To monitor your blood sugar (glucose) concentrations; to evaluate changes and trends in your glucose concentration over time.
Continuous Glucose Monitoring
National Institute for Health and Care Excellence (NICE) guidance recommends that all adults with type 1 diabetes should be offered a choice of real-time continuous CGM, or intermittently scanned CGM (‘flash’ monitoring). Real-time CGM should be offered to all children and young people with type 1 diabetes.
For patients with type 2 diabetes, eligibility is restricted to those taking multiple daily insulin injections who either have recurrent or severe hypoglycaemia (low glucose levels), impaired hypoglycaemic awareness, a disability which may affect their ability to perform finger-prick blood glucose checks, or those who are required to test their glucose levels more than 8 times per day.
The purpose of CGM is to help the patient and team control blood sugars better and avoid too many finger prick tests.
A continuous glucose monitoring (CGM) device includes a small sensor that is inserted beneath the skin of the tummy (abdomen) or the upper arm and held in place with an adhesive patch. The sensor measures glucose in the space around cells (interstitial space). CGM measures glucose at frequent intervals and sends the results wirelessly to a smart phone or hand-held reader. These digital readouts let you know your equivalent blood glucose level in real time.
No test preparation is required.
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How is it used?
CGM is now used by a large proportion of people with type 1 diabetes. As CGM devices become increasingly accurate and user-friendly, their use is increasing.
National Institute for Health and Care Excellence (NICE) recommend CGM for adults, children and young people with type 1 diabetes, and for a limited number of reasons for patients with type 2 diabetes (those requiring multiple daily insulin injections and have either recurrent or severe hypoglycaemic episodes, a disability affecting their ability to perform finger-prick checks, or need to test their glucose levels more than 8 times per day).
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When is it requested?
Real-time CGM may be used daily and constantly to have better glucose control when you have type 1 diabetes.
CGM may be used periodically when you have diabetes and your healthcare practitioner wants to collect and evaluate data on your day-to-day glucose variability and control.
CGM may be used in limited circumstances when you have type 2 diabetes (see above).
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What does the test result mean?
Glucose values from CGM devices generally correlate closely with blood glucose concentrations. Your target range for your glucose levels is determined by your healthcare professional and depends on several factors, such as:
- Your daily activities
- Other underlying conditions you may have, including heart disease
- Your likelihood of diabetes-related complications
- Whether you do not experience distinct symptoms of low blood sugar (hypoglycemia unawareness)
CGM results can identify variability in glucose levels throughout the day, identify trends and anticipate when your glucose level is getting too low (hypoglycemia) or too high (hyperglycemia), and send an alert to your smart phone or reader.
Looking at patterns of glucose data (such as data points collected over several days and graphed in a report) can help you and your healthcare practitioner evaluate variations in your glucose levels and suggest actions that may help stabilise glucose levels and improve glucose control.
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Can I buy a CGM device over-the-counter?
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Can I use a device for longer than indicated?
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Is there anything else I should know?