Continuous Glucose Monitoring Devices for People with Type 2 Diabetes

Continuous Glucose Monitors

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!

3 Parts of a CGM:

1. A glucose sensor:

  • This is inserted under the skin. It’s 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:

  • This 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:

  • This 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.

3 Types of CGMS:

Continuous Glucose MonitorsIn 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.

The Benefits of a CGM:

  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.

  1. Ed Beberman

    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!

    • Avatar

      Which device had that coupon??

    • Avatar

      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.

      • Avatar

        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.

  2. Avatar

    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!

    • Avatar

      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. Avatar

    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.

    • Avatar

      Thank you for the tip, Karen!

    • Avatar

      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. Avatar

    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!

    • Avatar

      FYI – as of 2019, Medicare covers my Libre Freestyle. It’s under Part D for the Freestyle. No idea about other CGMs (they are covered, but I don’t know under what). The primary requirements are using insulin 3 or more times a day or having a pump and using fingerstick 4 or more times a day. I’m not paying anything, due to coverage from another program, so I don’t know out of pocket for rest of Medicare recipients.

  5. Avatar

    I’m type 2. I’ve always been really bad about checking my sugar because I don’t take insulin, and therefore even if it is high, I can’t really do anything about it – being low was never an issue. After a particularly carb heavy meal, I usually didn’t WANT to know what it was – easier to pretend it wasn’t bad if I didn’t see it, right?

    I started with the Freestyle Libre 14 day last year. I didn’t really change my diet, but I did start going to the gym more. That combined with actually being able to see my numbers on a frequent basis (and then trying to actually keep them down), led to a 6.0 A1C. I had never been below 7.1 since I was diagnosed over 10 years ago. We backed off some of my medication, and 4 months later I was at 6.5.

    The one downside to the Freestyle, for me, was that I still had to swipe it. So, if I knew it was going to be high, sometimes I wouldn’t, just because, again, it was easier to pretend it wasn’t an issue if I didn’t have to see it. I’ve since switched to the Dexcom G6. It is awesome! I’ve only been on it for about 20 days, and haven’t had my A1C checked yet, but my GMI is 6.2%. I also haven’t gone to the gym in over a month, so once I get back to that, it’ll help as well. It definitely helps me watch what I eat, though.

    I realize this is anecdotal, and might be unique to my psychology (I know that the “If I don’t see the high number, it’s not an issue” thing isn’t rational), but I’m sure there are others out that that think at least somewhat like me. If you are a Type 2 diabetic, even if you don’t take insulin, I highly recommend a CGM if you are able to get one.

    • Avatar

      Thank you so much for sharing your experience, Chase! So many people feel the same way you do about checking/seeing blood sugars (people with both type 1 and type 2), and we’re glad you found a system and method that’s working so well for you. Kudos! 🙂

    • Avatar

      I was recently diagnosed with Type 2 diabetes by my family nurse practitioner. I was floored when she told me she wanted me to wear a monitor. I had done a little research and saw that these were almost exclusively reserved for type 1 patients. For me, the reason was that the FBG readings she took on 3 different occasions were not only quite high but were also all over the place. I got it installed at that appointment and it definitely took some getting used to.

      I am still within the first month of monitoring but my readings are still pretty inconsistent despite a focused effort on diet and exercise. The NP already told me it’s possible she will need to prescribe insulin treatment for me instead of (or in addition to) medication and I told her there’s no way I could ever give myself shots so if I need insulin, it’s going to be a pump. I am really, really hoping I don’t need the pump because the CGM itself is enough of an added weight and strange feeling on my abdomen. I can’t imagine adding another device there, one with a needle no less! Even if I don’t need insulin, I suppose I will still have to wear the monitor for a period of time. I just had no idea these were ever necessary for type 2. I’m learning more and more about this every day.

      • Hi Jim, Thanks for sharing your story. The monitor is an awesome tool for sure. There are lots of meds for type 2 diabetes that should be tried before insulin. So many questions…how old are you, are you overweight, what meds are you on, what other medical problems do you have, are you having symptoms of excessive thirst and urination, have you been tested for type 1 diabetes, etc. All of these questions are important.

    • Avatar

      Chase, does your insurance cover it? My understanding is that it’s only covered if you’re on insulin.
      I’m not on insulin and I want one!! Lol.
      Seems silly to require you to be on insulin, this would be a huge advantage to any diabetic!!

  6. Interested in the watch cgm

Leave a Reply