CGM-A Boon for Type1 Diabetes Patients

Make Changes to Treatment Procedures using Info from the Receiver

​Diabetes is a metabolic disease that affects 1 in 3 people worldwide. It is a terminology used for a group of conditions where the blood sugar levels are either above or below recommended normal glucose levels. Higher than normal glucose levels is called as hyperglycemia while lower than normal levels are called as hypoglycemia. Both, hyper- and hypoglycemia fall under the umbrella term type 2 diabetes. Type 1 diabetes (earlier known as juvenile diabetes) is a condition where the pancreas cannot make insulin or makes very little insulin owing to which sugar can’t enter the cells and hence, builds up in the bloodstream. This type of diabetes generally occurs in teenagers, kids, and young adults mostly. But, it is type 2 diabetes that’s commonly present in 80-85% of the population. It’s only the rest who succumb to type 1 diabetes, which becomes quite dangerous without without holding over a good glycemic control. Till today, we don’t have a specific treatment protocol for overcoming type 1 diabetes but abiding by some rules can help keep it under control—this includes pursuing a healthy lifestyle, consulting the physician for regular health checkups, and managing blood sugar levels. It also helps to understand self-management plans and execute them to avoid compromising on the individual’s quality of life.
 
Type 1 Diabetes: History
 
Insulin is a magic pill for diabetics, especially those with type 1 diabetes as the life expectancy was not more than a couple of months in those with this condition before insulin was discovered. Use of insulin has changed the management plan required for the disease but at the same time, widened the understanding of the common man that the disease leads to long-term complications and shortened life tenure.
 
For type 1 diabetes, it is necessary that individuals get their glucose levels assessed as per the physician’s recommendations while glycemic levels must be checked every quarter in those who don’t match glycemic goals or whose therapy has changed. There are various ways to monitor blood glucose levels including capillary blood glucose monitoring (BGM), continuous blood glucose monitoring, and more. BGM helps in avoiding hypoglycemia and provides ideal guidance to insulin dosages. Becoming hypoglycemic before certain situations is dangerous and these include—before bedtime, before, during, and after exercise, and before driving. Practically keeping a tab on the blood sugar levels very frequently is a big problem. Knowing the numbers can be irritating and even lead to lesser number of measurements taken in case of diabetic patients. To simplify things and make people’s life easier, getting hold of devices with in-built memory option is helpful in adjusting insulin doses correspondingly and observe variations in insulin levels.
 
Continuous Glucose Monitoring (CGM)
 
By now, most of us would be familiar with continuous glucose monitoring or CGM as it’s commonly called. A tool for individuals with diabetes, CGM is a wearable technology that makes tracking down blood sugar levels extremely simple and easy. It measures intestinal fluid glucose levels and provides semi-continuous information about glucose levels which would otherwise be impossible with conventional self-monitoring. You can measure blood glucose levels 24 hours a day while wearing this device choosing from either of the two CGM systems—retrospective or real-time systems with real time systems giving the actual glucose concentration on a display.
 
Every CGM comes with a sensor and a reader/receiver. The sensor is attached to the arms or tummy helping to measure interstitial fluid while the reader shows the results either on the smartphone or on an insulin pump (some types of CGM do this). There are some CGMs that come with alarm provisioning. The alarm goes off when blood sugar levels are too high or low.
 
Why use CGM?
 
Though we are pretty confident about the list of foods and the activities that increase/decrease blood sugar levels, there are times during which the glycemic levels change due to reasons unknown to us. In such cases, collecting data continuously using CGM helps in understanding these issues and patterns compared to finger-prick technology test. We saw previously that it’s possible for sudden shoot up in glucose levels during sleep or early mornings. Measuring such spikes is possible with CGM. Using continuous glucose monitoring is useful in knowing how exercising and medication impact blood sugar levels in the body.
 
Showing data every few minutes gives a clear idea of our body respond’s to blood sugar levels over time and make changes to eating habits, exercise goals, and lifestyle accordingly. While CGM tells you when the levels go up and down, they don’t answer the ‘why’ part. For this, analysing the data and reviewing them for patterns can help in personalizing diabetes care needs. Another big advantage with CGMs is their ability to send off an alarm in case of haphazard glucose levels. As most devices come built with this ability, the affected patients can make changes quickly before these numbers shoot up beyond control.
 
Also, using CGM reduces the number of fingerstick tests needed everyday to monitor glycemic levels. But, please understand that finger prick checks are needed every now and then as CGM readings lag by a couple of minutes behind blood sugar levels. Such time lags are improving more and more with technological advancements and hence, there is no need for using finger-prick method more than twice daily if the CGM calibrations are good.
 
Above all, we have a significant number of research and well-controlled clinical trials that indicate their advantage in achieving metabolic control and decreasing hypoglycemia risks.
 
Are CGMs Affordable?
 
With so many advantages related to using CGM for type 1 diabetes, why isn’t its use widespread and popular? One of the main reasons is the expensive nature of these monitoring devices. The high cost of CGMs is a big obstacle in purchasing them as it is not a one-time purchase but requires changing the sensor every 7-14 days or a couple of times every year in case of long-term implantable CGM devices.
 
There are a few companies that provide insurance coverage but still, the procurement procedures aren’t simple and various plans have different coverages of CGMs.
 
Can We Cure Diabetes with CGM?
CGM is only a tool that can help maintain blood sugar levels and keep them under control. Using CGM regularly helps in understanding your body’s way of responding to various activities and foods thereby making changes to maintain recommended glucose numbers. Use a CGM only when recommended by your physician and get back to them when numbers don’t match the recommendations. Else, it could result in coma, seizures, and even death.
 
The Bottomline
 
It is not very easy to understand the nuances of using a CGM. It takes time but once you become adept in handling the device, there must be no hiccups thereon. Though not a cure for diabetes, it is very much useful in gaining better knowledge about the disease and monitor the glucose trends closely. Sometimes, seeing the numbers frequently might induce stress but once you realize the importance of continuous monitoring and its advantage in preventing hypoglycemia, CGM becomes a boon for type 1 diabetes patients.
 
Follow a healthy lifestyle, be active physically, keep cholesterol levels under control, and minimize stress to keep glucose numbers in a healthy range with type 1 diabetes. Consulting a dietitian/nutritionist and managing overweight/obesity is a good way to incorporate a healthy lifestyle to control blood sugar levels. The additional use of CGM gives individuals mind peace and helps them go forward with their actions without worrying about extreme variations in blood sugar levels.