Diabetes technology has made significant strides over recent decades, with Continuous Glucose Monitors (CGMs) having emerged as one of the pivotal advancements supporting diabetes management. Compared to the widespread blood glucose measurement method involving a blood glucose meter and test strips that require people to prick their fingers and draw a drop of blood for reading, CGMs offer a more convenient and less intrusive solution, particularly when frequent monitoring is required.
CGMs can help healthcare professionals support the daily care of people with diabetes by providing real-time data that allows them to visualise patterns and trends in glucose levels after meals, during exercise, or at night. Using the information provided, they can work with their patients to make informed decisions about diet, insulin dosing, and overall lifestyle and adapt individual diabetes management plans to reach desired goals.
CGMs use small sensors placed under the skin. To eliminate discomfort when worn, they need to be inserted into fatty tissue that can be grabbed, not muscle. Commonly recommended places are similar to where a person would inject insulin: the back of the arm, the stomach, the outer thigh, and the upper buttocks. The placement of the CGM sensor depends on the device design and manufacturer’s instructions.
Connected through a needle or a catheter, the sensors are typically replaced every 7 to 14 days, ensuring continuous and reliable monitoring. Less common but growing in popularity are implantable CGMs, which can be worn for up to 90 days. The sensors transmit glucose levels to a receiver or smartphone app, eliminating the need for frequent and invasive finger pricks.
By eliminating the need to perform frequent finger pricks throughout the day, CGMs help make glucose monitoring more seamless and hassle-free
Using a CGM can offer a range of benefits for people with diabetes. One key advantage is the continuous tracking that provides a comprehensive view of glucose levels. This can help people with diabetes better understand how their bodies respond to food, physical activity and medication, and help identify patterns and trends that may go unnoticed with blood glucose meter monitoring.
CGMs also help reduce the risk of low blood glucose (hypoglycaemia) and high blood glucose (hyperglycaemia) by providing real-time alerts when glucose levels are out of range. These alerts allow for timely intervention and can prevent dangerous fluctuations in glucose levels. This added layer of safety can provide a sense of reassurance that supports mental well-being, which can be especially helpful for care-givers, parents of children with diabetes or people living alone.
Another benefit of CGMs is their convenience. By eliminating the need to perform frequent finger pricks throughout the day, glucose monitoring is more seamless and hassle-free.
Unlike blood glucose monitors, CGMs measure glucose levels from the fluid found in the spaces around cells, known as interstitial fluid. This results in a five- to fifteen-minute delay in reporting changes in glucose levels compared to finger-prick testing, which can cause differences in readings and how a person feels. It is, therefore, important to maintain finger-prick testing using a blood glucose meter as a backup.
The constant monitoring and stream of data associated with CGMs can exacerbate diabetes-related stress and cause anxiety and decision paralysis, increasing the emotional burden for people with diabetes. Other factors that can disrupt the seamless use of CGMs include:
For healthcare professionals, CGM data can be complex to understand and use effectively, requiring specialised knowledge and training. Furthermore, integrating CGM data analysis into routine patient consultations can be time-consuming, impacting the overall efficiency of healthcare delivery.
For healthcare professionals, CGM data can be complex to understand and use effectively, requiring specialised knowledge and training
Although CGMs have revolutionised diabetes management, barriers exist in accessing this technology, particularly in low- and middle-income countries (LMICs).
In higher-income countries, insurance coverage can limit access to CGMs and related supplies, leading to financial barriers for people with diabetes and healthcare facilities.
In LMICs, the affordability of devices and healthcare infrastructure challenges limit access to CGM technology. These constraints are compounded by healthcare professionals who do not have access to specialised training and resources to support people with diabetes in effectively using CGMs.
Diabetes education can play a crucial role in addressing and overcoming the challenges faced by people with diabetes and healthcare professionals in accessing and using CGM technology, particularly in LMICs.
For healthcare professionals, comprehensive training on CGM data interpretation and integration within clinical practice can enhance their proficiency in using CGMs and help streamline the incorporation of CGM data into routine consultations, allowing them to make the most of the limited time that they have with their patients.
For people living with diabetes, a team-based approach involving healthcare professionals, diabetes educators, nutritionists and mental health professionals, with the support of diabetes advocates to facilitate community engagement, can help them to cope with the emotional challenges related to CGM usage and improve their well-being.
Diabetes education can play a crucial role in addressing and overcoming the challenges faced by people with diabetes and healthcare professionals in accessing and using CGM technology
IDF-FIND partnership
To support the effective integration of CGMs into healthcare systems in LMICs and foster a broader understanding of CGM technology in these settings, the International Diabetes Federation (IDF) and FIND have partnered to develop online educational materials for people living with diabetes and healthcare professionals.
The first free online course for people living with diabetes – Continuous Glucose Monitoring (CGM) – and their carers is available here.
A free online course for healthcare professionals will be available from the IDF School of Diabetes in July.
