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Continuous Glucose Monitor (CGM) is revolutionizing diabetes care by providing real-time how everything from morning coffee to evening workouts affects blood sugar levels. Pushpanayan talks to Dr Vijay Viswanathan, chairman of the Research Association of Diabetes Research and Research in India (RSSDI) about how these wearables can help you manage diabetes. Please take a look…
How good is CGM to monitor blood sugar levels?
These wearables provide real-time information about glucose levels and provide greater insight into the body's sugar trends than traditional finger-induced tests. CGM can show how a variety of foods, exercise, sleep and stress affect a person's glucose levels 24/7. This data helps doctors provide diet and medication adjustments to optimize blood sugar levels. Several studies suggest that CGM can detect early signs of glucose tolerance or prediabetics even in patients with normal HBA1C (glucose average of 2-3 months) levels. This feedback also motivates people with diabetes to adopt healthier lifestyle choices, such as normal physical activity and a balanced diet.
When would you recommend it?
In a specific case. Last week, I had a patient with HBA1C of 6.1, which is a very good control for people with diabetes, but the fasting and post-meal (after meals) sugar levels were very high. We found out that it was probably because my patients were eating mango almost every day. Although HBA1c is the gold standard, it does not reveal glucose fluctuations that occur throughout the day. Normal HBA1C with frequent hypoglycemia and hyperglycemia shows wide shaking that the average does not capture. Despite “good” clinic measurements, high HBA1Cs mean spikes or overnight high sugars in babies that are not captured on intermittent tests. If the patient's averages hide significant blood glucose variability, CGM is recommended. It provides the timing, magnitude and frequency of variation, allowing physicians to identify the root causes of the disparity and adjust dietary plans and treatments accordingly.
Are they tools to improve diagnosis?
yes. For example, the somogie phenomenon or rebound hyperglycemia (hyperglycemia) and the dawn phenomenon are two different causes of high morning blood glucose in diabetic patients. The Somogyi phenomenon occurs when episodes of nocturnal hypoglycemia (hypoglycemia) cause the release of anti-regulatory hormones such as glucagon, cortisol, and epinephrine, which function to raise blood glucose. In diabetic patients who lack sufficient insulin, this mechanism can overshoot, leading to hyperglycemia levels in the morning. Dawn phenomenon is a more natural process in which hormones cause blood sugar levels between 2am and 8am, preparing them to wake up. These hormones increase insulin resistance and cause the liver to produce more glucose. In people without diabetes, the pancreas releases enough insulin, but not diabetics, and blood sugar levels rise when they wake up. Unlike the Somogyi phenomenon, the dawn phenomenon does not have a prior hypoglycemic event. Because treatments are different, it is important to distinguish between the two. CGM helps caregivers adjust diagnosis, insulin dosage and medication timing, helping caregivers have a lower risk of long-term health outcomes and complications.
Overloading of information can cause anxiety, unfair dietary restrictions, and sometimes unhealthy obsession with food among healthy people. Needless to say, unnecessary costs
Dr. Viswanathan
Even healthy people use CGM as a predictive health tool to prevent diabetes. Would you recommend it?
The physician's body, including RSSDI, is cautious about recommending it to be widely used in healthy people as their needs have not yet been proven. Also, most devices have algorithms tailored to the needs of your diabetes, which can lead to data misunderstanding. There is also the risk of information overload that can cause anxiety, unfair dietary restrictions, and sometimes unhealthy obsession with diet among healthy people. Not to mention unnecessary spending. That said, manufacturers design commercially available devices for those who do not use insulin and do not have the risk of hypoglycemia. Healthy people are advised to maintain a balanced diet, exercise and healthy weight for glucose management.
Can CGM help children and the elderly?
They significantly reduce the need for a test of seducing with painful fingers that older people may have difficulty with hating children. Both are susceptible to hypoglycemia and may not experience typical symptoms. CGM can provide low-glucose life-saving alerts that help prevent severe episodes. And modern CGMs are often user-friendly and can benefit older people with cognitive impairments.
