Are you a diabetic? Then you are probably very familiar with taking a drop of blood from your finger several times a day and checking your sugar level. But don't you sometimes think that this is a bit annoying and painful? This new technology has come to help them. We call this CGM, which stands for Continuous Glucose Monitoring. Let's see what it is, how it works, and what benefits it can bring to you.
Simply put, what is CGM?
A CGM is a small device that we wear on our bodies. It measures and shows you your blood sugar levels continuously, that is, 24 hours a day. When we take blood from our finger, we can only know the sugar level at that moment. But when you wear this CGM, you can see how your sugar level changes at all times, such as when you sleep, eat, and exercise.
This is a very helpful tool for managing diabetes . Because our body's sugar levels change due to various factors. Sometimes, sugar levels go up and down for reasons we can't even imagine. So, this CGM can monitor all of that in real-time.
Does this measure blood sugar?
There's a slight difference here. We use our finger to measure blood sugar levels directly. But the tiny sensor in a CGM sits just under our skin. So it doesn't measure sugar in a blood vessel. Instead, it measures sugar levels in a delicate fluid called interstitial fluid that surrounds our cells.
Think about it, when we eat a meal, sugar first goes into the blood. Then, from that blood, sugar gradually accumulates in this interstitial fluid. So there can be a slight delay of a few minutes between the sugar level in the blood and the sugar level in this fluid. That's normal.
How does this CGM device work?
There are several types of CGMs on the market today. They all work in much the same way. However, there may be slight differences in appearance and additional features. However, each CGM has three main components.
| Part of the device | What happens? |
|---|---|
| Sensor | This is the smallest part that is placed under the skin. This is what measures the sugar level in the interstitial fluid. Typically, this sensor can be used for 7 to 15 days. After that, a new one needs to be inserted. |
| Transmitter | This is the part that connects to the sensor. The sugar data measured by the sensor is sent wirelessly to your phone or other device through this transmitter. Some types can be reused. Some need to be removed along with the sensor. |
| Data receiver | This can be an app on your smartphone, a separate handheld receiver, or an insulin pump. It allows you to see a graph of your blood sugar levels, whether they are rising or falling. |
How to use a CGM step by step
1. Inserting the sensor: This small sensor is usually inserted under the skin on the abdomen or arm. It comes with an applicator, making it quick and easy to do. Then, it is secured to the skin with adhesive tape.
2. Connecting the Transmitter: Next, you need to connect the transmitter to the sensor.
3. "Warm-up" period: After the sensor is inserted, it takes a short time for the data to start showing. This is called the "warm-up" period. It can be anywhere from 30 minutes to two hours.
4. View data: Once the warm-up period is over, you can continue to monitor your blood sugar levels on your phone or receiver. You can even set alarms to notify you if your blood sugar levels get too low or too high.
5. Replacing the sensor: When the sensor expires (e.g. after 14 days), you need to remove it and insert a new one. You have to repeat these steps from the beginning.
Imagine, you normally check your blood sugar with your finger. It's like reading just one page of a book. You only see it at that moment. But a CGM is like watching the whole book, or the whole movie, all at once. You get a complete picture of how your blood sugar levels are behaving throughout the day.
Is it difficult to use a CGM?
To be honest, these are a bit complicated little devices. So it takes a little time and interest to understand the technical side of it first. For example:
- You need to learn how to insert the sensor correctly.
- Sometimes you need to calibrate the device by taking blood from your finger, checking your sugar level, and so on.
- You need to set the alarm as you want.
- You need to learn how to put data into a computer or a phone.
- You should look at the data you receive and make the necessary changes to your treatment plan.
It takes some time to learn these things. But you don't have to do them alone. When you decide to use a CGM, your doctor will refer you to someone who can train you on how to use it safely.
Do I need to check my blood sugar with my finger even if I have a CGM?
Yes, sometimes it is necessary. Using a CGM will greatly reduce the number of times you have to test your blood sugar with your finger. But it is still important to have a regular glucose meter and test strips nearby.
Imagine if your CGM sensor suddenly came off or stopped working, you would need a regular meter to check your sugar until you get a new one.
Also, if you are sometimes unsure about the value shown by the CGM (for example, it shows low sugar but you don't feel it), it is best to take a blood test from your finger to confirm it.
Can people without diabetes use CGM?
These are primarily designed for people with diabetes, but doctors may also recommend them for some other medical conditions.
- Prediabetes.
- Obesity.
- Certain medical conditions that cause frequent low blood sugar (e.g. glycogen storage diseases).
- Insulinoma is a rare tumor that secretes excess insulin.
If you think a CGM could benefit your health, talk to your doctor about it.
What are the advantages and disadvantages of using a CGM?
Like any technological tool, a CGM has both advantages and disadvantages.
| Advantages | Disadvantages & Challenges |
|---|---|
| Get a complete picture: Seeing how your blood sugar levels change throughout the day gives you a better understanding of how things like food, exercise, and stress affect your blood sugar. | Expensive: CGM devices and the sensors they require are relatively more expensive than a regular glucose meter. |
| Personalized Treatment: You and your doctor can analyze your data and tailor a treatment plan that suits you. | Information overload: The constant influx of data can be stressful for some people. |
| Early warning: You can receive an alarm before your sugar levels get too high or too low, so you can take action before a dangerous situation arises. | Alarm fatigue: When your alarm goes off frequently, it can be annoying and disrupt your sleep. |
| Reduced finger pricks: Finger pricks can be significantly reduced several times a day. | Always on: Since this has to be worn all the time, it takes some people a while to get used to it. |
| Lower A1C: Studies have shown that people who use CGM have lower A1C and lower rates of hypoglycemia. | Skin allergies: Some people may be allergic to the adhesive on the sensor. |
Things that affect the accuracy of CGMs
Although these devices are largely accurate, some medications and vitamins can cause slight variations in their values. For example:
- Acetaminophen (Acetaminophen - Panadol®)
- Hydroxyurea
- Vitamin C (Ascorbic acid)
These can cause the CGM to show a higher or lower blood sugar level than it actually is. Therefore, it is important to ask the manufacturer or your doctor about what factors affect the type of CGM you are using.
When should I see the doctor?
If you have any questions about how to use a CGM safely, talk to your diabetes doctor. Also, too high or too low blood sugar levels can be dangerous. If you have any symptoms that concern you, seek medical advice immediately.
Ultimately, managing diabetes is like shooting at a moving target. When you're just looking at your blood sugar with your finger, it's like you're shooting at a target with your eyes closed. But with a CGM, you can see where the target is going and how fast it's moving. That means CGM is a very powerful tool for managing your diabetes. If you're interested in this, definitely talk to your doctor.
Take-Home Message
- CGM (Continuous Glucose Monitoring) is a wearable device that measures and displays your body's sugar levels 24 hours a day.
- This measures the sugar level in the interstitial fluid under the skin, not in the blood.
- A CGM can help you better manage your diabetes because it gives you a complete picture of how your sugar levels change throughout the day.
- It has the ability to alert you via alarm before your sugar levels become dangerously high or low.
- Even if you have a CGM, in some cases it may be important to test your fingerstick with a regular glucose meter to confirm.
- Talk to your doctor to learn more about this technology and whether it's right for you.
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