For diabetic people monitoring glucose (sugar) levels is an integral part of their life. Generally, there are two types of testing for sugar levels. The first is by giving a blood sample to the Laboratory, where it is tested and your glucose levels are determined. Second, testing at home through sugar or glucose levels testing devices, with the help of test strips. But with people who have fluctuating sugar levels, whether they are type 1 or type 2 diabetics, then there is one more monitoring system which is called ‘Continuous Glucose Monitoring’ (CGM) Device.
CGM is a device that tracks your blood sugar level in real-time. It can help you make better decisions about food, exercise, and medication.
How it works
- A small sensor is inserted under your skin usually on your arm or belly.
- The sensor estimates your blood sugar level in the fluid around your cells.
- The sensor sends data to a receiver, insulin pump, phone or smart watch.
- You can view your blood sugar level on your device.
Benefits
- CGM can help you avoid hypoglycemia (very low sugar level) or hyperglycemia (very high sugar level).
- CGM can help you make better decisions about food, exercise, and medicine.
- CGM can help you improve your quality of life.
- CGM can help you manage your diabetes.
Types of CGM
- Some CGMs have disposable sensors that you can insert under your skin.
- Some CGMs have implantable sensors that are placed inside your body.
Basically CGM s have three parts-
- First there is a sensor (as explained above).
- Second is transmitter, which sends the information, without using wires.
- This information is send to third part, a software program that is stored on a smart phone, or on an insulin pump, or a separate device called receiver.
Any one who is suffering from type 1 or type 2 diabetes can use CGM. Some models can be used for children as young as 2 years old.
Some CGMs send and display information to your smartphone or receiver automatically. These are called ‘real-time’ CGM devices. Another type of CGM, called ‘intermittent-scan’ estimates glucose levels continuously. But you will need to scan the CGM with a separate receiver or smartphone every few hours to view and store data. A third type of CGM collects data about your blood glucose level for your doctor to download and review later. Doctors provide this type of CGM to check on your diabetes care, and you wear for limited time.
Issues with CGM
For safety, you may sometimes need to compare your CGM glucose readings with finger-stick test and a standard blood glucose meter. This could be needed if you doubt the accuracy of your CGM readings.
You might have to replace parts of your CGM over time. Disposable CGM sensors should be replaced every 7-14 days, depending on the model. Some implantable sensor can last up to 180 days. You may have to replace the transmitter of some CGMs. You may also need to reconnect the CGM, transmitter, and receiver or smart phone if your CGM is not working correctly.
In India no company manufactures CGM, all types of CGMs are imported, leading to high import costs. The discontinued Libre Pro, by Abbott Pharmaceuticals, was designed for professionals costing just over Rs 2000. In contrast, the company’s patient-use version FreeStyle Libre costs over Rs 5000.
The difference in the above two types was their functionality. The professional one was for blinded use giving all 14-day glucose analysis via a reader during doctor visits. The patent-use on the other hand, offers real-time readings. This professional version can give 96 readings per day. Type 1 diabetes patients rely on such frequent monitoring to regulate insulin, checking even in the middle of night. Earlier Type 1 diabetics used glucose meters and they needed 8 to 10 pricks daily. The cost of test strip varies from Rs 20 to 25, this means patient using 8 strips per day could spend Rs 4800 to Rs 6000 in a month for test strips only.
The Abbott company spoke person in a statement said “ FreeStyle Libre offers the advantage of delivering glucose readings directly to users’ phones. This technology has successfully served for Indian market for a considerable time, which is why company has decided to discontinue the previous generation product LibrePro”. This means the diabetic patients who wants to monitor their blood sugar levels using CGM will have to spend more now.
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Anil Malik
Mumbai, India
4th March 2025