And some notes and suggestions on my favorite CGM systems

Using a continuous glucose monitor (CGM) is an incredibly valuable tool to help gather data and be curious about what impacts blood sugar trends. I find that for my clients who have been newly diagnosed with diabetes or pre-diabetes, or for those who are motivated to get their A1c down, adding a CGM becomes an invaluable resource and tool. It is especially helpful when you have a trusted dietitian (Hi! Me 🙋🏻‍♀️) to support you in understanding trends, through a more neutral and curious lens.

What Exactly is a Continuous Glucose Monitor and Am I Now a Bionic Human?!

How does a CGM work? CGM sensors estimate the glucose level in your Interstitial fluid (the fluid between your cells), which is very similar to the glucose level in your blood. This reading occurs every 1-5 minutes and is stored in a device over a 24-hour period of time. Most CGMs are worn for 10-14 days, and then replaced with a new one.

There are three important parts to the functionality of a CGM:

• The Sensor: This is a very tiny tube that is inserted under your skin where the CGM is placed - usually the back of the arm, upper butt area, abdomen, or thigh (anywhere with a little extra fat).
  

• The Transmitter: The transmitter sends the information using bluetooth, to the third part, a software program/display device that reads and interprets the results.
  

• The Software Program/Display Device: this is stored on a smartphone, insulin pump, or on a separate device called a receiver. This is where you can actually view all the data being collected from the sensor and transmitter.

And yes, you are now a bionic human. It 's a great conversation starter.

How to Insert the Dexcom G6

How to Insert the Freestyle Libre 3

Why I love the CGM (as a Type 1 Diabetic!!!)

Having diabetes is hard on a good day. Keep reading to learn why this Dietitian recommends using a CGM (in no particular order of importance):

1. It gives us a continuous (hence the name!) look at blood sugar trends over a 24 hour period of time without having to prick your finger! No.Finger.Pricking 🥰
   

2. There is sort of a "set it and forget it" mentality, which allows you to focus on what you love doing without worrying about your blood sugar constantly
   

3. Having a 24 hour blood glucose reading helps us understand trends. There are at least 42 things that impact blood sugar and wearing a CGM helps us take a magnifying glass to all of those things. Factors that I often see impacting my clients and my own blood sugar include increased stress, travel, poor sleep and being sick.
   

4. You get to wear it for 10-14 days
   

5. It helps you to make informed and empowered decisions about your life
   

6. It uses bluetooth and connects directly to your phone
   

7. You can share the data with your healthcare team in real time
   

8. While I always recommend keeping a glucometer nearby, you can do cool things like go paddle boarding or take your tiny purse out for a fun night, without hauling your insulin and/or glucometer kit with you.
   

9. People ask you what it is and that becomes an opportunity to educate them on what life with diabetes is like

That's pretty dope...where do I get one?

In most instances, you will need a prescription from your doctor to get a CGM. Insurance generally covers the cost, especially if you have a diabetes diagnosis. The most commonly used CGM systems are The Abbott Freestyle Libre 2 and 3 and the Dexcom G6 and G7. There are a few others on the market as well, including an implantable option. For this blog post, I will be focusing on the most commonly prescribed/requested CGMs. It is important to consider that for some folks, the cost of the CGM is prohibitive or it may not be covered by their insurance. However, both Abbott Freestyle Libre and Dexcom provide either patient discount options and/or are covered by Medicare and Medicaid, thus making their products more accessible and affordable.

Abbott Freestyle Libre 2 and 3

• Reads glucose every 60 seconds

• Sensor lasts 14 days

• Takes 30 minutes (Libre 3) or 2 hours (Libre 2) to calibrate and be ready for use

• Bluetooth range is 20-33 ft

• Sensor and transmitter are one piece

• Size references

  • Freestyle Libre 2: about the size of two stacked quarters

  • Freestyle Libre 3: smaller than 2 stacked pennies

Dexcom G6 and G7

• Reads glucose every 5 minutes

• Sensor lasts 10 days

• Takes 2 hours to calibrate and be ready for use

• Bluetooth range is 20-33 ft

• Sensor and transmitter or two separate pieces

• Size references

  • Freestyle Libre 2: about the size of two stacked quarters

  • Freestyle Libre 3: smaller than 2 stacked pennies

Tips For Getting Your CGM To Stay Put

• Wash the placement area with and warm water or clean with alcohol

• Wait until it is COMPLETELY dry before placing the sensor

• Use Skin-Tac

• Use adhesive Over-patches

• Be careful to not pull it off when dressing, undressing, getting into and out of cars, or walking through doorways. Thin tank top straps and underwear are especially annoying when it comes to this

• Know who to contact when you need a replacement

  • Dexcom

  • Freestyle Libre

If you are interested in learning more about your blood sugar trends, schedule a free discovery call with me today!