Continuous Glucose Monitoring Systems
Continuous glucose monitoring systems measure glucose concentrations in the interstitial fluid. Two types of devices are available. The real time CGM provides information directly to the user by displaying moment-tomoment absolute glucose levels and trending arrows, and by providing alarm notifications in the event that the glucose level is above or below a preset limit. A blinded CGM captures, but does not display, the glucose readings, which are then downloaded onto a computer for viewing and retrospective analysis by the health-care provider .
CGM technology incorporates a subcutaneously inserted sensor, an attached transmitter and, in the case of real-time CGM, a display unit . In professional CGM, the transmitter captures and retains the data. In Canada, 2 real-time CGM and 2 professional CGM are available. Real-time CGM has been consistently shown to reduce A1C in both adults and children with type 1 diabetes with and without CSII, and to reduce A1C in adults with type 2 diabetes . Real-time CGM also has been shown to reduce the time spent in hypoglycemia . Professional CGM has been shown to reduce A1C in adults with type 2 diabetes and in pregnant women with type 1 or type 2 diabetes .
What Causes Blood Sugar To Be High
Many things can cause high blood sugar , including being sick, being stressed, eating more than planned, and not giving yourself enough insulin. Over time, high blood sugar can lead to long-term, serious health problems. Symptoms of high blood sugar include:
- Feeling very tired.
- Having blurry vision.
- Needing to urinate more often.
If you get sick, your blood sugar can be hard to manage. You may not be able to eat or drink as much as usual, which can affect blood sugar levels. If youre ill and your blood sugar is 240 mg/dL or above, use an over-the-counter ketone test kit to check your urine for ketones and call your doctor if your ketones are high. High ketones can be an early sign of diabetic ketoacidosis, which is a medical emergency and needs to be treated immediately.
Subsidies On The Ndss
The Australian Government has established the National Diabetes Services Scheme to support people living with and caring for people living with diabetes. This scheme also includes subsidies for the cost of blood glucose test strips and offers free needles and syringes to people who use insulin.
After initial registration, people living with diabetes will have access to subsidised glucose test strips for one year. If needed, your doctor or diabetes educator can apply for an additional six months access. People using insulin therapy will have ongoing, lifetime access to subsidised glucose test strips.
If youre an Australian citizen or permanent resident and have been diagnosed with diabetes, you are eligible for enrollment in the NDSS. The registration form must be signed by a doctor or credentialed diabetes educator. Registration with the NDSS is free and lifelong. Find out more about NDSS, including registration forms.
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What Are The Advantages Of Using Cgm To Manage Diabetes
Using a CGM device can make it easier to manage Type 1 or Type 2 diabetes. Some people use CGM for a week to understand their blood sugar patterns. Most use CGM long-term.
A CGM device can:
- Show you a bigger picture of how diabetes affects you: CGM measures glucose levels every few minutes. That data shows a more complete picture of how your blood sugar levels change over time. This information can help you and your provider better understand how things like food, activity, stress and illness impact your blood sugar levels.
- Lead to more personalized care: CGM doesnt give the whole story of all the ways diabetes affects you. It tells you when glucose goes up or down, not why. But your provider can download CGM data from your device and review it for patterns and trends. They can then personalize your care based on what they learn.
- Alert you to highs and lows: Most CGM devices send an alert when your glucose levels rise or fall a certain amount. With this information, you can make changes quickly. You may be able to treat or prevent highs or lows before they turn into a big problem.
- Reduce how many fingerstick checks you need to do: CGM significantly reduces how many fingerstick tests youll need to do each day.
What Hba1c Do I Aim For
The goal for most people with diabetes will be in the 6.5-7 percent range however this may need to be higher for some people including children and the elderly. Your doctor or Credentialled Diabetes Educator can help you decide on a target that is both appropriate and realistic for your individual circumstances.
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Type 2 Diabetes: Blood Glucose Self
How often should you monitor your blood glucose levels if you have type 2 diabetes? Download a factsheet about self-monitoring and managing diabetes.
Self-monitoring your blood glucose levels is not routinely recommended if you have type 2 diabetes and are not taking insulin or a sulfonylurea. Talk to your healthcare provider about reviewing your self-monitoring of blood glucose levels.
Home Blood Sugar Monitoring For Type 2 Diabetes
People with diabetes are often advised to check their blood sugar levels at home by pricking a finger and testing the blood with a glucose meter. They can review the results with their doctors over the phone, online, or at the next office appointment. The value of this for people with type 2 diabetes is uncertain.
