CGM Continuous Glucose Monitor

[yakers]

Anyone have one? I am interested in the Abbott Freestyle Libre, Dr will not prescribe as I am 'only' prediabetic. I would buy one but a prescription is required in the US but not in Canada, maybe order one from there?

 

[Bamaman]

If you're just prediabetic, there's really no reason to go to the lengths of continuous monitors. The initial cost of such items is high, but there is also supplies that go along with it. Medical device companies take advantage of diabetics, as can be seen in Medtronic's insulin pumps @ $6800 plus the supplies run $7 a day to run it. Insulin is $315 a vial--or about $100 a week if you're on the pump.

Most diabetics' best investment would be a Weight Watcher's plan, as losing a little weight goes a long, long way to improving your blood sugars. And hard physical labor can lower your blood levels 50 points alone.

 

[wolf]

Pre diabetic. Just eat a well balance diet. Lose some weight. And you should be good to go. Only a small percentage of pre-diabetic's become diabetic.

Continuous glucose monitor. Why?

 

[dadu007]

A CGM is more suited towards a Type 1 diabetic, and not a Type 2 diabetic (and especially not a pre-diabetic).
Do the finger sticks once or twice a day and be done with it. You can probably get a meter for free if you search for promos from the manufacturers.


Also, a low-carb/keto diet will often move an early stage Type 2 diabetic back into normal A1c range.


Type 1 diabetes can also be well controlled with a low-carb diet and minimal (but mandatory) insulin, but that is another story, and I'm not offering medical advice.

 

[harley]

Also, a low-carb/keto diet will often move an early stage Type 2 diabetic back into normal A1c range.

I was type II for 15 years, but over the past year a low carb/keto diet and intermittent fasting produced a 45 lb weight loss and moved me solidly out of the diabetic (and even pre-diabetic) range.

I can't imagine why anyone who is not diabetic (also known as pre-diabetic) would want to deal with a CGM. Seems a little obsessive to me. As dadu007 says, a CGM isn't even really for a type II. Type I definitely, and type 1.5 maybe if they are having serious issues.

 

[audreyh1]

Most diabetics' best investment would be a Weight Watcher's plan, as losing a little weight goes a long, long way to improving your blood sugars. And hard physical labor can lower your blood levels 50 points alone.

Seems like carbohydrate restriction will move a pre-diabetic back into normal A1C ranges plus help shed some pounds. Unfortunately, Weight Watchers doesn’t really focus on this type of weight loss as they still preach that the body needs plenty of carbs even though that is not true and furthermore that works against someone who is becoming diabetic (is insulin resistant) and trying to improve their blood sugars plus lose weight.

 

[harley]

^ +1

 

[The Cosmic Avenger]

+2

WeightWatchers was pretty good 10-11 years ago when I started, but they keep tinkering with the formula, and EVERY time, I had to rig my accounting to compensate. (But that's a whole other thread.)

I finally gave up and started using MyFitnessPal, which tracks any nutrient you want, including carbs and sugars (which I don't worry about yet, but it's there). All I do is keep my caloric intake down, because if I don't track, I probably could consume 3,000+ calories a day.

 

[sengsational]

Unlike many posters here, I'm not going to try to talk you out of it, hehe!


Why? Because I think that if you're ready to change your eating behavior, then getting solid data is worth it. This is especially true if you would be less than motivated when your doctor says "eat better and get more exercise" (oh, thanks, that was helpful). With the CGM, you're no longer shooting from the hip when it comes to how foods affect your blood sugar. Everyone is different when it comes to glucose and insulin response. Certain of your typical meals might be really good or bad. Finger sticks are cheaper, but they don't show the curve. You really want the area under the curve.


The answer to the question is "no", I don't have a CGM (but I might be in part of a food study shortly that will deliver one to me).


The value of the data will be helpful at first, as you find out which meals are "bad" and which meals are "good". Then you'll have solid results to guide your behavior. After using it for "a while", you'll probably be able to predict what each curve will look like. After that, it's probably not worth wearing, except once in a while to check your intuition.

 

[yakers]

Unlike many posters here, I'm not going to try to talk you out of it, hehe!


