These stylish steady glucose displays? 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 displays (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 sort 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 underneath 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 pattern, producers of expertise developed to assist diabetics—by warning of probably 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 supply metabolism insights which will result in adjustments in diet and train.

Don’t get me incorrect—I’m insanely grateful for CGM expertise. It’s grown a lot over the previous handful of years, from an anxiety-inducing nuisance that continually throws false alarms, to actually life-saving expertise 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 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 sometimes requested if I’m secure at dwelling.

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

You’ll hope my CGM would alert me to a low glucose episode however—as I do know first hand from makes an attempt at lengthy, sizzling 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 enjoyable.)

In the event 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.

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1. CGMs don’t measure blood sugar.

Yep, you learn that proper. And yep, a bunch of individuals are saying it incorrect—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 move from blood vessels to the tissue surrounding them. Interstitial fluid glucose ranges are just like blood glucose ranges, however lag them by a very good quarter-hour or so. 

To a non-diabetic, the lag doesn’t make a distinction. To a diabetic, it might probably 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 affect your glucose ranges.

CGMs are being marketed to non-diabetics as a instrument that enables them to look at the affect of meals on their glucose ranges. However loads of different elements can affect 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 stage, and left irate—and with a studying within the 400s. (The assembly didn’t go nicely, to say the least.)

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

Some firms are advertising and marketing CGMs to non-diabetics as a brief inconvenience. Put on a sensor for 2 weeks and achieve information on how meals impacts your glucose ranges legitimate for a whole 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 possibility of growing the situation, a type of neuropathy that makes a CGM a day by day necessity. Don’t get me incorrect—I’m extremely grateful for my CGM. However my arms are visibly broken—as was my abdomen, once I often wore them there.

(Common CGM customers are suggested to rotate “websites” after 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 nicely 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 decisions a day in an effort to maintain their glucose and ketone ranges in examine. The medical time period for this: “cognitive burden.” 

Once I was younger, typically 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. 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 maintaining a tally of issues. It helps shoulder that cognitive burden.

For non-diabetics, nevertheless, CGMs may have an reverse impact. Until you have got hypoglycemia, pre-diabetes, or one other well being situation that places you in danger for prime or low blood glucose ranges, you could discover {that a} sensor induces a hectic state of data 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). Actually, such a “instrument” would most likely ship my nervousness by way of 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 doubtlessly life-saving expertise—and that’s an issue.

Insulin, insulin pumps, and now CGMs—add them to the checklist of costly therapies diabetics want however can’t all the time 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 keeping with a study published this year 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 line with 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 research speculate.

To non-diabetics utilizing CGMs, my message is that this: Take pleasure in the brand new gadget—although insertion will be fairly painful, which takes away among the enjoyable. Use the information to enhance your well being, in the event you can. And in the event you discover it’s not the whole lot you’d hoped, contemplate donating your unused, unexpired CGM sensors to a charity like Insulin For Life, which distributes provides to diabetics in growing nations.

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