If you know a diabetic, or someone with a diabetic child, chances are they’ve spoken to you about at some point about continuous glucose monitoring (CGM).
In this article, I’ll explain what CGM is, and 5 reasons that it’s absolutely game-changing for those with diabetes.
So what is CGM?
Continuous glucose monitoring is the alternative to the more ‘traditional’ methods of testing your blood sugar levels via finger pricking. Diabetics can have to test anything up to 15 times a day (and beyond!) and it’s painful and inconvenient. Imagine having to wake yourself up during the night to prick your finger!
A CGM device consists of a sensor that sits just underneath your skin and provides the user with 24 hour readings – allowing you to identify trends and adjust insulin requirements based on the results. Now CGM is not a new technology, I was first put onto a Dexcom CGM in 2010 when I couldn’t get my blood sugars under control.
Back then, the model I used involved a less-than-fetch grey wire that was permanently attached to your body with a clunky monitor on the end of it. You had to put the monitor in a special waterproof bag when you took a shower, and you still had to finger prick on a regular basis to calibrate the results on the screen, with what was actually going on with your blood sugar levels.
As much as it gave invaluable information that I wouldn’t have been able to get from regular finger prick testing, it was annoying, painful at times, and pretty unsightly.
This technology was only available to me through the nurses at the Diabetes Centre. It wasn’t something you could really request, nor was it something you could wear for longer than the two weeks you were allocated (as there was often a waiting list)
How have things changed since then?
Fast forward 8 years, and diabetics have access to more advanced technology globally. You no longer have to go to the hospital to get a CGM, you can order them online.
The sensors that come with the devices are now smaller, more discreet, and can send the information directly to your mobile phone or smart watch (depending on which one you use).
Here are my five reasons why CGM devices should be available to all:
#1 The convenience
Having the ability to swipe a device rather than pull out a blood testing kit, perform a (sometimes) painful finger prick and make decisions based on the results is a monotonous procedure.
It takes time, is anything but discreet and when you’re on the move or living your life it’s really just a pain in the…finger.
CGM allows you to swipe and go, make a decision there and then on what your next move should be, without disrupting your day-to-day.
#2 It’s relatively pain free
Ok so I mentioned above that finger-pricking was sometimes painful. Sure – the odd one or two a day is bearable. But increase that number on a particularly bad day for control to 15, and you have sore, bloodied fingers.
The CGM kits involve a pain free sensor application once every two weeks (roughly) and each swipe or test involves no pain.
#3 The reassurance
The Dexcom device in particular sends real-time blood glucose readings to up to 5 smart devices via magical unicorn waves, meaning parents, partners or relatives can be kept up to date with how the sensor wearer is doing.
There’s no distance restriction, which means a diabetic child could be at school and their parents at work, and they’d be able to check on their child’s sugar levels – pretty cool hey?
#4 The freedom
As a (now late) twenty-something year old, I enjoy socialising, walking and the (very) occasional trip to the gym.
I can honestly say there is nothing more satisfying than only having to take my phone out with me to check my blood sugars (HAVE YOU EVER TRIED TO FIT A FAT BLOOD TESTING KIT INTO A CLUTCH BAG? IT DOESN’T WORK)
#5 The data
OK so probably the most important feature of the CGM technology is the data it gives the user.
I can see 24 hour + blood sugar trends whilst I’m wearing my sensor, allowing me to adjust the amount of insulin I administer and weigh it up against the food I eat or have eaten.
I get access to an average result, trend graphs and the added ability to track food and insulin injections, all on the monitor or smart device.
The user also gets to see overnight readings, which is something that you’d be unable to get with a finger-prick test (unless you woke up every hour to test your sugars – not fun)
It’s imperative that overnight readings remain in range where possible. With the average person sleeping for 7 hours a night, if these 7 hours of readings aren’t in range it can have a detrimental effect on your overall average blood sugar and health.
Basically, the CGM provides context, rather than just a reading.