Why? Because I think that if you're ready to change your eating behavior, then getting solid data is worth it. This is especially true if you would be less than motivated when your doctor says "eat better and get more exercise" (oh, thanks, that was helpful). With the CGM, you're no longer shooting from the hip when it comes to how foods affect your blood sugar. Everyone is different when it comes to glucose and insulin response. Certain of your typical meals might be really good or bad. Finger sticks are cheaper, but they don't show the curve. You really want the area under the curve.


The answer to the question is "no", I don't have a CGM (but I might be in part of a food study shortly that will deliver one to me).




The value of the data will be helpful at first, as you find out which meals are "bad" and which meals are "good". Then you'll have solid results to guide your behavior. After using it for "a while", you'll probably be able to predict what each curve will look like. After that, it's probably not worth wearing, except once in a while to check your intuition.

Thank you.


I want more detailed data on how my body is reacting to particular foods.
I wish there was a whole forum for 'skinny diabetics'. I try to extract what I can use but nothing matches very well. I do not need to lose weight, my doctor was initially worried about my quick weight loss (wasn't overweight to start) but that stabilized but I have to manage myself to eat enough to keep my weight from falling. I was dx prediabetic but on a fast trajectory (<5, 5.7, 5.9) in less than a year. I jumped on it with LCHF diet and got my BS below 5.6 but it seems to be creeping up a bit FBG (and random) is almost always >100 lately. Will do a home A1C test next month. AFAIK this all came on from chemo & radiation treatments 2.5 yrs ago for stage 4 throat cancer. Talk about weight loss.
My thyroid was damaged too but no weight gain or other symptoms at the time, have to take thyroid pill daily. I have little interest in food, rarely hungry and have great discipline in eating, food is for me, medicine for 3 years now. I used My Fitness Pal until I knew precisely what I am eating. For example; I count out exact numbers olives when part of a meal. It may sound obsessive but I have to do this to manage that I eat enough and good food. So far it has worked and if I need to go on meds I will.
Because I am prediabetic my Dr (&HMO) will not prescribe a meter, have to buy it myself, cheap enough. The only tests I get is A1Cs every 6 mo. I do the home A1C tests intermittently. The meter has been useful to me (my frequent use of it does drive my wife crazy though, even worse she is a vegan and I'm a carnivore). I can't tell if I don't make enough insulin or am insulin resistant or some other complication, maybe the liver as much as the pancreas? I take some supplements like nician (for other reasons but it may effect BS) and berberine, it seems to help but it is absolutely remarkable how much my BS come down from red wine, anywhere from 20 to 40 points, nothing works as well as that but I don't want to damage my liver with too much alcohol to have it stop releasing so much sugar.

 

[bmcgonig]

I don't know if you're familiar with Peter Attia, but he does a lot of research into this kind of stuff and has a great podcast. Anyway he uses the Dexcom G6 for exactly the reasons you want one, just to find out how his body reacts.

https://twitter.com/x/status/1172945638796881920

 

[MikeD]

I have been using Dexcom's G5 and G6 for about two years. I have been a diabetic since 1960, when they told my mother don't let him eat sugar and he'll be fine.


I am not fine. I think I have had every diabetic complication except an actual heart attack but It was grossly enlarged before my kidney xplant so I got that going for me.

I think you don't need a CGM but it certainly wouldn't hurt. I would find a Dr that would Rx one and if you pay for it the insurance can't complain and Why does he care?

I think the use of the CGM, specifically the within 5 mins readings and alarms will add years to me life. It costs a real lot.

I love mine.

Feel free to ask any specific questions.

I think the dexcom with the Constant bluetooth is better than having to explicitly decide to hold up your phone to get a reading.

Mike D.

 

[TromboneAl]

Just eat a well balanced diet.

 

[TromboneAl]

I've often thought that the day that you can go to your pharmacy and purchase a non-invasive continuous glucose monitor (e.g. worn like a wristwatch) is the day that people will realize that sugar is the enemy, not fat.

 

[harley]

+1000. It's so simple, and they keep getting it so wrong! There couldn't be something influencing these decisions, could there? *cough money cough*

 

[yakers]

I've often thought that the day that you can go to your pharmacy and purchase a non-invasive continuous glucose monitor (e.g. worn like a wristwatch) is the day that people will realize that sugar is the enemy, not fat.

