A lady rises slinkily from a sizzling tub—her lengthy, moist hair glistening within the daylight, a picturesque dawn earlier than her—and a steady glucose monitor completely centered on the again of her flawless proper arm.
It’s a scene from an advert for a kind of stylish steady glucose screens (also called 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 beneath 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 development, producers of know-how developed to assist diabetics—by warning of doubtless 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 modifications in food plan and train.
Don’t get me improper—I’m insanely grateful for CGM know-how. It’s grown a lot over the previous handful of years, from an anxiety-inducing nuisance that continually throws false alarms, to really life-saving know-how 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 protected at house.
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 crucial. Diabetics are warned to be extraordinarily cautious in sizzling tubs, for the reason that warmth can induce hypoglycemic unawareness that forestalls the same old 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 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 discovered from over a decade of CGM-wearing. Listed below are a number of 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 improper—even a few of the so-called “professionals.” CGMs don’t measure blood glucose ranges. They measure glucose in interstitial fluid, between layers of tissue. Glucose tends to stream 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 could 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 components that influence your glucose ranges.
CGMs are being marketed to non-diabetics as a instrument that permits them to watch the influence of meals on their glucose ranges. However loads of different components can influence these ranges, from sickness and sure medicines 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 simple to put on for per week or two—and far more durable 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 achieve knowledge on how meals impacts your glucose ranges legitimate for a whole 12 months, they declare.
However such a state of affairs doesn’t apply to diabetics, particularly ones with hypoglycemic unawareness.
The longer one has diabetes, the better the possibility of growing the situation, a type of neuropathy that makes a CGM a every day necessity. Don’t get me improper—I’m extremely grateful for my CGM. However my arms are visibly broken—as was my abdomen, once I repeatedly 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 have been solely authorised 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 other 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.”
After 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. Sporting 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 may have an reverse impact. Except 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 might discover {that a} sensor induces a traumatic state of data 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 continuing stream of such knowledge (and making an attempt to course of and interpret comparatively small variations). Actually, such a “instrument” would most likely ship my anxiousness by way of the roof—and I’ve to surprise if CGMs do the identical for at the least some non-diabetics.
5. Not everybody has equal entry to this probably life-saving know-how—and that’s an issue.
Insulin, insulin pumps, and now CGMs—add them to the checklist of pricy 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. Based on a research revealed this 12 months within the medical journal Diabetes Care, use of diabetes know-how like insulin pumps and CGMs was greater than 20% decrease in Black sufferers when in comparison with white sufferers. And in keeping with a 2021 research in an identical 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 research speculate.
To non-diabetics utilizing CGMs, my message is that this: Take pleasure in the brand new gadget—although insertion could be fairly painful, which takes away a few of the enjoyable. Use the info to enhance your well being, in the event you can. And in the event you discover it’s not all the pieces you’d hoped, think about 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 could possibly save a diabetic’s life.