Since wearing my sensor (pretty much continually since Autumn 2016) my average blood sugar reading (Hba1c) has dropped substantially. I am able to identify potential issues with my control, before they become issues.
It also means, I am less at risk of the many complications diabetics face if they have poor control.
But as with everything, this supposed ‘luxury’ does not come without cost.
This technology is not currently available on prescription on the Island, meaning everyone that is using a CGM system is self-funding.
I currently use the Freestyle Libre system, which is a ‘flash glucose monitoring’ device rather than a CGM. The difference being that I have to tap my monitor or mobile device onto my sensor to get a reading – but it will then still show me the trend of the last however many hours and store all data.
Here’s a quick cool ‘n hip vid of me applying one of my Freestyle Libre sensors. This sensor helps me monitor my blood sugar and costs me £60. It will last me two weeks, after then it will expire and I’ll need to apply a new one. The sensor is applied with a needle (which I tried to point out on the vid) and sits just underneath my skin on the top of my arm. It’s sort of discreet, but I don’t try to hide it. Lots of people have seen it and asked questions like;‘Is that a nicotine patch?’ ⚪️‘Do you take Apple Pay?’ 🤪‘Are you a cyborg?’ 🤖EVEN BETTER GUYS. I’M MONITORING MY BLOOD SUGAR. 😎This type of system is called a Flash Glucose Monitoring system, and enables me to tap a monitor or smart device on the sensor to instantaneously read my blood sugars, removing the need for finger prick testing. It is continuously monitoring my sugars, so I can identify trends in my readings (I LOVE DATA) and adjust my insulin if I need.I am personally covering the costs for my two sensors a month (well, half paid by my wonderful mother ❤️) and will continue to do so until they become available on prescription. I absolutely know how lucky I am to be able to afford these at the moment, and occasionally when I am a few days without a sensor, I am reminded of the frustration and sheer inconvenience of finger prick testing. I am working with the Manx Diabetic Group and other members of the community to get this system and other continuous glucose monitors on prescription for all diabetics on the Island. Watch this space for more info on how you can help. #TalkAboutDiabetes
Posted by Natasha Parry on Thursday, 21 June 2018
I pay £60 for one sensor, which lasts me two weeks. All the mathematics out there will have worked out that it costs £120 a month, leaving me with an annual personal cost of £1,440 (plus delivery, which is around £5 a time!)
CGM giants Dexcom recently launched their newest model, the G6, and when it was released I requested a callback from their sales team to hear more about what the Dexcom technology could give me that Libre couldn’t.
The answers were:
- Continuous glucose monitoring (without having to physically tap a monitor to check sugars)
- A fully customisable alerting system when blood sugars are rising to unsafe levels (high) and a an inbuilt hypo (low-blood sugar) alarm, both of which would alert all users signed up to receive notifications (i.e. parents, carers, or teachers) which gives parents and users peace of mind.
These additional perks, obviously, come at more of a cost. The Dexcom G6 starter kit, including 3 sensors and a transmitter is £159. The subscribe & save option for a 12 month supply totals £1908.
It is something I will consider investing in in the future, but for the time being, the Libre is accurate enough for me.
As you can imagine, CGM technology enhances a diabetic’s life substantially. It also gives the parents of diabetic children absolute reassurance on how their child is and what their sugars are doing at any given point. But, as you can see above, it’s expensive.
There are families on the Island who have openly discussed spending all of their savings on ensuring their child always has access to CGM technology.
Local charity, the Manx Diabetic Group are supporting a parent-led initiative newly launched on the Island, called ‘Monitors4Kids’. This is a follow on campaign to ‘Pumps4Kids’ launched a few years ago, which raised tens of thousands of pounds and removed the waiting list for insulin pumps on the Island.
Their aim is to raise £120,000 over two years to help diabetic children on the Island have continual access to this technology.
The campaign launch is taking place next Thursday 19th July at Cycle 360. If you would like to attend, you can reserve tickets here.