When the Apple watch (or equivalent other company) moniters blood glucose I am buying one. I've used an exercise heart monitor for workouts and to monitor afib. The common cheap blood finger stick meters are a useful first step but a CGM would tell so much more.

 

[audreyh1]

+1000. It's so simple, and they keep getting it so wrong! There couldn't be something influencing these decisions, could there? *cough money cough*

Must be.

But I think there are several issues:

1. Treating the symptom blood sugar, instead of the cause - hyperinsulinemia. If chronic high insulin levels are the cause of diabetes, then giving a diabetic insulin is like fighting fire with more fire. That’s why type 2 diabetes is called a “chronic and progressive disease”. Because standard of care is to only treat blood sugar levels which does not cure the problem. Doctors have mostly been educated to treat the blood sugar, even though lowering blood sugar by medications such as insulin which just forces blood sugar into other tissues, has not been shown to improve long-term diabetic complications such as eye problems, wounds, neuropathy, kidney and liver problems.

2. Extreme fear of fat in western medicine caused by misguided (and wrong) dietary guidelines. Because diabetics are far more likely to suffer from heart disease they are often counseled to eat a supposedly heart friendly low fat diet which is thus high carb. Even though it’s the high carb intake that got them into this condition in the first place. Whereas a high fat low-carb diet will make both their blood sugar and insulin levels drop and reverse the disease in most cases.

3. Yes, there is tons of money to be made off of diabetics stuck in the standard of care that guarantees a chronic and progressive disease that gets increasingly more expensive to treat. Diet can reverse this expensive disease, yet who makes money off of that? Nobody except maybe some select food companies.

It does astound me that even though it has been known, and shown via several methods since 2008, that type 2 diabetes can be reversed in most cases, i.e. getting a patient below diabetic blood sugar levels and off most if not all diabetes medications. Yet here we are over 10 years later with the same general standard of care mostly focused on medications. Treatment by diet has made inroads, but they are tiny. It’s like there is this massive inertia and little motivation to change the status quo. Doctors and scientists making inroads are very aggressive with publishing their impressive results in medical and scientific journals, yet so much seems to be ignored. It’s just not moving into the mainstream.

Note that Swiss Re, one of the worlds largest life reinsurance companies, has started to be very vocal about low carb for health (longevity). At some point the many governments struggling under the staggering costs due to the diabetes epidemic are going to start cracking down. They have to. They can’t afford the current treatment that doesn’t improve patient’s health but instead worsens it.
http://foodmed.net/2018/07/swiss-re-type-2-diabetes-reversal-lchf/

 

[audreyh1]

I was dx prediabetic but on a fast trajectory (<5, 5.7, 5.9) in less than a year. I jumped on it with LCHF diet and got my BS below 5.6 but it seems to be creeping up a bit FBG (and random) is almost always >100 lately. Will do a home A1C test next month. AFAIK this all came on from chemo & radiation treatments 2.5 yrs ago for stage 4 throat cancer. Talk about weight loss.

Just to reiterate, somewhat elevated fasting blood glucose can be a result of a low carb diet and not necessarily a marker for increased risk of diabetes. It may in fact be your highest blood sugar level for the day and go down from there. Virta Health has some good articles about it. This phenomenon is sometimes called “adaptive glucose sparing” and is not a sign of the insulin resistance that can cause diabetes. If your A1C and fasting insulin levels are good, I doubt you need to worry about it at all.

 

[Retired Expat]

Just to reiterate, somewhat elevated fasting blood glucose can be a result of a low carb diet and not necessarily a marker for increased risk of diabetes. It may in fact be your highest blood sugar level for the day and go down from there. Virta Health has some good articles about it. This phenomenon is sometimes called “adaptive glucose sparing” and is not a sign of the insulin resistance that can cause diabetes. If your A1C and fasting insulin levels are good, I doubt you need to worry about it at all.

My Endocrinologist, who is not Diabetic and a skinny little thing, went on the Freestyle libre sensor just to study it and wrote an article. I found Out the same things she did. We all react differently to food and have rhythms (circadian or otherwise) related to blood sugar levels and reactions. The CGM showed me that my levels are quite low at 5am but 2 hours before I wake up they start to rise naturally, sometimes by 20-30 points. A small serving of potato with a serving of protein has much less impact then a single cracker on an empty stomach. White rice is terrible for me but not so much for my wife , who is also trying out the meter.

