This content material initially appeared on diaTribe. Republished with permission.
By April Hopcroft
Key takeaways:
- While you’re first carrying a CGM, make sure to share your knowledge together with your healthcare crew – doing so can assist you determine patterns and higher handle your diabetes.
- CGM can assist stop low blood sugar, particularly throughout bodily exercise.
- Seeing real-time glucose knowledge may show you how to perceive carbohydrates and regulate diabetes drugs.
Whereas an increasing number of individuals have entry to diabetes expertise like steady glucose screens (CGMs), many individuals nonetheless wrestle to care for his or her diabetes. Totally different meals, each day schedules, bodily exercise, and stress ranges can all have an effect on your glucose management. Fortunately, CGM can assist you higher perceive and handle blood sugar together with your healthcare supplier.
Dr. Julia Blanchette, an assistant professor of medication at Case Western Reserve who additionally lives with kind 1 diabetes herself, provided 5 pointers for how you can take advantage of your CGM to higher your diabetes care.
“It’s actually wonderful to have the minute-to-minute knowledge to be taught out of your behaviors and to know how various factors affect your self administration in actual time,” Blanchette, who can be a diabetes care and training specialist at College Hospitals in Cleveland, mentioned.
1. Share your CGM knowledge together with your supplier and different useful events.
Should you haven’t already achieved so, share your CGM knowledge together with your healthcare supplier. Relying on which CGM system you utilize, you’ll both must be sure to’ve linked your Freestyle LibreView Account to your healthcare skilled’s account, have your healthcare supplier e-mail you an invite to share knowledge through Dexcom Readability, or arrange your CareLink account for Medtronic CGMs.
CGM knowledge sharing is vital as a result of a healthcare supplier ought to be capable of assist with knowledge interpretation so you possibly can perceive how your eating regimen and each day routine have an effect on your blood glucose. They’ll probably evaluation your ambulatory glucose profile (AGP), which summarizes CGM knowledge over a number of days.
Should you’re new to carrying a CGM, attempt to eat related meals and snacks for just a few days. Maintain checking your fasting, pre- and post-meal blood sugars, and bedtime blood glucose. This can assist your healthcare supplier consider your medicine wants and regulate your dose, if wanted.
Reviewing your weekly and even month-to-month CGM knowledge can assist you determine patterns, cut back glucose variability, and enhance your time in goal glucose vary.
“Even should you have a look at your knowledge each few weeks to each month to replicate on what’s happening, you may make adjustments to realize goal time in vary,” Blanchette mentioned.
Sharing knowledge with mother and father, caregivers, and family members will also be useful. “For folks and caregivers, you possibly can nonetheless be sure that your child is okay with out bodily being there,” Blanchette defined.
CGM development arrows can assist kids perceive their our bodies and learn to care for themselves, even when they aren’t acquainted with all the particulars of diabetes.
“A college-aged youngster might know what a down arrow means, even when they could not be capable of state precisely how they really feel,” Blanchette mentioned. “This may empower youngsters to make their very own self-management choices.”
That mentioned, Blanchette identified primarily based on her personal private expertise that it’s vital to set wholesome boundaries for data-sharing between teenagers with diabetes and their mother and father.
2. Work with a clinician to set blood glucose targets primarily based in your particular person wants.
Normal time in vary glucose targets vary from 70 to 180 mg/dl, however when beginning out with a CGM, it might be vital to set acceptable excessive and low blood glucose targets primarily based in your particular person wants.
For example should you’re on insulin remedy or taking one other medicine that places you vulnerable to hypoglycemia, attempt to maintain this goal practical. For example, when you’ve got hypoglycemia unawareness and don’t really feel your lows, Blanchette mentioned that it’s smart to set the goal above 70 mg/dl.
Select a excessive goal primarily based in your common glucose ranges and the best blood sugar you normally expertise in a day. Many individuals choose 180 mg/dl because the excessive goal, however it’s best to take into account your individual blood glucose administration when setting this quantity.
“ rule of thumb is that in case your A1C is over 7%, you’ll need to set a goal above 180 and slowly decrease it over time,” Blanchette mentioned. “For example, if the best blood glucose you expertise in a day is 300, it’s a good suggestion to start out nearer to 300 and trickle it down.”
Blanchette really helpful beginning with the next time above vary goal whilst you regulate to a CGM system, determine your patterns, and perceive how you can handle your diabetes. As you make changes to drugs and life-style, you possibly can steadily decrease the goal.
