Continuous Glucose Monitor (CGM)

Overview: CGM

What is a CGM?

A Continuous Glucose Monitor (CGM) is a device that tracks glucose levels in real-time throughout the day and night. It uses a small sensor placed under the skin to measure glucose in the interstitial fluid. This sensor sends your data to a reader, updating glucose readings every few minutes. CGMs provide valuable insights into glucose trends and patterns which help users manage their diabetes more effectively. They can also alert users to high or low blood sugar levels, reducing the risk of dangerous swings. Unlike traditional blood glucose meters that require frequent fingersticks, CGMs offer continuous monitoring with fewer manual tests. CGMs are especially beneficial for individuals with type 1 diabetes or those with type 2 diabetes who need intensive monitoring.

How does a CGM work?

CGMs provide real-time glucose readings, showing current levels and trends over time. They alert users to rising or falling glucose levels, enabling timely adjustments to diet, exercise, or insulin. This continuous data helps users avoid dangerous highs (hyperglycaemia) and lows (hypoglycaemia), and is also critical for doctors to take preventative measures against diabetes.

CGM Impact on Longevity

Why is measuring the amount of glucose important?

Measuring glucose levels is vital for detecting, managing, and preventing diabetes. For individuals with diabetes, regularly monitoring blood glucose allows them to adjust their diet, physical activity, and medication to maintain levels within a healthy range. This prevents complications like hypoglycemia, cardiovascular disease, nerve damage, and kidney failure. Beyond diabetes management, glucose measurement plays a significant role in assessing overall metabolic health. Fluctuating or consistently high glucose levels may indicate problems with insulin sensitivity, which can be an early sign of metabolic syndrome or other health issues. Intermittent fasting has emerged as a notable intervention for improving insulin sensitivity and glucose control, offering a preventive strategy that could reshape metabolic health assessments. Aside from health, in research, clinical trials, and sports performance, glucose monitoring is essential for understanding how the body responds to various interventions, including dietary changes like intermittent fasting or physical exertion. This data is crucial for developing better treatments, preventive strategies, and performance optimization plans.

Getting Started With Your CGM

Where can I get a CGM?

In Australia, you are able to purchase a CGM from either online or at a pharmacy through a prescription. At Everlab, we will provide you with the CGM when you are up to do your lifestyle review.

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What is the process of getting a CGM?

1. Consultation with Healthcare Provider: The first step is to discuss your interest in a CGM with your doctor, endocrinologist, or diabetes specialist. They will assess your need for a CGM based on your medical history, diabetes management goals, and current treatment plan. If a CGM is deemed appropriate, the doctor will provide a prescription for it.

2. Selecting a CGM Device: There are several CGM devices available, such as the Freestyle Libre. Your healthcare provider will help you choose the best device based on your individual needs and preferences. At Everlab, we will provide you with a device.

3. Installation and Setup: Setting up a CGM typically involves inserting a small sensor under the skin, usually on the abdomen or the back of the arm. The sensor continuously monitors glucose levels and transmits the data to a receiver, smartphone app, or insulin pump. The installation process may be done at home or under the guidance of a healthcare professional, depending on the device and your preference.

4. Training and Monitoring: After installation, you’ll receive training on how to use the CGM, interpret the data, and troubleshoot any issues. Ongoing monitoring and regular follow-ups with your healthcare provider are important to ensure that the CGM is effectively helping manage your diabetes. Adjustments to your treatment plan may be made based on the CGM data.

5. Ongoing Use and Replacement: CGM sensors typically need to be replaced every 7 to 14 days, depending on the device. You’ll continue using the CGM as part of your diabetes management plan, with regular check-ins with your healthcare provider to review your progress and make any necessary adjustments.

How much does a CGM cost in Australia?

CGMs can vary in price, but devices generally cost approximately $100 each. Disposable sensors such as the Freestyle Libre brand should be replaced every 7 to 14 days. In total for a year, this can amount to anywhere from $1000 to $4000. Since late 2022, the government has subsidised the cost of CGM products for any Australian over the age of 21 with Type 1 diabetes, so that it would cost them only $390 every year. However, those with Type 2 diabetes still need to pay a hefty price.

What else do I need to know?

How can I interpret my CGM?

There are several key parts of the data that should be looked at. Try having a read of the graph below!

Axes:

The horizontal axis represents the time of day, spanning from 12 AM (midnight) to 12 AM (the following midnight). The vertical axis represents average glucose levels in mmol/L ranging from 21 mmol/L to 0 mmol/L.

Target Range (3.9-10 mmol/L):

The green band represents the target glucose range, which is typically 3.9 to 10 mmol/L for most healthy individuals.

Time in Range (TIR):

The green lines within the target range (3.9-10 mmol/L) represents the percentage of time the glucose levels stayed within this desired range. Higher time in this range is generally an indicator of good glucose management.

Glucose Variability:

The broader the bands, the more variable the glucose levels. Narrower bands indicate more consistent glucose control. Glucose variability is usually measured as a %, where the lower the % the better.

Interpretation:

Look for times when the glucose levels are consistently above or below the target range. Identify patterns, such as periods of frequent highs or lows at specific times of the day. This information can help in making adjustments to diet, medication, or other lifestyle factors to achieve better glucose control.

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