Milk in the morning, and we are confirmed cafe con leche drinkers, spiked our sugars but almond milk has no effect. The ability to test regularly, and see how stress, exercise, sleep, various foods and the time of day you eat, without having to stick yourself constantly is fantastic and the results eye opening.... glucose numbers are coming down and I finally am learning what are my triggers...amazing...

Tell your doctor you just want to try them out for a month two and they will like give you free samples. If your smart phone has an NFC reader (like an iPhone) you won’t need a reader and can save another $40. Oh and while the sensor does get implanted in the skin, they are totally painless!

 

[Scratchy]

Thank you.


I want more detailed data on how my body is reacting to particular foods.
I wish there was a whole forum for 'skinny diabetics'. I try to extract what I can use but nothing matches very well. I do not need to lose weight, my doctor was initially worried about my quick weight loss (wasn't overweight to start) but that stabilized but I have to manage myself to eat enough to keep my weight from falling. I was dx prediabetic but on a fast trajectory (<5, 5.7, 5.9) in less than a year. I jumped on it with LCHF diet and got my BS below 5.6 but it seems to be creeping up a bit FBG (and random) is almost always >100 lately. Will do a home A1C test next month. AFAIK this all came on from chemo & radiation treatments 2.5 yrs ago for stage 4 throat cancer. Talk about weight loss.

Like you, I am skinny and but saw my HbA1c levels steadily creep up to prediabetic levels despite regular exercise and what I thought was a healthy diet. I eventually saw an endocrinologist who specializes in diabetes who prescribed the Libre CGM and it was very illuminating for me. I got to see exactly how my blood glucose level varied by time of day, specific foods, and exercise. Based on that information I modified my diet and my HbA1c levels have come down nicely. Much of the information was a surprise-individual glucose levels can react very differently to the same challenge.

I only used the Libre for two weeks (one sensor lasts two weeks). The plan is to repeat that every six months and the endocrinologist will review and make recommendations as appropriate. She seems confident that this kind of monitoring is the best way to reduce the chance of progression to diabetes.

So I would predict a Libre device even just once would be helpful to you. The issue you seem to have is getting one. Possible workarounds:

-See if your MD will prescribe a "professional" version. This lacks the feature of allowing the patient to see the glucose reading real time-the data is stored and downloaded in the MD office. If you have kept good logs of your diet and exercise, you and your MD can get the same information the "personal" Libre version provides. My insurance covered the professional version, although it would not cover the personal version.

-See if your MD will give you a free sample of the personal version. However, it is unlikely the MD will have one to give you unless he/she is an endocrinologist.

-You mention you are in an HMO. Since it is open enrollment now, consider switching to PPO. I have a strong suspicion your HMO will not refer you to an endocrinologist or make it easy for you as a prediabetic to get a Libre.

Overall, your HbA1c does not seem too bad and you are doing the right things. Even if you don't manage to get a Libre, do not stress out about it too much!

 

[FIREd_2015]

One big concern with the Freestyle is the accuracy. An article I found said:

"In 40% of instances in which the device indicated that a patient’s glucose was <60 mg/dL, the patient’s glucose was actually in range (81–160 mg/dL)."
​

Here is the link to the article:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898159/

Various studies have shown that home meters can be way off depending on the medications/supplements one is taking. Something as simple as ascorbic acid (Vitamin C) can result in inaccurate readings. Even hospital grade meters are only required to be within 10%. Because of drug interference issues there is currently only one meter approved by the FDA for use on critically ill patients - Nova Biomedical's Statstrip. Here is the link to their press release.
https://www.novabio.us/press/07.16.18.php

Unfortunately, the Statstrip is only available to hospitals but I've seen the older models of Statstrip on Ebay as hospitals upgrade to the newer version of Statstrip. Be aware though that if the meters have not been de-configured so that it will work with any strip lot number and QC lot number the meters from Ebay will be completely useless. Also, the strips and QC solutions are not available from any retail outlet (but I've seen on Ebay) since it's a hospital grade meter.

 

[Bamaman]

Abbott sells the Freestyle Libre monitor cheap, but it costs $84.95 for the stick on sensor that only lasts 14 days. That's $6 a day to watch your blood sugars.

