CGM: Is it an abbreviation to remember?

The age of technological advancement sees the world awe-inspired as we reach out for new frontiers in space, and we enjoy improved features and capabilities from our smart devices. In the medical industry, it can feel like there are fewer blue-sky advancements. Many are waiting for a breakthrough or a cure for chronic conditions. Progress in the medical field can drastically improve the quality of life for many people, simply by counteracting some of the debilitating symptoms they live with.

Now, thanks to simple finger pricks, it’s easy to get a real-time reading of blood sugar levels. Thus, we can correct high or low readings. We are now also able to identify patterns – if a diabetic has the same reading outside of the target zone each day, we can address it. Now, thanks to improved insulins and glucose monitoring, diabetics can fall pregnant and give birth to healthy babies – a feat that was not possible (or at least not advisable, since these babies hardly ever made it to term, healthy) just a few decades ago.

However, that’s not to say it has become easier. For many, it’s grueling. It’s frustrating. It’s a full-time job with no holidays. A CGM is the next advancement that offers people better control of the condition.

What are CGMs?

CGM stands for continuous glucose monitor. It refers to a device that is implanted into the skin which continuously measures the blood glucose levels of a person, giving a minute-by-minute graph of how their blood sugar levels fluctuate. While each device is different, they generally come with similar features. You can expect alerts to let you know before your blood sugar levels rise or drop outside of your target zone. You can expect a reasonably compact and small device attached to your body which sends a signal to your mobile device or smartwatch with your glucose readings. These features vary – some have advanced settings while others are basic in order to stay cost-effective.

The Pros and Cons of a CGM.

Pro – Better control over overall blood sugar control thanks to identifying problem patterns easier.
Pro – Alerts when blood glucose levels are going up or down rapidly, enabling the user to prevent an out-of-target reading by counteracting it.
Pro – A CGM is discreet and enables real-time readings.
Con – Increased monthly costs – it’s not just the once-off purchase of the device that’s expensive. The sensors, which need to be changed regularly, are very costly.
Con – Certain CGMs might limit the level of activity – extreme sports may disrupt the placement and signal giving false alerts.
Con – Many CGM devices still require daily calibration, which means users still need to have test strips and perform daily finger pricks, albeit far fewer.

Four unique devices empowering people with diabetes

Eversense

Eversense offers a unique benefit, taking the concept of discreetness beyond simply having a device attached to your body. The Eversense is implanted under the skin, which means users have more freedom to participate in wild and crazy adventure sports and potentially choose outfits more freely. Another helpful feature is the on-body vibrations that provide an alert if there’s a drop or a rise in glucose levels.

Key features:

Requires calibration twice daily
Very small in size
90-day system
Suitable for diabetics and individuals with hypoglycemia unawareness

Most CGMs work with a mobile application, readings feed through to the app in real-time, providing an easy alternative to finger-pricking. One of the challenges faced by users with other CGMs is the short lifespan of the sensors (around 14 days). Eversense’s sensors last for 90 days. That means fewer changes. Eversense also enables the removal of the transmitter without needing to change the sensor.

Pros

90-day system.
Discreet and flexible.
Can plot every single reading for a graphical view.

Cons

Still requires two finger pricks per day for calibration.

Website: https://www.eversensediabetes.com

Dexcom G6 CGM System (A great CGM for convenience)

Dexcom has been one of the industry leaders when it comes to innovating CGM devices. They’re an established and trusted brand. What makes the Dexcom particularly convenient is that there’s no need to calibrate daily – The calibrations are only done when needed. While it’s not the cheapest option out there, it’s undoubtedly the most “hands-free” option.

Key features:

The sensor is painlessly inserted
Works with any smart device to deliver readings from under the skin
10-day wear sensor
Suitable for age two and up

Dexcom claims to have lowered patients’ HBA1C (a measure of long term control) readings by giving them better insight into how effective their control actually is. The device pairs with compatible smartphones and watches to give a real-time reading in order to mitigate those undesirable numbers altogether.

Pros

No finger pricks daily.
Easy to insert with its applicator.
Sharing readings with caregivers or family is done wirelessly.

Cons

10-day wear sensor.
More expensive due to frequent sensor changes.

Website: https://www.dexcom.com

Medtronic’s Guardian Connect (best CGM through which to collaborate with care providers)

In some ways, the Medtronic Guardian Connect still has ways to go. It’s only available for use by a specific age group, and its mobile app is not compatible with Android devices as yet. Is it still worth it? Absolutely. Users can share real-time readings with up to five people making it easier for loved ones to administer care if necessary. These caregivers can get an SMS to alert them if levels are out of range.

Key features:

High Alert Settings
Low Alert Settings
Up to 288 sensor glucose readings every 24 hours

Users can also upload reports to the cloud where a doctor can view them and advise on diabetes care accordingly. The user-interface requires familiarisation but it’s efficient and comprehensive.

Pros

A 60 minute alert before levels go out of range.
Access the innovative Sugar.IQ™ diabetes assistant app.

Cons

Android app not yet available, likely in summer 2020.
Only suitable for people over the age of 14 and under the age of 75.

Website: www.medtronic.com

Freestyle Libre CGM (most affordable CGM)

The Freestyle Libre is something in between a traditional CGM and the older finger-prick tests. There are no pricks involved, and you can get as many readings as you need, but you do have to calibrate the device twice daily, and the user has to swipe the reader over the sensor (which is attached to the body) to get a reading. The benefit is that it’s a fraction of the cost in comparison to other devices.

Key features:

14-day sensor lifespan.
Swipe over the reader for a sugar reading.
Swipe provides current reading, trend, and 8-hour history.

This CGM also gives you reports – time you have spent in your target range, and time above or below target. You can get a comprehensive report of each day’s readings, enabling better care as problem areas are identified. The manufacturer claims it is clinically proven to reduce the number of hypoglycemic incidents.

Pros