a very small catheter which is inserted into your skin. This sensor automatically takes a sample test of your blood sugar levels at the given interval (1-5 minutes).
Users will also need to take 3-5 traditional finger stick test to supplement the continuous glucose monitoring system results. The CGM system is typically used for 3-4 days (although some are worn up to 7 days).
Throughout the day you will also record, typically by pressing a button, when you took insulin (and how much), when you exercised and when you ate a meal or snack. The meter and subsequent data analysis will factor this all together to determine how your body and treatment is performing.
Results are provided in real time on the monitor and at the end of the monitoring period (3-7 days). The test data is uploaded and shared with your health care provider for analysis. The sheer volume of information can really help your doctor formulate a successful treatment plan to work with you as an individual.
WHY DO CGM?
There are a number of advantages and benefits from doing CGM. Primarily, our blood sugar levels are not necessarily consistent or predictable.
Finger stick testing, even if done regularly, only provides the briefest of snapshots regarding your glucose levels. Imagine if you had to do a finger test every minute, or even every 5 minutes! You simply could not do this effectively.
Finger stick testing alone may miss wide fluctuations in your glucose levels, particularly when you are sleeping.
In fact, some studies have found that optimal glucose control using traditional monitoring methods is less than 30 percent.
Some Key Benefits, Advantage and Reasons to CGM:
- Worried about Hypoglycemia (low blood sugar) (Particularly at night).
- Use Insulin to managed diabetes.
- Experience fluctuating glucose levels.
- Want to achieve better understanding and control over your diabetes.
Are Their Disadvantages?
CGM may not be right for everyone. The meters are rather expensive ranging from approximately $1,000 and up. If you are not experiencing poor diabetes control, then this system or monitor may not be worth the extra price. Nonetheless, it is worth a conversation with your healthcare provider to determine your ultimate course of action and treatment.
FDA APPROVED CGM’S
- Dexcom G4 Platinum. The G4 Platinum is the latest CGM from Dexcom and actually replaces the Seven Plus. It now features a color screen, and the receiver can be up to 20 feet away from the sensor. It reads your glucose levels every 5 minutes. This is a stand alone CGM.
- Dexcom – SEVEN PLUS. The SEVEN PLUS is a very popular choice and allows for continuous monitoring up to seven days. It is a stand alone CGM. The Seven Plus is being phased out in favor of the G4.
- MiniMed – Guardian REAL Time System. The Guardian is a stand alone continuous Glucose monitor. The sensor can be up to 6 feet away from the receiver and the sensor can be worn for up to 3 days before you need to change it.
- MiniMed – Paradigm REAL Time Revel. The Paradigm Revel is an integrated CGM and insulin pump. It is the only system of its kind on the market today.
- Abbott Diabetes Care – Freestyle Navigator. The Navigator is no longer available in the United States. For some inexplicable reason, Abbott puled it from the U.S. market but continues to offer it elsewhere. Safety was not the issue. The Navigator provides monitoring for up to 5 days. Also, it is the only monitoring system that takes readings every 60 seconds.
CGM offers unprecedented opportunity to monitor and ultimately control your diabetes. However, you will need to coordinate with your doctor to see if the cost is worth the benefits in your individual situation.
Additionally, CGM is not a fool proof system. Don’t get bogged down in data analysis, which is easy to do. Especially, if you are techno-geek! You know who you are!
You can monitor your glucose levels every minute, but if you do not use the data properly it won’t do you any good. Eating right, proper exercise and following your doctor’s treatment regime is ultimately your best bet.
Glycemic Characteristics in Continuously Monitored Patients with Type 1 and Type 2 Diabetes, Diabetes Care, Vol. 28, 2361-66 (2005).
By Erich Schultz – Last Reviewed January 2013.