In a study published in JAMA Internal Medicine, researchers enrolled 450 people with Type 2 diabetes, none of whom were taking insulin. They were randomly assigned to one of three groups:
- no self-monitoring of blood sugar
- once daily self-monitoring of blood sugar
- once-daily self-monitoring of blood sugar with enhanced feedback from their blood glucose meters with messages intended to educate and motivate the study volunteers.
After one year these researchers found that, compared with those not self-monitoring blood sugar, those who self-monitored had no improvement in the control of their blood sugar, and had no improvement in measures of quality of life.
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Work With Your Health Care Team
Most people with diabetes get health care from a primary care professional. Primary care professionals include internists, family physicians, and pediatricians. Sometimes physician assistants and nurses with extra training, called nurse practitioners, provide primary care. You also will need to see other care professionals from time to time. A team of health care professionals can help you improve your diabetes self-care. Remember, you are the most important member of your health care team.
Besides a primary care professional, your health care team may include
- an endocrinologist for more specialized diabetes care
- a registered dietitian, also called a nutritionist
- a nurse
Are You Leading An Active Lifestyle
Type 2 diabetes: when to check blood sugar for athletes and active people? Its said that activity helps control blood sugar levels and fight the disease. Your body becomes sensitive to insulin, and you may need more checkups when leading an active lifestyle. Its better to consult your doctor on this issue.
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How Can I Check My Blood Sugar
Use a blood sugar meter or a continuous glucose monitor to check your blood sugar. A blood sugar meter measures the amount of sugar in a small sample of blood, usually from your fingertip. A CGM uses a sensor inserted under the skin to measure your blood sugar every few minutes. If you use a CGM, youll still need to test daily with a blood sugar meter to make sure your CGM readings are accurate.
Follow Your Diabetes Meal Plan
Make a diabetes meal plan with help from your health care team. Following a meal plan will help you manage your blood glucose, blood pressure, and cholesterol.
Choose fruits and vegetables, beans, whole grains, chicken or turkey without the skin, fish, lean meats, and nonfat or low-fat milk and cheese. Drink water instead of sugar-sweetened beverages. Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. Learn more about eating, diet, and nutrition with diabetes.
Questions To Ask Your Doctor
When visiting your doctor, you might keep these questions in mind to ask during your appointment.
- What is my target blood sugar range?
- How often should I check my blood sugar?
- What do these numbers mean?
- Are there patterns that show I need to change my diabetes treatment?
- What changes need to be made to my diabetes care plan?
If you have other questions about your numbers or your ability to manage your diabetes, make sure to work closely with your doctor or health care team.
Special Features Of A Cgm
CGMs are always on and recording glucose levelswhether youre showering, working, exercising, or sleeping. Many CGMs have special features that work with information from your glucose readings:
- An alarm can sound when your glucose level goes too low or too high.
- You can note your meals, physical activity, and medicines in a CGM device, too, alongside your glucose levels.
- You can download data to a computer or smart device to more easily see your glucose trends.
Some models can send information right away to a second persons smartphoneperhaps a parent, partner, or caregiver. For example, if a childs glucose drops dangerously low overnight, the CGM could be set to wake a parent in the next room.
Currently, one CGM model is approved for treatment decisions, the Dexcom G5 Mobile. That means you can make changes to your diabetes care plan based on CGM results alone. With other models, you must first confirm a CGM reading with a finger-stick blood glucose test before you take insulin or treat hypoglycemia.
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Monitoring Your Blood Sugar
Regular blood sugar monitoring is the most important thing you can do to manage type 1 or type 2 diabetes. Youll be able to see what makes your numbers go up or down, such as eating different foods, taking your medicine, or being physically active. With this information, you can work with your health care team to make decisions about your best diabetes care plan. These decisions can help delay or prevent diabetes complications such as heart attack, stroke, kidney disease, blindness, and amputation. Your doctor will tell you when and how often to check your blood sugar levels.
Most blood sugar meters allow you to save your results and you can use an app on your cell phone to track your levels. If you dont have a smart phone, keep a written daily record like the one in the photo. You should bring your meter, phone, or paper record with you each time you visit your health care provider.
