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 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.
- 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.
- 90-day system.
- Discreet and flexible.
- Can plot every single reading for a graphical view.
- Still requires two finger pricks per day for calibration.
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.
- 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.
- No finger pricks daily.
- Easy to insert with its applicator.
- Sharing readings with caregivers or family is done wirelessly.
- 10-day wear sensor.
- More expensive due to frequent sensor changes.
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.
- 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.
- A 60 minute alert before levels go out of range.
- Access the innovative Sugar.IQ™ diabetes assistant app.
- Android app not yet available, likely in summer 2020.
- Only suitable for people over the age of 14 and under the age of 75.
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.
- 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.
- Easy to operate.
- Great option for all diabetics.
- Requires two calibrations daily.
So, CGM: Is it an abbreviation to remember?
In short, yes!
To put it all together – CGM stands for continuous glucose monitor. A CGM is a small device that is inserted into the skin (usually onto the upper arm or around the belly). It measures glucose levels by testing the sugar in interstitial fluid (the fluid that lies between the cells).
It sends its readings to a device, like a phone where they can be interpreted. They provide useful graphical data to understand more closely how a person’s blood sugar levels are responding to different things throughout the day. The most appropriate device is one that fits into a person’s life the best while balancing this against costs.
This area of health technology is providing people with diabetes actionable data. This can help improve long term outcomes but also help with preventing severe low or high blood sugar events, and assist with enhancing the quality of life. It’s also a high growth area of health technology for many companies, with competition in the area contributing to ongoing advances in devices for patients.