This content material initially appeared on diaTribe. Republished with permission.
By April Hopcroft
Key takeaways:
- Whenever you’re first carrying a CGM, you’ll want to share your information along with your healthcare crew – doing so may help you determine patterns and higher handle your diabetes.
- CGM may help forestall low blood sugar, particularly throughout bodily exercise.
- Seeing real-time glucose information also can assist you perceive carbohydrates and regulate diabetes drugs.
Whereas increasingly folks have entry to diabetes know-how like steady glucose displays (CGMs), many individuals nonetheless wrestle to care for his or her diabetes. Totally different meals, day by day schedules, bodily exercise, and stress ranges can all have an effect on your glucose management. Fortunately, CGM may help you higher perceive and handle blood sugar along with your healthcare supplier.
Dr. Julia Blanchette, an assistant professor of drugs at Case Western Reserve who additionally lives with sort 1 diabetes herself, provided 5 pointers for the right way to profit from your CGM to raised your diabetes care.
“It’s actually wonderful to have the minute-to-minute information to study out of your behaviors and to grasp how various factors affect your self administration in actual time,” Blanchette, who can also be a diabetes care and schooling specialist at College Hospitals in Cleveland, stated.
1. Share your CGM information along with your supplier and different useful events.
In the event you haven’t already accomplished so, share your CGM information along with your healthcare supplier. Relying on which CGM system you employ, you’ll both must be sure you’ve linked your Freestyle LibreView Account to your healthcare skilled’s account, have your healthcare supplier e mail you an invite to share information by way of Dexcom Readability, or arrange your CareLink account for Medtronic CGMs.
CGM information sharing is necessary as a result of a healthcare supplier ought to be capable to assist with information interpretation so you may perceive how your eating regimen and day by day routine have an effect on your blood glucose. They are going to possible assessment your ambulatory glucose profile (AGP), which summarizes CGM information over a number of days.
In the event you’re new to carrying a CGM, attempt to eat related meals and snacks for a number of days. Preserve checking your fasting, pre- and post-meal blood sugars, and bedtime blood glucose. This may help your healthcare supplier consider your treatment wants and regulate your dose, if wanted.
Reviewing your weekly and even month-to-month CGM information may help you determine patterns, cut back glucose variability, and enhance your time in goal glucose vary.
“Even if you happen to have a look at your information each few weeks to each month to mirror on what’s happening, you can also make adjustments to attain goal time in vary,” Blanchette stated.
Sharing information with dad and mom, caregivers, and family members will also be useful. “For fogeys and caregivers, you may nonetheless make sure that your child is okay with out bodily being there,” Blanchette defined.
CGM development arrows may help youngsters perceive their our bodies and discover ways to maintain themselves, even when they aren’t acquainted with all the particulars of diabetes.
“A college-aged baby might know what a down arrow means, even when they could not be capable to state precisely how they really feel,” Blanchette stated. “This will empower children to make their very own self-management choices.”
That stated, Blanchette identified primarily based on her personal private expertise that it’s necessary to set wholesome boundaries for data-sharing between teenagers with diabetes and their dad and mom.
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 necessary to set acceptable excessive and low blood glucose targets primarily based in your particular person wants.
As an illustration if you happen to’re on insulin remedy or taking one other treatment that places you vulnerable to hypoglycemia, attempt to maintain this goal life like. As an illustration, when you’ve got hypoglycemia unawareness and don’t really feel your lows, Blanchette stated 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 very best blood sugar you often expertise in a day. Many individuals choose 180 mg/dl because the excessive goal, however you need to take into account your personal blood glucose administration when setting this quantity.
“An excellent 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 stated. “As an illustration, if the very best blood glucose you expertise in a day is 300, it’s a good suggestion to begin nearer to 300 and trickle it down.”
Blanchette really helpful beginning with the next time above vary goal when you regulate to a CGM system, determine your patterns, and perceive the right way to handle your diabetes. As you make changes to drugs and life-style, you may step by step decrease the goal.
3. Be aware of various factors that have an effect on your blood glucose response to carbohydrates.
A CGM could be a useful device to grasp the right way to eat a balanced eating regimen and cut back post-meal blood glucose spikes, Blanchette famous. The bottom line is to grasp how carbohydrates work and the right way to stability them to get the vitamins you want.
As an illustration, whereas objects like apples might trigger spikes in blood sugar when eaten alone, they’re an necessary supply of vitamins and nonetheless might be diabetes-friendly if consumed strategically.
“We have a tendency to think about fruit and entire grains as wholesome, and they’re,” Blanchette stated. “They’re nonetheless nourishing in your physique, and you might even see that you’ve blood sugar spikes once you eat these meals so much 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 great distance; for example, introducing cheese or peanut butter to a snack of apple slices might be useful to attenuate blood glucose fluctuations.
Sporting a CGM also can assist you determine if the order by 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 sort 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 would possibly 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 study 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 must pause to do a fingerstick and test your blood glucose ranges,” Blanchette stated. She defined which you can eat carbohydrates – reminiscent of small sips of Gatorade and glucose tabs – as wanted to stop lows and maintain your glucose up as you train.
CGM also can assist you obtain better time in vary with bodily exercise. Earlier than CGM, Blanchette defined, folks 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 needed to attend the entire follow.
“Now, with CGM, we will train with glucose that begins in vary (however not the decrease finish of in-range),” she stated. “And if glucose begins dropping, we will deal with it because it’s occurring, as an alternative of getting to begin larger and never know what’s going to occur,” she stated.
Likewise, for endurance athletes reminiscent of distance runners or cyclists, CGM might be useful to determine the precise blood glucose ranges the place it’s essential to take some carbs so that they don’t must disrupt their exercises.
Blanchette identified that CGM will also be useful in determining what time of day is greatest for train. Some folks discover they’re extra insulin resistant within the morning, particularly because of the daybreak phenomenon, so it might be greatest 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 stated.
5. Use your CGM information 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 may help you make changes to your diabetes administration, together with insulin and different drugs.
In the event you’re spending numerous time above or beneath vary or if you happen to’re spending lower than 70% of your time inside goal vary, it’s a good suggestion to achieve out to your healthcare supplier to see how one can regulate your insulin remedy.
Actual-time information from CGM will also be useful for folks beginning new drugs. As an illustration, many GLP-1 receptor agonists can cut back insulin wants and result in hypoglycemia. Blanchette encourages folks with sort 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, right this moment 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 may help you enhance day by day diabetes administration and self-care.
It’s helpful to do not forget that carrying a CGM doesn’t work greatest in isolation, nonetheless. It’s necessary to share your information along with your healthcare supplier, particularly if you find yourself simply getting began, as a way to higher perceive patterns in your glucose ranges.
