Are You ON The CGM Rollercoaster? Get OFF With These PRO Tips
byBrian Lucido; Editor Scott King
It is generally accepted that tight blood sugar control can reduce the risk of microvascular complications (kidney disease, nerve damage, and eye disease) in people with diabetes. Tight control can be dangerous if you dip too low without warning. CGMs (Continuous Glucose Monitors) make tight control more feasible by giving us a layer of safety with automatic warnings when blood sugar is too high or too low. The technology to achieve instantaneous readings with 100% accuracy hasn’t arrived yet, but it’s coming. The Dexcom G5 with a MARD (Mean Absolute Relative Difference between CGM and fingerstick) of 9% is close. Lower is better, and when we reach 0% with instant results, we will have some fantastic tools in our hands. For comparison, the Medtronic Enlite has a MARD of 13.6%, and the Abbot Freestyle has a MARD of 11%.
In spite of these official MARD results, this technology varies in different hands and bodies. Here we present some strategies to get the best possible results with the Dexcom.
Roller Coaster Glucose Connection
First, we must discuss the limitations of modern CGM technology. Foremost, modern CGMs measure the glucose concentration of the interstitial fluid — NOT blood. This is very important to know because it means that your readings from the CGM are delayed by about 15-20 minutes from your actual blood glucose levels. (The lag time varies greatly depending on many things and whether glucose is going up or going down.)
To conceptualize this, imagine a roller coaster where the front car is your blood glucose (fi Continue reading