These fashionable steady glucose displays? I’ve been carrying them for greater than a decade. Right here’s what I’ve discovered

It’s a scene from an advert for a type of fashionable steady glucose displays (also called a CGM) that just lately popped up in my social feed.

It doesn’t even barely resemble my life with a CGM—and I ought to know what that life is like. I’ve been a kind 1 diabetic for 1 / 4 century, since I used to be 12. And I’ve worn a wide range of CGM merchandise for greater than a decade, from comparatively giant sensors “stapled” into my abdomen to pill-sized sensors implanted below the pores and skin of my higher arm.

And let me let you know, it’s not a glamorous life.

Within the newest well being wearable development, producers of know-how developed to assist diabetics—by warning of doubtless lethal excessive and low glucose episodes—are actually marketing their products to non-diabetics. Their pitch: A sensor inserted between layers of pores and skin by way of a spring-loaded needle will provide metabolism insights that will result in modifications in diet and train.

Don’t get me improper—I’m insanely grateful for CGM know-how. It’s grown a lot over the previous handful of years, from an anxiety-inducing nuisance that consistently throws false alarms, to actually life-saving know-how that nearly all the time reliably warns me of impending excessive and low glucose ranges.

However I look nothing just like the mannequin. After years of taking pictures CGMs into the again of my higher arms (in addition to injecting insulin and inserting insulin pump and pod infusion websites there), mine are marred and bruised—to the extent that I’m sometimes requested if I’m protected at house.

And an extended soak in a scorching tub? That’s a no-go (or a “proceed with excessive warning”) for me, as somebody for whom a CGM is medically vital. Diabetics are warned to be extraordinarily cautious in scorching tubs, for the reason that warmth can induce hypoglycemic unawareness that stops the same old warning indicators of low blood sugar ranges, like shakiness and sweats.

You’d hope my CGM would alert me to a low glucose episode however—as I do know first hand from makes an attempt at lengthy, scorching baths—they have an inclination to cease studying as soon as submerged for some time. (I spend extra time silencing “misplaced sign” alarms than actually stress-free.)

For those who’re counting on reads out of your CGM, be cautious of prolonged time within the water—that’s one lesson I’ve discovered from over a decade of CGM-wearing. Listed below are just a few others.

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1. CGMs don’t measure blood sugar.

Yep, you learn that proper. And yep, a bunch of persons are saying it improper—even some of the so-called “pros.” CGMs don’t measure blood glucose ranges. They measure glucose in interstitial fluid, between layers of tissue. Glucose tends to circulate from blood vessels to the tissue surrounding them. Interstitial fluid glucose ranges are just like blood glucose ranges, however lag them by a superb quarter-hour or so. 

To a non-diabetic, the lag doesn’t make a distinction. To a diabetic, it could possibly imply a delay in alert of a low glucose degree and, thus, remedy.

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2. Meals and train aren’t the one components that impression your glucose ranges.

CGMs are being marketed to non-diabetics as a instrument that permits them to watch the impression of meals on their glucose ranges. However loads of different components can impression these ranges, from sickness and sure drugs to emphasize, lack of sleep, and menstrual cycles. I as soon as went into a really contentious assembly with my son’s college with a reasonably regular blood glucose degree, and left irate—and with a studying within the 400s. (The assembly didn’t go properly, to say the least.)

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3. Sensors are simple to put on for every week or two—and far more durable to put on for longer than that. 

Some corporations are advertising and marketing CGMs to non-diabetics as a short lived inconvenience. Put on a sensor for 2 weeks and achieve information on how meals impacts your glucose ranges legitimate for a complete yr, they declare.
However such a situation doesn’t apply to diabetics, particularly ones with hypoglycemic unawareness.

The longer one has diabetes, the higher the prospect of growing the situation, a type of neuropathy that makes a CGM a each day necessity. Don’t get me improper—I’m extremely grateful for my CGM. However my arms are visibly broken—as was my abdomen, once I commonly wore them there.

(Common CGM customers are suggested to rotate “websites” once they can—arms, legs, abdomen, higher buttocks—to protect “actual property.” Traditionally, nevertheless, some CGMs were only approved for use on the abdomen or higher buttocks, the later of which might’t be reached with out assist. And, not all websites work properly for all diabetics.)

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4. CGMs can ease the “cognitive burden” of diabetics—however they could have the other impact for non-diabetics.

It’s been estimated that kind 1 diabetics make round 180 health-related decisions a day in an effort to maintain their glucose and ketone ranges in test. The medical time period for this: “cognitive burden.” 

After I was younger, generally my dad would sit up on a Saturday morning and monitor my glucose ranges utilizing a conventional blood-based monitor, so I may catch some further sleep. Sporting a CGM is a bit like having that degree of assist—however even higher, and on a regular basis. It permits me to shift extra of my focus elsewhere, understanding that one thing is maintaining a tally of issues. It helps shoulder that cognitive burden.

For non-diabetics, nevertheless, CGMs may have an reverse impact. Until you could have hypoglycemia, pre-diabetes, or one other well being situation that places you in danger for top or low blood glucose ranges, you could discover {that a} sensor induces a annoying state of knowledge overload. As somebody who doesn’t have points sustaining wholesome oxygen saturation or blood strain ranges, I can’t think about being offered with a continuing stream of such information (and making an attempt to course of and interpret comparatively small variations). Truthfully, such a “instrument” would most likely ship my nervousness via the roof—and I’ve to surprise if CGMs do the identical for at the very least some non-diabetics.

5. Not everybody has equal entry to this probably life-saving know-how—and that’s an issue.

Insulin, insulin pumps, and now CGMs—add them to the checklist of pricy remedies diabetics want however can’t all the time afford. For diabetics—particularly kind 1s—cognitive burden is a factor, however so is the monetary burden.

However there’s a documented lack of entry to CGMs amongst racial and ethnic “minorities” that may’t be defined by socioeconomic standing alone. In accordance with a study published this year within the medical journal Diabetes Care, use of diabetes know-how like insulin pumps and CGMs was greater than 20% decrease in Black sufferers when in comparison with white sufferers. And based on a 2021 study in a similar journal, lower than a 3rd of Black youth had entry to insulin pumps and CGMs, whereas practically three-quarters of white sufferers did (40% of Hispanic sufferers had entry).

Among the many causes: supplier bias, systemic racism, and (comprehensible) distrust of the medical system, the authors of the later examine speculate.

To non-diabetics utilizing CGMs, my message is that this: Get pleasure from the brand new gadget—although insertion may be fairly painful, which takes away a few of the enjoyable. Use the information to enhance your well being, in case you can. And in case you discover it’s not all the pieces you’d hoped, think about donating your unused, unexpired CGM sensors to a charity like Insulin For Life, which distributes provides to diabetics in growing nations.

The system that annoys and disappoints you would save a diabetic’s life.