People who have diabetes can choose from several methods to monitor their blood glucose levels. Many individuals with diabetes appreciate the real-time information provided by a continuous glucose monitor, or CGM since you can see almost immediately how the food you eat affects your blood sugar. CGM also eliminates uncomfortable finger-sticks and improves the ability to control hyperglycemia and hypoglycemia before health complications arise. Explore the research about CGM to determine whether this tool is right for you or a family member who has type 1 diabetes.
The Basics of CGM
The continuous glucose monitor consists of a small sensor with a tiny needle that penetrates the abdomen, held in place with a special adhesive patch for up to two weeks. The sensor reads your blood glucose and provides readings about every five minutes, 24 hours a day, directly to your smartphone, a dedicated monitor, or another wireless device. You can even set up custom alerts so the continuous glucose monitor will let you know when your blood glucose moves out of a desirable range.
The Research About CGM for Adults Who Have Type 1 Diabetes
The Journal of the American Medical Association published findings in 2017 from a randomized clinical trial designed to determine whether self-monitoring or continuous glucose monitoring provides better HbA1c control among adult study participants with type 1 diabetes. The researchers found that after 24 weeks, the participants showed significantly better blood sugar control with CGM than with traditional self-monitoring methods. The study authors note that larger follow-up studies must support changes to clinical practice and recommendations based on this information.
A newer study, published in 2020 by JAMA and conducted by a group of researchers from the University of North Carolina at Chapel Hill, found that using CGM could significantly reduce the number of episodes of hypoglycemia and the severity of these episodes among older adults who have this diabetes type.
Click here to see a list of frequently asked questions about glucose monitoring.
This randomized controlled trial studied more than 200 people ages 60 and older in 22 different clinical settings and found that the group using CGM spent an average of 39 minutes each day in a hypoglycemic range, compared to 73 minutes before the study began. In comparison, the control group averaged 68 minutes per day in a hypoglycemic state before the study and 70 minutes per day after the six-month study, during which they used traditional self-monitoring methods.
Continuous glucose monitoring also has benefits for adolescents and young adults. Another JAMA-published study, this one from June 2020, looked at the effects of CGM on diabetes care for a group of 153 type 1 patients ages 14 to 24. All the teens and young adults in this research study had HbA1c levels ranging from 7.5 to 11.0%. During the study, the control group performed self-management with four daily quick sticks while the test group wore a CGM calibrated with twice-daily sticks.
After 26 weeks, researchers reported:
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- HbA1c levels remained at 8.9% for the control group throughout the study.
- HbA1c levels for the CGM group dropped from an average of 8.9% to 8.5%.
- The control group spent less time in the target glucose range over the course of the study.
- The test group increased time in the target glucose range over the course of the study.
While these results persisted a year after the initial study ended, more CGM participants stopped wearing their device every day over this period.
Patient Recommendations for CGM
Currently, most insurance companies consider CGM a medical necessity for patients who have type 1 diabetes, have completed a detailed education program about managing this chronic illness, need multiple insulin injections or frequent adjustments to insulin pump dosage each day, test their own blood glucose at least four times a day and have frequent episodes of hypoglycemia.
According to the Endocrine Society, the ideal CGM group for optimal outcomes includes adults who have type 1 diabetes, can use the device as directed, and have A1C levels higher than 7%. The organization also cites CGM as appropriate for people who require intensive insulin therapy for diabetes care, who experience hypoglycemia overnight, or who have difficulty recognizing the signs of hypoglycemia. Doctors can prescribe certain continuous glucose monitors for children ages 2 and older with type 1 diabetes.
Some of the key benefits of CGM include:
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- Alerts for users when your blood sugar exceeds or drops below preset limits that you can adjust as needed
- Actionable feedback about the impact of physical activity on nutrition on your blood glucose in real-time
- Noninvasive management without the discomfort of multiple finger sticks
- Ability to easily visualize trends in blood sugar management over time
Using CGM according to doctor and manufacturer instructions improves the accuracy of its readings compared to self-management. Many devices require calibration with finger sticks once or twice a day for precise glucose monitoring and need replacement sensors once or twice a week to work correctly.
The American Diabetes Association stresses the importance of holistic diabetes care personalized to the individual for adolescents, young adults, and older adults who have type 1 diabetes. Continuous glucose monitoring technology or self glucose monitoring is an important piece of a puzzle that must also include appropriate nutrition, regular exercise, and follow-up visits with primary and specialty care providers.
Dangers of High and Low Glucose Levels With Type 1 Diabetes
Over time, elevated glucose levels can lead to severe complications in adults who have type 1 diabetes. Some of the health problems that result from high blood sugar include:
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- Nerve damage, which causes pain, tingling, or numbness in the extremities
- Eye damage leading to vision problems and eventual blindness
- Cardiac issues such as heart attack and stroke because of blood vessel damage
- Kidney damage and eventual kidney failure
- Erectile dysfunction
- Non-healing wounds on the extremities that eventually lead to foot or leg amputation
Low blood sugar can also be dangerous for adults with type 1 diabetes. However, unlike the damage caused by high blood pressure, symptoms of low blood glucose arise right away and may include:
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- Fainting or loss of consciousness
- Seizures
- Confusion
- Irritability or mood changes
- Severe headache
- Fatigue or exhaustion
- Weakness
- Insatiable hunger
- Pale lips and skin
- Sweating
- Shaking
When blood sugar drops below 100, eat 5 to 15 grams of carbohydrates as a small-snack. Take a quick-acting carbohydrate if blood sugar drops below 70. In either case, recheck after 60 minutes and call your health care provider if glucose has not risen above 70.
For most people who have type 1 diabetes, low blood sugar or hypoglycemia is a common occurrence. Understanding how to manage these symptoms can help you avoid long-term complications.
Having the diabetes supplies you need on hand makes it easier to manage type 1 diabetes, whether you rely on traditional self-monitoring, CGM, or plan to make the transition from one to the other. Get in touch with the team at MedEnvios Healthcare for convenient home delivery of supplies for people of all ages who have type 1 diabetes.
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