Category: Continuous Glucose Monitoring

Use a CGM for improved Diabetes control

We decided that a continuous glucose monitoring system was the way to go soon after our daughter was diagnosed. She has another health condition that makes diabetes management more difficult (EDS) and with frequent episodes of hypoglycemia, we needed more information.

A CGM (continuous glucose monitor) was the best choice. It relays her glucose level every five minutes, 24 hours a day. It has given her more flexibility and improved control. It's given us the most peace of mind a parent can have when their child has Type 1 Diabetes.

 

The top choices

 

 

Medtronic's 640G CGM system

Automatically suspends insulin delivery to reduce hypoglycemia

Dexcom G5

FDA approved for treatment without a confirmation finger prick test.

A brief introduction to continuous glucose monitoring

A blood glucose test provides a single number at the time of testing. Continuous glucose monitoring is a process that provides glucose information roughly every five minutes, 24 hours a day. A small sensor is inserted under the skin and a transmitter is attached to it that wirelessly transmits the information to either a dedicated receiver, a particular insulin pump or a mobile phone.

CGM glucose information is not the same as a blood glucose monitor (BGM) test. BGMs test the level of glucose in the blood stream using a finger prick test, whilst a CGM measures the level of glucose in the interstitial fluid. Glucose, once ingested takes about 10-15 to make it into the blood stream and another 10-15 minutes to reach the interstitial fluid. As a result, the CGM reading often lags about 10-15 minutes behind a blood glucose monitor reading. When levels are stable, this is quite irrelevant, but when it's rapidly changing, there can be quite a big gap between the two. This gap doesn't mean the sensor isn't accurate neither does it make it less valuable - all you have to do is follow the current trend 10-15 minutes into the future mentally and it's a pretty good prognosis of what's going on now.

There are three big brands available on the market – the Freestyle Libre flash system from Abbot, the Guardian and Enlite from Medtronic as well as the G4 and G5 from Dexcom. Each of the systems has its own advantages and disadvantages.

Our choice: Dexcom G5 paired with Galaxy S6

We have experimented with all three brands for at least eight weeks and have selected the Dexcom G5 as our current sensor of choice because of its high accuracy, customizable high and low alerts, excellent share capability to multiple smartphones and it's FDA approved for making treatment decisions.

Cass' Dexcom G5 is paired with a Samsung Galaxy S6. It fits comfortable underneath her clothes and has a very small footprint.We share the data through the Dexcom share app to both a Galaxy S7 and S8, again with no issues. It's been a huge benefit to have CGM data available on each of our phones all the time. It's also got the benefit of excellent reliability with far fewer signal dropouts and although none of the CGMs on the market is infallible, the Dexcom G5, despite the occasional blip, has become indispensable.

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