Continuous Glucose Monitoring
What is Continuous Glucose Monitoring?
Continuous glucose monitoring systems display real-time glucose readings allowing you to see your current glucose level, glucose graphs, how fast and in what direction your glucose level is heading, allowing early intervention to reduce the frequency and severity of glucose episodes. Depending on the systems used there are a variety of alerts and graphs such as:
- Real-time readings displayed every few minutes
- Alerts providing early warning signals to avoid or minimise oncoming lows and highs
- Alerts to show when glucose levels are changing
- Real-time graphs to show previous glucose readings
- Real-time trend arrows and alerts to show the direction of your glucose level
- All can be downloaded to produce additional graphs and data
Who Can Benefit from Continuous Glucose Monitoring?
- Adults and children with Type 1 or Type 2 diabetes
- People whose glucose level is outside of the normal range, not yet diagnosed with diabetes or other medical conditions
- People with diabetes who have lost the ability to detect hypoglycaemia during the night or day
- Pregnant ladies with diabetes, gestational diabetes or trying to conceive
- People with diabetes wishing to reduce erratic blood glucose fluctuations
- People with diabetes who are involved in sporting activities
- People with diabetes whose concentration is affected by changing glucose levels
- People with diabetes who require additional monitoring whilst driving
- People with diabetes who live alone
- People who are changing diabetes therapy such as starting insulin pump therapy
- People with diabetes who require observation during hospital admission
Continuous glucose monitoring allows you to discover how day-to-day living - diet, exercise, medication and lifestyle affect your glucose level. You can hire different continuous monitoring systems from London Medical to help you find out any ‘hidden’ problem periods in your 24-hour glucose patterns, or to decide the best system to meet your needs.
Facts about Continuous Glucose Monitoring (CGM)
With the availability of continuous glucose monitoring devices, we have entered a new millennium in diabetes care. Glucose monitoring up to the 1980s was done in urine, and during the last 30 years we have become used to ‘spot testing' glucose in the blood. Since the ‘noughties', it has become evident that continuous can be measured continuously in the tissue fluid via a subcutaneously inserted sensor.While you go about your daily activities, continuous glucose monitoring (CGM) "reads" your glucose levels throughout the day and night. It gives you a window into the patterns of blood glucose highs and lows after eating different foods, physical activity and insulin bolusing, and allows you to gain better control.
Benefits of CGM
- § Can tell if blood glucose is rising or falling, indicating a possible need to treat
- § An alarm sounds if blood glucose goes too high or too low
- § Can improve diabetes control witha lowerrisk of hypos
- § Assists in adjusting basal insulin and meal bolusing
- § Invaluable for very active people and athletes requiring insulin
Limitations of CGM
- § Does not yet replace the fingertip blood glucose testing: you still need to do a BG meter reading for accuracy & conversion of electrical current (Amps) into mmol/L
- § Information overload: requires expert training and competence in diabetes & insulin management
- § Expensive: CGM is not yet routinely covered by the NHS or insurance companies
Learning Curve in CGM
The CGM sensor is an ultra-thin flexible electrode you insert under the skin, which transmits tissue glucose measurements to the receiver, where they are displayed in real time. You need to replace the sensor every five to seven (5 - 7) days (depending on the make of the CGM) although in practice, many users are finding that a sensor can be safely used over several spells of the minimum durability indicated. You will also need to learn to align the sensor tissue fluid glucose level to the blood glucose readings you get from your BG meter and understand the "lag" time difference between their readings at the time of rapid change, such as up to two hours post-meal or with an approaching low.
London Medical has started training courses for people considering CGM and for those who have purchased one and healthcare professionals who want to learn how to use it.
Interest in using these devices will continue to grow, especially when the device prices come down with increasing competition between the manufacturing companies. The price of sensors has already fallen, with three companies vying with each other for new users.
Real-Time Continuous Glucose Monitoring: Is It for You?
If you're wondering what continuous glucose monitoring (CGM) is all about, this one-day workshop is for you. Day Three of our Insulin Pump & Continuous Glucose Monitoring training course is specifically for people who are using a continuous glucose monitor (CGM) in their diabetes self-management or for Health Care Professionals who wish to move further into today's diabetes technology in their specialist clinics. Facilitated by an experienced Certified Diabetes Educator & Nurse Consultant, you'll learn how a CGM device works, along with the benefits CGM has to offer, including warnings of high and low blood glucose, whether your glucose is rising or falling, and identification of "trouble spots" in your glucose patterns and areas for improvement. Key features of various CGM devices (Medtronic Paradigm REALTime, Abbott Navigator 1.5, and DexCom Seven Plus) will be discussed to help you make an informed decision about the device that might be best for you. This workshop will also give you the opportunity to ask any questions you have about CGM. The program is designed to help CGM users enhance their diabetes self-management by focusing on advanced CGM topics, such as calibration, setting alarms, optimizing post-meal glucose patterns, and managing "information overload". In addition, you'll be given guidance on downloading reports from CGM software. Lunch and snacks are provided, allowing you to observe and review the effects of food on post-meal glucose patterns. You'll also benefit from a small group setting in which you can share experiences, concerns and helpful advice with others.
Downloads:
There are a number of CGM systems available at London Medical:
MiniMed Gardian
See : http://www.minimed.com/products/guardian/
Abbott Freestyle Navigator
See: http://www.freestylenavigator.com/ab_nav/
DexCom SEVEN
Find out about our: Insulin Pump & CGM Training Course