The tubing and supplies that goes with my Medtronic insulin pump is another $7 a day. I'm not a severe Type II diabetic and could get by on pills, but those on the pump are much more stable and actually live a couple of years longer on average. It's bad enough that insulin is $315 a vial--$100 a week on average.

Being a diabetic is expensive. Losing weight and eating right is just much cheaper.

 

[Retired Expat]

Abbott sells the Freestyle Libre monitor cheap, but it costs $84.95 for the stick on sensor that only lasts 14 days. That's $6 a day to watch your blood sugars.

The tubing and supplies that goes with my Medtronic insulin pump is another $7 a day. I'm not a severe Type II diabetic and could get by on pills, but those on the pump are much more stable and actually live a couple of years longer on average. It's bad enough that insulin is $315 a vial--$100 a week on average.

Being a diabetic is expensive. Losing weight and eating right is just much cheaper.

I know this thread is a bit old but.... and anyway, I want to brag a bit.

After years of more meds and increasing glucose numbers and an ever increasing waistline have finally turned it around. #1 was using the Freestyle libre to learn my reaction to foods and my daily cycles. Completely different than even sticking your self every hour!

Lots of people advise type 2 folk and pre diabetics to forgo the CGM sensor. But did you know your glucose can go way up at the gym? Many people will eat a banana or protein bar before hitting the gym. This is a double boost to your sugar levels. Or that your sugar may take 2x as long to come down at night? (Mine does anyway). A cold, infection or just stress can raise your blood sugar.

If I steal a few French fries from my wife on an empty stomach it is like drinking juice or coke. If I Eat a medium size potato as part of a meal with a lean protein and fiber rich veggies the impact is not too bad at all with normal glucose rise but no crazy spikes.

The proof? In two months brought down my A1C from 9.7 to 6.8 and dropped 20 pounds. While cutting back on some of the prescription meds. Although weight lose also attributed to a new drug called Ozempic that seems to reduce appetite and works on stubborn belly fat. It may we’ll be the placebo effect, so don’t tell me anything to the contrary and let my blissful ignorance and pant size reduction continue.

Generally doing great and it is about time! Are some of these things expensive? Yeah, sure but the knowledge gained is unbelievable. Based on the sensors the doctor suggested a rapid acting insulin pen to control some of the spikes or to lower my sugar if it is high before eating and that is helping a lot but my need for it has fallen way off too. Although nice to know I can use it and have some dessert without my sugar going through the roof.

All in all just damn happy with how things are going and wanted to crow about it!

 

[bmcgonig]

I know this thread is a bit old but.... and anyway, I want to brag a bit.

After years of more meds and increasing glucose numbers and an ever increasing waistline have finally turned it around. #1 was using the Freestyle libre to learn my reaction to foods and my daily cycles. Completely different than even sticking your self every hour!

Lots of people advise type 2 folk and pre diabetics to forgo the CGM sensor. But did you know your glucose can go way up at the gym? Many people will eat a banana or protein bar before hitting the gym. This is a double boost to your sugar levels. Or that your sugar may take 2x as long to come down at night? (Mine does anyway). A cold, infection or just stress can raise your blood sugar.

If I steal a few French fries from my wife on an empty stomach it is like drinking juice or coke. If I Eat a medium size potato as part of a meal with a lean protein and fiber rich veggies the impact is not too bad at all with normal glucose rise but no crazy spikes.

The proof? In two months brought down my A1C from 9.7 to 6.8 and dropped 20 pounds. While cutting back on some of the prescription meds. Although weight lose also attributed to a new drug called Ozempic that seems to reduce appetite and works on stubborn belly fat. It may we’ll be the placebo effect, so don’t tell me anything to the contrary and let my blissful ignorance and pant size reduction continue.

Generally doing great and it is about time! Are some of these things expensive? Yeah, sure but the knowledge gained is unbelievable. Based on the sensors the doctor suggested a rapid acting insulin pen to control some of the spikes or to lower my sugar if it is high before eating and that is helping a lot but my need for it has fallen way off too. Although nice to know I can use it and have some dessert without my sugar going through the roof.

All in all just damn happy with how things are going and wanted to crow about it!

Well done!!