3. Pay attention to various factors that have an effect on your blood glucose response to carbohydrates.
A CGM generally is a useful device to know how you can eat a balanced eating regimen and cut back post-meal blood glucose spikes, Blanchette famous. The hot button is to know how carbohydrates work and how you can stability them to get the vitamins you want.
For example, whereas objects like apples might trigger spikes in blood sugar when eaten alone, they’re an vital supply of vitamins and nonetheless may be diabetes-friendly if consumed strategically.
“We have a tendency to think about fruit and entire grains as wholesome, and they’re,” Blanchette mentioned. “They’re nonetheless nourishing in your physique, and you might even see that you’ve got blood sugar spikes whenever you eat these meals loads if they don’t seem to be balanced with different meals teams or eaten in extra.”
Including just a bit little bit of protein to carbohydrates can go a good distance; as an illustration, introducing cheese or peanut butter to a snack of apple slices may be useful to reduce blood glucose fluctuations.
Carrying a CGM may assist you determine if the order during which you eat completely different meals impacts your blood sugar. Some analysis means that consuming carbohydrates because the final a part of your meal can cut back post-meal glucose in kind 2 diabetes.
This might imply consuming scrambled eggs with sauteed greens first for breakfast, after which having a small slice of avocado toast following a wholesome dose of protein and fats. A lunch or dinner meal may contain consuming hen first, then some greens, and ending with a chunk of fruit.
4. Tune in to your CGM simply earlier than and through train to cease hypos earlier than they begin.
People who find themselves vulnerable to low blood glucose ranges – these on insulin remedy or different glucose-lowering drugs that may trigger hypoglycemia – can look at the development arrows earlier than or throughout their exercise to stop exercise-induced hypoglycemia.
“ what your blood glucose is and the place it’s trending earlier than and through your exercise is so good, since you don’t should pause to do a fingerstick and verify your blood glucose ranges,” Blanchette mentioned. She defined which you can devour carbohydrates – akin to small sips of Gatorade and glucose tabs – as wanted to stop lows and maintain your glucose up as you train.
CGM may show you how to obtain higher time in vary with bodily exercise. Earlier than CGM, Blanchette defined, individuals with diabetes had been informed to start train at the next blood glucose stage to keep away from hypoglycemia.
“In highschool, I performed softball and I all the time ran excessive as a result of CGM didn’t exist. I needed to maintain my blood sugar at 200 mg/dL if I wished to attend the entire observe.
“Now, with CGM, we will train with glucose that begins in vary (however not the decrease finish of in-range),” she mentioned. “And if glucose begins dropping, we will tackle it because it’s taking place, as a substitute of getting to start out greater and never know what’s going to occur,” she mentioned.
Likewise, for endurance athletes akin to distance runners or cyclists, CGM may be useful to determine the precise blood glucose ranges the place it’s essential to take some carbs in order that they don’t should disrupt their exercises.
Blanchette identified that CGM will also be useful in determining what time of day is finest for train. Some individuals discover they’re extra insulin resistant within the morning, particularly because of the daybreak phenomenon, so it might be finest to get up somewhat earlier to get a morning stroll or jog in.
“Personally, I don’t know the way I’d train with out CGM at this level,” she mentioned.
5. Use your CGM knowledge to regulate insulin and different drugs.
Whereas it’s really helpful to see a diabetes healthcare skilled each three to 6 months, many individuals with diabetes don’t have entry to this stage of care. In between common appointments, CGM can assist you make changes to your diabetes administration, together with insulin and different drugs.
Should you’re spending plenty of time above or beneath vary or should you’re spending lower than 70% of your time inside goal vary, it’s a good suggestion to succeed in out to your healthcare supplier to see how one can regulate your insulin remedy.
Actual-time knowledge from CGM will also be useful for individuals beginning new drugs. For example, many GLP-1 receptor agonists can cut back insulin wants and result in hypoglycemia. Blanchette encourages individuals with kind 2 diabetes on insulin remedy who start taking a GLP-1 to attempt CGM to stop lows and optimize their insulin remedy.
The underside line
Though CGMs had been initially developed for security functions to keep away from hypoglycemia, in the present day they’re a priceless device for offering perception on how various factors have an effect on blood glucose. From adjusting your eating regimen to exercising worry-free, a CGM can assist you enhance each day diabetes administration and self-care.
It’s helpful to keep in mind that carrying a CGM doesn’t work finest in isolation, nonetheless. It’s vital to share your knowledge together with your healthcare supplier, particularly when you’re simply getting began, so to higher perceive patterns in your glucose ranges.
