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What is CGM (Sensor)?
What is CGM (Sensor)?
Continuous glucose monitoring (CGM) is a system that uses a small sensor inserted under the skin to measure and track glucose levels every few minutes. The sensor sends this information to a receiver or smartphone app, which allows people with diabetes to see their glucose levels in real time and identify trends.
What are the benefits of using a sensor?
What are the benefits of using a sensor?
CGM can be used to improve diabetes management by helping people to:
Identify and avoid high and low blood sugar levels
Adjust insulin doses as needed
Make better dietary and lifestyle choices
See how different activities and foods affect their blood sugar levels
CGM is especially beneficial for people with type 1 diabetes who need to keep their blood sugar levels within a tight range to avoid complications. However, CGM can also be used by people with type 2 diabetes and other forms of diabetes.
CGM is a safe and accurate way to monitor blood sugar levels. It is also convenient, as it eliminates the need for frequent fingerstick tests.
What CGM systems are on the market?
What CGM systems are on the market?
Dexcom G7: The Dexcom G7 is a real-time CGM system that uses a small sensor inserted under the skin to measure glucose levels every 5 minutes. The sensor sends this information to a receiver or smartphone app, which allows people with diabetes to see their glucose levels in real time and identify trends. The Dexcom G7 is approved for use in people with type 1 and type 2 diabetes, ages 2 and older.
Dexcom G6: This is the previous version and is still on the market. The major difference is that G7 combines the sensor and transmitter into one piece which makes the process much easier.
FreeStyle Libre 3: The FreeStyle Libre 3 is a real-time CGM system that uses a small sensor inserted under the skin to measure glucose levels every minute. The sensor sends this information to a reader or smart device (phone or pad), which displays glucose levels in real time and stores up to 90 days of data. The FreeStyle Libre 3 is approved for use in people with type 1 and type 2 diabetes, ages 4 and older.
Freesyle Libre 2: This is still on the market. The major difference between Libre 2 and Libre 3 is that the Libre 3 does not need to scan to get the real time data.
Medtronic Guardian Connect 4: The Medtronic Guardian Connect 4 is a real-time CGM system that uses a small sensor inserted under the skin to measure glucose levels every 5 minutes. The sensor sends this information to a transmitter, which then sends the information to a receiver or smartphone app. The Medtronic Guardian Connect 4 is approved for use in people with type 1 and type 2 diabetes, ages 2 and older.
Medtronic Guardian Connect 3: This is still on the market. The major difference between the two is that the Guardian 4 do not need fingerstick to calibrate.
Senseonics Eversense: The Senseonics Eversense is a long-term CGM system that uses a small sensor inserted under the skin to measure glucose levels every 5 minutes. The sensor sends this information to a transmitter, which then sends the information to a smartphone app. The Senseonics Eversense is approved for use in people with type 2 diabetes, ages 18 and older. It lasts 6 months.
Which CGM do you recommend?
Which CGM do you recommend?
I consider the following factors in my recommendation:
Cost: CGMs can be expensive, so it is important to consider the cost when making a choice. Some insurance may cover a certain brand and then I will go along with the insurance. If insurance does not cover any, then I recommend Freestyle Libre which is much more affordable. You can get from Walmart or Kroger for around $75 a month (2 sensors).
Accuracy: All of the CGMs on the market are pretty accurate, but in my opinion Dexcom G7 is the most accurate.
Ease of use: In the older version of Dexcom G6 is much more complicated with Libre. Now both of them are very easy. Senseonics Eversense needs an invasive procedure. For this reasons I only recommend it to people who cannot use Freestyle Libre or Dexcom for whatever reason.
Features: CGMs also vary in terms of features. Now all CGMs have features such as alarms, trends, and reports. Medtronic Guardian is not really available as a stand-alone sensor. However if you want to use the full feature of Medtronic's insulin pump closed loop system, you have to use the Medtronic Guardian. If you want to use the T-slim x2 and OmniPod 5 insulin pump, then you have to use Dexcom G6. Most recnetly the company is lauching the intergration of the G7. The integration of Libre 3 with insulin pumps has been approved but not rolled out yet. The Senseonics Eversense is under the skin so it will not fall off.
Why is the sensor number so different from my fingerstick?
Why is the sensor number so different from my fingerstick?
There are a few reasons why the sensor number may be different from your fingerstick:
They check different fluids. CGMs measure glucose levels in the interstitial fluid (ISF), which is the fluid that surrounds your cells. Fingerstick tests measure glucose levels in your blood. ISF glucose levels lag behind blood glucose levels by about 5-10 minutes. This means that your CGM sensor may read lower or higher than your fingerstick, depending on whether your blood glucose levels are rising or falling.
The gold standard is the lab blood test. The fingerstick is not the standard. The result can have 10-15% difference from the lab blood test. The CGM can also have 10-15% difference from the lab blood, They both are considered accurate.
My sensor does not stick. What can I do?
My sensor does not stick. What can I do?
There are a few things you can do to prevent your CGM sensor from falling off:
Choose the right sensor site. Place your sensor on a flat, fleshy area of your body. Avoid placing your sensor on areas of skin that are hairy, sweaty, or bony.
Clean your skin before applying the sensor. Wash your skin with soap and water and pat it dry. Then, use an alcohol wipe to remove any oil or dirt from the skin.
Shave if you have lots of hair.
Do not use any lotion or oil containing moisturizer where you insert the sensor
Apply the sensor correctly. Follow the instructions provided by your CGM manufacturer. Make sure to press the sensor firmly against your skin.
Wear loose-fitting clothing. Avoid wearing tight clothing that could rub against your sensor and cause it to fall off.
Use a skin adhesive spray or patch. These products can help to keep your sensor in place. Amazon has a lot of affordable products.
I am allergic/oversensitive to the sensor. What can I do?
I am allergic/oversensitive to the sensor. What can I do?
General considerations:
Clean skin with oil-free, antimicrobial soap and dry thoroughly
Gentle exfoliation recommended for oily skin
Do not use any lotion or oil containing moisturizer where you insert the sensor
Do not insert the sensor immediately after a shower/bath or in a steamy bathroom—minimize humidity with a hairdryer or apply in a dry environment
Solid or spray antiperspirant (unscented) may help with skin prone to sweating. Create an empty oval on the skin with the antiperspirant, wait 10–15 min. Insert sensor on clean skin in center of oval.
Barrier Film
Barrier film may help prevent mild skin irritation from adhesives
Create an empty oval on the skin with the barrier film and insert sensor on clean skin in center of oval
Let barrier film dry completely before placing sensor.
May apply one layer and a second after first layer has dried.
Some barrier film products recommended by Dexom you can try
Smith and Nephew Skin prep/no-sting skin prep
Cavilon™ No Sting Barrier (3M™)
AllKare® Protective Barrier Wipe
Barrier Patches and Bandages
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