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 knowledge along with your healthcare staff – doing so can assist you determine patterns and higher handle your diabetes.
- CGM can assist forestall low blood sugar, particularly throughout bodily exercise.
- Seeing real-time glucose knowledge also can aid you perceive carbohydrates and regulate diabetes medicines.
Whereas increasingly more folks have entry to diabetes know-how like steady glucose displays (CGMs), many individuals nonetheless battle to care for his or her diabetes. Completely 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 along with your healthcare supplier.
Dr. Julia Blanchette, an assistant professor of drugs at Case Western Reserve who additionally lives with kind 1 diabetes herself, provided 5 pointers for methods to take advantage of your CGM to raised your diabetes care.
“It’s actually wonderful to have the minute-to-minute knowledge 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 training specialist at College Hospitals in Cleveland, mentioned.
1. Share your CGM knowledge along with your supplier and different useful events.
Should you haven’t already performed so, share your CGM knowledge along with your healthcare supplier. Relying on which CGM system you employ, you’ll both must be sure to’ve linked your Freestyle LibreView Account to your healthcare skilled’s account, have your healthcare supplier electronic mail you an invite to share knowledge by way of Dexcom Readability, or arrange your CareLink account for Medtronic CGMs.
CGM knowledge sharing is essential as a result of a healthcare supplier ought to have the ability to assist with knowledge interpretation so you may perceive how your food plan and each day routine have an effect on your blood glucose. They are going to doubtless evaluate 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 comparable meals and snacks for a couple of days. Maintain checking your fasting, pre- and post-meal blood sugars, and bedtime blood glucose. This can assist your healthcare supplier consider your remedy 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 in case you have a look at your knowledge each few weeks to each month to replicate on what’s occurring, you can also make adjustments to attain goal time in vary,” Blanchette mentioned.
Sharing knowledge with mother and father, caregivers, and family members may also be useful. “For fogeys and caregivers, you may nonetheless ensure 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 aware of the entire particulars of diabetes.
“A college-aged little one might know what a down arrow means, even when they could not have the ability to state precisely how they really feel,” Blanchette mentioned. “This may empower youngsters to make their very own self-management selections.”
That mentioned, Blanchette identified based mostly on her personal private expertise that it’s essential 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 based mostly 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 essential to set applicable excessive and low blood glucose targets based mostly in your particular person wants.
As an example in case you’re on insulin remedy or taking one other remedy that places you vulnerable to hypoglycemia, attempt to hold this goal reasonable. As an example, in case you have hypoglycemia unawareness and don’t really feel your lows, Blanchette mentioned that it’s sensible to set the goal above 70 mg/dl.
Select a excessive goal based mostly 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 it is best to think about your personal 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. “As an example, 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 a better time above vary goal whilst you regulate to a CGM system, work out your patterns, and perceive methods to handle your diabetes. As you make changes to medicines and life-style, you may steadily decrease the goal.
3. Be aware of various factors that have an effect on your blood glucose response to carbohydrates.
A CGM generally is a useful software to grasp methods to eat a balanced food plan and cut back post-meal blood glucose spikes, Blanchette famous. The hot button is to grasp how carbohydrates work and methods to steadiness them to get the vitamins you want.
As an example, whereas objects like apples might trigger spikes in blood sugar when eaten alone, they’re an essential supply of vitamins and nonetheless might be diabetes-friendly if consumed strategically.
“We have a tendency to consider 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 blood sugar spikes if 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 good distance; as an illustration, 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 totally 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 would possibly contain consuming hen first, then some greens, and ending with a bit 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 medicines that may trigger hypoglycemia – can look at the development arrows earlier than or throughout their exercise to forestall 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 mentioned. She defined which you could eat carbohydrates – similar to small sips of Gatorade and glucose tabs – as wanted to forestall lows and hold your glucose up as you train.
CGM also can aid you obtain higher time in vary with bodily exercise. Earlier than CGM, Blanchette defined, folks with diabetes have been instructed to start train at a better blood glucose degree to keep away from hypoglycemia.
“In highschool, I performed softball and I at all times ran excessive as a result of CGM didn’t exist. I needed to hold my blood sugar at 200 mg/dL if I needed to attend the entire apply.
“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 handle it because it’s occurring, as an alternative of getting to begin larger and never know what’s going to occur,” she mentioned.
Likewise, for endurance athletes similar to 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 may also be useful in determining what time of day is finest for train. Some folks discover they’re extra insulin resistant within the morning, particularly because of the daybreak phenomenon, so it might be finest to get up a little bit earlier to get a morning stroll or jog in.
“Personally, I don’t understand how I’d train with out CGM at this level,” she mentioned.
5. Use your CGM knowledge to regulate insulin and different medicines.
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 degree of care. In between common appointments, CGM can assist you make changes to your diabetes administration, together with insulin and different medicines.
Should you’re spending plenty of time above or under vary or in case you’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 knowledge from CGM may also be useful for folks beginning new medicines. As an example, many GLP-1 receptor agonists can cut back insulin wants and result in hypoglycemia. Blanchette encourages folks with kind 2 diabetes on insulin remedy who start taking a GLP-1 to strive CGM to forestall lows and optimize their insulin remedy.
The underside line
Though CGMs have been initially developed for security functions to keep away from hypoglycemia, at present they’re a beneficial software for offering perception on how various factors have an effect on blood glucose. From adjusting your food plan 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, nevertheless. It’s essential to share your knowledge along with your healthcare supplier, particularly when you find yourself simply getting began, with the intention to higher perceive patterns in your glucose ranges.
