Continuous Glucose Monitors: A Type 2’s Weapon of Mass Instruction

Glucose monitoring has come a long way from urine kit testing in the 1950’s to home glucometers with finger pricks in the 1980s to continuous glucose monitors (CGM) in the 2000s. Wait a minute – what is a continuous glucose monitor and why haven’t I heard about it yet? CGMs have been around for a while now, but have been used much more frequently in type 1 diabetes. However, in 2018, there are now plenty of great options for CGMs for type 2s!

A CGM has 3 main parts:

  1. A glucose sensor inserted under the skin. This is a small wire about the size of a tiny piece of hair that is inserted under the skin. It checks the glucose in the tissue under your skin every 1-5 minutes. The sensor is worn on the skin for 7-10 days. You can’t feel it under your skin and it can even be worn in the water (shower, pool, ocean, etc.)
  2. A transmitter is attached to the sensor on the outside of the skin. It transmits information to a receiver, smart phone, or Apple watch.
  3. The receiver collects and displays the glucose data on a screen. The receiver may look similar to the glucose meter you are used to carrying. For some CGMs, a smartphone or Apple watch can also be used as the receiver.

There are 3 types of CGMs available for people with diabetes. Let’s compare them:

In my opinion, the advantages of CGM outweigh the disadvantages, but let’s talk about both. CGM is expensive if it is not covered by your insurance, so you should check this out with your insurance company. CGM is now covered by Medicare for patients who are on multiple injections of insulin daily. Some people fear they will have issues with the adhesive used to keep the sensor on the skin. Most people actually tolerate this just fine. If you do have adhesive issues, talk with your healthcare provider (HCP) about barriers you could use to help. Some patients are also worried about the appearance or what to do during times of intimacy. However, the current CGMs are quite small and usually do not bother most people.   While the package inserts will suggest wearing the CGM on your stomach or arm, you can talk to your HCP about other areas that may work better for you.

Now let’s talk about all of those great benefits! What can a CGM do for you?

  1. It turns out the CGM can actually lower your A1c without changing your medication. Wow, great news! This can happen because by paying attention to data from your CGM, you can learn about which activities and foods are best for your blood sugar.
  2. No more messy, painful finger sticks! That is, of course, if you are talking about the Libre or Dexcom CGMs (Medtronic still requires finger sticks.)
  3. Trends…and we aren’t talking fashion here folks. Your CGM can tell you where your glucose is going. This can be very helpful to avoid serious lows and highs with certain foods or activities. It can even help change your medication dosing if you are on insulin. Talk to your HCP to get more information about how to use these arrows.
  4. Alarms…the good kind! Alarms on the Dexcom and Medtronic CGMs can alert you to a low or high blood glucose before it gets in the danger zone.

Having all of this information at your fingertips can absolutely help you Take Control of Your Diabetes. Don’t forget that some folks are a bit surprised at what they see when they first start wearing a CGM. For example, your numbers may look pretty good most of the time if you are only checking fasting glucose first thing in the morning. So it may be eye-opening to see what actually happens throughout the day. Also, remember that your number on your CGM will not exactly match the number on your meter if you prick your finger. Not to worry. It turns out that both meters and CGMs have a margin of error. This means that the numbers you see may not be the exact number, but rather more of an estimation. And meters aren’t perfect either, so you should not be surprised if the numbers do not match perfectly.

Overall CGM is a wonderful new technology that can really help make both your life, and your diabetes management, easier. Stay tuned – even more advances in home glucose monitoring are on the horizon!

 

*The Libre just received FDA approval for 14 day wear time and 1-hour warm up, so look for the upgrade coming soon.

13 Comments
  1. As alway, great article. In anticipation of being out of town for an extended time, I picked up 7 Sensors at CVS Rosecrans (San Diego). A delightful clerk assisted me. In addition to a $145 coupon she found, the 7th unit was free, so my total cost was only $120 for 7 Sensors. Thank you Sheila and CVS.

    • That’s awesome Ed!

    • Which device had that coupon??

    • I think the Freestyle libre works but the lack of customer service is very, very poor.
      I have no had to go buy a different blood measuring system due to the lack of support from Abbott in the US and here in HK.
      Sure you agree, as diabetics you need confidence in products you buy but these guys just don’t seem to care after you make a purchase.
      Lost confidence in Abbott and wouldn’t buy any more of their products.
      Ian.

      • I was surprised to read your post Ian. I’ve the complete opposite experience with Freestyle Libre’s Customer Service. I’ve contacted them a few times, and they were fantastic! Caring, understanding, professional and there was no long wait time. I will be sticking with this product because of the exceptional customer service I received.
        Kim

  2. When I heard about the Freestyle Libre at the last TCOYD conference I knew I had to have it! I hate finger pricks, and test strips are expensive. My doctor had not heard of Freestyle Libre, but she was willing to give me a prescription. I did have a hard time finding pharmacies who carry it (CVS and WalMart do!) It has been wonderful to scan without pricks and I can scan anytime I want, as many times as I want throughout the day or night. It is so easy and quick, and had definitely influenced my food and exercise choices. I am on my third sensor. The downside is that I have had issues with adhesive. The company recommended I purchased skin tac to help. Another time I bumped into a wall and knocked the sensor off. I look forward to the upgrade!

    • Thanks for sharing your experience, Adriana! We know a lot of people who have had good success with skin tac, so I hope that helps!

  3. I had problems with my sensor not staying stuck the entire 10 days. I attributed the issue to the oil (conditioners) in the shower gel I was using so now clean my arm with Blue Dawn prior to using the alcohol swabs and applying the sensor. Have not had another problem.

    • Thank you for the tip, Karen!

    • Thanks Karen, I have been having the same problem with my new Free system sensors. The first one only lasted 5 days and the second 6 with the sensors coming loose after showering on that day. Abbot was great and shipped out 2 sensors which arrived in less than 3 days. The service rep also recommended the additional adhesive skin coatings. I will try adding your solution to theirs. I test six to 7 times a day and the finger sticks were getting intolerable. I am 70 but still active with a 5 acre mini-homestead doing a lot of home repair and yard work including felling dead trees, etc. Here in central Indiana it was a hot summer with highs in around 90 F most of the summer and high humidity. As typical it went from 91 to a high of 40 withing 10 days. As Mark Twain once said of the mid-West: “If you don’t like the weather, just wait a while.”

  4. Does Medicare (B?) cover these CGMs AND Sensors? OR are they considered DME (Durable Medical Equipment) with coverage amount dependent on someone’s Medicare Supplement (Medigap) or Part D Drug options selected?
    Can you provide range-of-price estimates?

    • Hi Linda,
      We feel your pain of confusion with Medicare! The best thing for you to do would be to check out the Dexcom website because they do have a page dedicated to Medicare questions, and they have a number you can call for medicare questions too.The Freestyle Libre is approved by Medicare, so you might find some good info on their site as well. Good luck!

Leave a Reply

LATEST TYPE 1 POSTS

LATEST TYPE 2 POSTS

990 Highland Drive, Suite 312
Solana Beach, CA 92075
800.998.2693