Managing Diabetes: Continuous Glucose Monitoring

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Managing Diabetes: Continuous Glucose Monitoring

June 2017

By Kathy Cuddy

Diabetes is a condition that requires constant monitoring of blood glucose levels to keep them within target levels and to limit the extreme highs or lows. A doctor can help determine a target range that is best for you, and develop a care plan to attain that goal.

– abnormally low blood glucose levels, usually less than 70 mg/dl. Typical symptoms of hypoglycemia include shakiness, irritability, confusion, rapid heartbeat, blurred vision, headaches, fatigue, lack of coordination, seizures and unconsciousness.

Hyperglycemia – abnormally high blood glucose levels, which occurs when the body has too little insulin or when the body can’t use the insulin properly. Symptoms of hyperglycemia include frequent hunger, increased, and urinary frequency/volume.

It is very important to keep blood glucose in the target range to prevent the complications often seen with diabetes: skin complications, vision issues, neuropathy, foot complications/wounds, Ketoacidosis, kidney disease and gastroparesis.

To keep blood glucose in the target range, frequent glucose monitoring is required to help make decisions about food, exercise and medication. A common method of checking levels is using a lancing device to get a blood sample from a fingertip or other area to test in a glucose monitor. This may need to be done several times a day, and has been the traditional way to test glucose levels throughout the day.

Continuous glucose monitoring (CGM) systems contain three-pieces that continuously measure glucose levels: sensor, transmitter, and receiver. A tiny sensor inserted under the skin into the interstitial fluid to register glucose levels. Using a transmitter connected to the sensor, information about glucose levels are sent to a receiver. The receiver/hand held monitor can be set to alarm high and low levels, so that the appropriate treatment can be made to get the glucose level back to target ranges. The real-time measurements of glucose levels can be tracked to aid in management of diabetes and discussed with a physician to update your care plan.

CGMs are a more expensive method of monitoring, but can enable better glucose control. Several devices have been approved by the Food and Drug Administration (FDA) and available with a prescription. Many insurances cover the CGMs, including Medicaid, BCBS, Tufts, and Harvard Pilgrim. (Medicare does not cover them at this time.)

Please check with your healthcare provider to see if a CGM or insulin pump might be the right solution to better manage glucose levels.