These stylish steady glucose screens? I’ve been sporting them for greater than a decade. Right here’s what I’ve realized

It’s a scene from an advert for a type of stylish steady glucose screens (often known as a CGM) that not too long ago 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 quite a lot of CGM merchandise for greater than a decade, from comparatively giant sensors “stapled” into my abdomen to pill-sized sensors implanted underneath the pores and skin of my higher arm.

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

Within the newest well being wearable pattern, producers of expertise developed to assist diabetics—by warning of probably lethal excessive and low glucose episodes—are actually advertising and marketing their merchandise to non-diabetics. Their pitch: A sensor inserted between layers of pores and skin by way of a spring-loaded needle will supply metabolism insights that will result in adjustments in weight loss plan and train.

Don’t get me unsuitable—I’m insanely grateful for CGM expertise. It’s grown a lot over the previous handful of years, from an anxiety-inducing nuisance that always throws false alarms, to really life-saving expertise that just about at all times reliably warns me of impending excessive and low glucose ranges.

However I look nothing just like the mannequin. After years of capturing 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 often requested if I’m secure at dwelling.

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, because the warmth can induce hypoglycemic unawareness that forestalls the standard 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 a tendency to cease studying as soon as submerged for some time. (I spend extra time silencing “misplaced sign” alarms than really stress-free.)

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

1. CGMs don’t measure blood sugar.

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

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

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

CGMs are being marketed to non-diabetics as a software that permits them to look at the impression of meals on their glucose ranges. However loads of different elements 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 faculty with a reasonably regular blood glucose stage, and left irate—and with a studying within the 400s. (The assembly didn’t go effectively, to say the least.)

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3. Sensors are straightforward to put on for per week or two—and far tougher to put on for longer than that. 

Some corporations are advertising and marketing CGMs to non-diabetics as a brief inconvenience. Put on a sensor for 2 weeks and acquire knowledge on how meals impacts your glucose ranges legitimate for a complete yr, they declare.
However such a state of affairs 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 every day necessity. Don’t get me unsuitable—I’m extremely grateful for my CGM. However my arms are visibly broken—as was my abdomen, after I repeatedly 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 have been solely authorized to be used on the stomach or higher buttocks, the later of which might’t be reached with out assist. And, not all websites work effectively for all diabetics.)

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

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

Once I was younger, generally my dad would sit up on a Saturday morning and monitor my glucose ranges utilizing a standard blood-based monitor, so I might catch some additional sleep. Carrying a CGM is a bit like having that stage of assist—however even higher, and on a regular basis. It permits me to shift extra of my focus elsewhere, realizing that one thing is keeping track of issues. It helps shoulder that cognitive burden.

For non-diabetics, nevertheless, CGMs might have an reverse impact. Until you’ve got hypoglycemia, pre-diabetes, or one other well being situation that places you in danger for top or low blood glucose ranges, chances are you’ll discover {that a} sensor induces a nerve-racking state of knowledge overload. As somebody who doesn’t have points sustaining wholesome oxygen saturation or blood stress ranges, I can’t think about being offered with a relentless stream of such knowledge (and making an attempt to course of and interpret comparatively small variations). Truthfully, such a “software” would most likely ship my anxiousness via the roof—and I’ve to surprise if CGMs do the identical for a minimum of some non-diabetics.

5. Not everybody has equal entry to this doubtlessly life-saving expertise—and that’s an issue.

Insulin, insulin pumps, and now CGMs—add them to the listing of pricey therapies diabetics want however can’t at all times afford. For diabetics—particularly sort 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 line with a examine printed this yr within the medical journal Diabetes Care, use of diabetes expertise like insulin pumps and CGMs was greater than 20% decrease in Black sufferers when in comparison with white sufferers. And in response to a 2021 examine in an analogous journal, lower than a 3rd of Black youth had entry to insulin pumps and CGMs, whereas almost 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 could be fairly painful, which takes away among the enjoyable. Use the information to enhance your well being, in case you can. And in case you discover it’s not every thing you’d hoped, contemplate donating your unused, unexpired CGM sensors to a charity like Insulin For Life, which distributes provides to diabetics in growing international locations.

The machine that annoys and disappoints you may save a diabetic’s life.