Sometimes having high blood sugar can feel like a test you didnt pass. But numbers are just numbers. Think of them instead as information. Did a certain food or activity make your levels go up or down? Armed with that knowledge, you can make adjustments and get closer to your target range more often.
Is There Enough Evidence For A Change In Practice
Many systematic reviews have looked at this question. However, their conclusions are only as good as the trials available for analysis. In real life, compliance with self-monitoring of blood glucose may have been poor. There are no studies assessing how well people actually implement the advice they are given on when to test and what to do with their results.
While slight variations in the research question have led to slight differences in the inclusion criteria of the reviews, there is remarkable unanimity in the results, with the size of benefit of self-monitoring ranging from a 0.16% to 0.39% absolute fall in glycated haemoglobin .
The Canadian review of eight randomised controlled studies, including more than 2400 people, showed no effect of self-monitoring regardless of intensity of education. The analysis found a mean change in HbA1c of 0.22% for programs where the intensity of education was less or unspecified, compared to 0.28% when the education was more intense. Six studies of patients with an HbA1c of 810.5% showed a mean reduction of only 0.3% in HbA1c.
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When Should I Check My Blood Sugar
How often you check your blood sugar depends on the type of diabetes you have and if you take any diabetes medicines.
Typical times to check your blood sugar include:
- When you first wake up, before you eat or drink anything.
- Before a meal.
- Two hours after a meal.
- At bedtime.
If you have type 1 diabetes, have type 2 diabetes and take insulin, or often have low blood sugar, your doctor may want you to check your blood sugar more often, such as before and after youre physically active.
How Do Continuous Glucose Monitoring Devices Work
You can choose among a handful of CGM devices available today. Each works pretty much the same way. The main differences are in a devices look, feel and features.
In general, heres how CGM works:
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Diabetes And Checking Blood Sugar
How often do you check your blood sugar with type 2 diabetes? There are 3 common reasons for monitoring your blood sugar levels:
- youre interested in the result but have no prescription for blood sugar monitoring.
- you take insulin daily.
- you arent prescribed the insulin injections.
The last 2 points should be answered in more detail. Lets clear the issue and determine how often to check blood sugar type 2 diabetes in such cases.
Monitoring Your Blood Glucose Levels
Self-monitoring of glucose levels for people with type 2 diabetes is no longer recommended or supported in the NHS, unless a doctor states an acceptable reason or benefit for doing so. For this reason, test strips for blood glucose monitors are no longer routinely provided on NHS prescriptions.
There is evidence to suggest self-monitoring of blood glucose for type 2 diabetes can have positive effects.
However, there is evidence to suggest that using structured self-monitoring of blood glucose for type 2 diabetes can have positive effects, such as improving diabetes control and giving a better understanding of their condition.
While blood glucose monitoring is no longer routinely provided by the NHS, if have you been newly diagnosed or you’re worried about your blood glucose levels, it may be beneficial for you to consider testing your blood glucose at home.
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Type 2 Diabetes: When To Check Blood Sugar
You cant find the exact answer to the question because there are different cases in the medical practice:
- Glucose monitoring is different if youre a newly diagnosed patient.
- The number of fingertip practices varies if you lead an active lifestyle.
- If there are any safety issues, you need to develop a personalized number of records.
- If you cant use a lancet and test often due to health issues, it also must be mentioned.
Lets take a look at each of the cases separately.
How Do Carbs Affect Blood Sugar
Carbs in food make your blood sugar levels go higher after you eat them than when you eat proteins or fats. You can still eat carbs if you have diabetes. The amount you can have and stay in your target blood sugar range depends on your age, weight, activity level, and other factors. Counting carbs in foods and drinks is an important tool for managing blood sugar levels. Make sure to talk to your health care team about the best carb goals for you.
Make A Note Of Your Readings
It may sound obvious, but you must record your readings. Note them down in a diary, a notebook or in your phone calendar. Some meters have software that lets you do this. You could try a diabetes app too.
You and your healthcare team can then look back over your results to see if you need to adjust your treatment.
What Were The Results
At the end of the one-year study, there were no differences, on average, in blood sugar levels and quality of life between people who checked their blood sugar daily and those who didnt. People who tested their blood sugar levels daily had slightly lower blood sugar levels in the middle of the study than those who didnt test. But this difference didnt last until the end of the study. Among people who checked their blood sugar levels, there were no differences in blood sugar levels or quality of life between those who did and didnt receive text messages.
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