IMPROVING YOUR HEALTH WITH CONTINUOUS GLUCOSE MONITORING
What are continuous glucose monitors?
Fingerstick blood sugar testing is a thing of the past, and that is all thanks to a new technology known as Continuous Glucose Monitors or CGMs. These are small sensors that you wear on your body that give you an instant look at your glucose without the need to prick your finger or draw blood. These devices, which can be placed onto the stomach or the back of the arm, are able to test your interstitial glucose values, which is the fluid between cells in your body. This information can help you be more in control of your health because you are able to see your current reading at any time and also see if your glucose is trending either upwards or downwards. Most importantly, this allows you to respond appropriately if you see that your levels might become too high or too low.
What you should know before starting a CGM.
Most systems are composed of 2-3 devices. The first device is the sensor that is placed onto either the back of the arm or the stomach. This is what measures your glucose levels. There is also the receiver which collects and displays the glucose data for you to see. There may also be a transmitter device that sends data from the sensor to the receiver. In some instances, the transmitter may be housed inside the sensor leaving only 2 devices in the system. For most CGMs, there is a compatible smartphone app that can be used in place of the receiver.. This means all you would need is the sensor and your phone to read your glucose level. The most common CGMs currently available include the Freestyle Libre, the Guardian 3 from Medtronic, and the Dexcom G6. Each of these devices are unique in their own ways, but all have the same basic functionality.
Before you start using a CGM, you should make sure that your healthcare provider has educated you on the basics of applying and removing the sensor. Remember to rotate application sites and only wear the sensors as recommended by the manufacturer. Sensors can be worn in the shower and can be submerged underwater for up to 30 minutes. If the sensor does fall off before it is intended to, it cannot be re-applied and must be discarded. There are various adhesives available that you can put over the sensor if you’re concerned about it falling off.
How can they help you?
Having an insight into how your blood glucose levels trend throughout the day can be valuable information for you, but also for your health team. For example, some patients experience episodes of low blood sugars while they are sleeping, and levels may return to normal by the morning. In this case, CGMs can notify you with alarms when your glucose is dropping too low. After some time of wearing the CGM continuously, you will have access to a report that outlines the time you spent inside the goal range for your glucose. Knowing how glucose levels are affected by diet and exercise is valuable information that can be used for adjusting diabetic medications.
CGMs are most commonly utilized in patients with Type 1 or Type 2 diabetes. One study concluded that CGMs can have a positive impact on reducing 3-month blood glucose averages or HbA1c by about 1%.1 This is made possible through the minute-to-minute insights that CGMs offer to patients and the face that they can see, in real time, how the food that they eat can affect their glucose levels. This allows patients to have confidence in making better lifestyle decisions everyday. This can be beneficial for patients who are looking to reduce their numbers by making lifestyle decisions rather than starting prescription medications. Another study supports the use of CGM devices for patients who are considered pre-diabetic, or on the verge of soon becoming diabetic.2 These patients can use CGM devices to see how their food and activity choices affect their blood sugar and make lifestyle changes to stop to progression to receiving a diagnosis of diabetes. This study also discusses the increasing prevalence of dysglycemia which is the fluctuation of glucose levels above and below what is considered normal. Authors suggest that the information that is provided by CGMs can help to diagnose more people who fall into this category thus catching more people in the pre-diabetes phase.2 This is important because the earlier dysglycemia can be identified, the easier it is to reverse.
Even people who do not have diabetes could benefit from incorporating a CGM into their health journey. One study suggests that monitoring glucose with a CGM helped overweight/obese patients to make better health decisions regarding frequent snacking and physical inactivity.3 Both frequent snacking and inactivity were shown to raise glucose levels above the recommended target for diabetes management. When patients used CGM devices they were able to see how these habits increased their blood sugar. This study suggests that patients who are overweight or obese and identify as being a frequent snacker or inactive could benefit from a CGM device, regardless of having diabetes.3 The information provided by the CGM can help to start and reinforce new changes in diet and exercise helping the patients to experience weight loss.3
Ultimately, the goal of using a CGM is to make assessing glucose readings more accessible so that patients can use the information to make the best decisions for their health. If you have diabetes, we have other posts that you might be interested in. Check out The Diabetes Gut Connection and Vitamin C and Diabetes. We also have a podcast episode Insulin Resistance and Diabetes.
If you are concerned about your blood sugar or have diabetes and want to pursue a functional medicine approach, you can schedule a free 15 minute consultation with a pharmacist in your state.
Post Written By: Dalton Lewis, PharmD Candidate 2023 Cedarville University School of Pharmacy
Edited by Lindsey Dalton, PharmD
- Ehrhardt N, Al Zaghal E. Behavior Modification in Prediabetes and Diabetes: Potential Use of Real-Time Continuous Glucose Monitoring. J Diabetes Sci Technol. 2019;13(2):271-275. doi:10.1177/1932296818790994
- Gottfried S, Pontiggia L, Newberg A, Laynor G, Monti D. Continuous glucose monitoring metrics for earlier identification of pre-diabetes: protocol for a systematic review and meta-analysis. BMJ Open. 2022;12(8):e061756. Published 2022 Aug 25. doi:10.1136/bmjopen-2022-061756
- Kishimoto I, Ohashi A. Impact of Lifestyle Behaviors on Postprandial Hyperglycemia during Continuous Glucose Monitoring in Adult Males with Overweight/Obesity but without Diabetes. Nutrients. 2021;13(9):3092. Published 2021 Sep 2. doi:10.3390/nu13093092
- Freestyle Libre. User Manual. Abbott U.S.; 2020
- Guardian Sensor 3. User Guide. Medtronic’s; 2018
- Dexcom G6. User Guide. Dexcom; 2022