Getting the Most of your CGM-Continuous Glucose Monitor

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You decided to take the plunge and ordered a continuous glucose monitor (CGM) a few months ago. Maybe you were having frequent low blood glucose readings or perhaps you just want to tweak your control and lower your A1C.

Wearing it these past months has been very helpful. It alerts you when you are trending down rapidly so you can prevent a low blood glucose reaction before it occurs by either eating or adjusting your insulin delivery, if you are on a pump, and notifies you when you need a bit of additional insulin to ward off an impending spike.

It’s even taken away some of the anxiety you used to feel about never quite knowing if you gave the right amount of insulin after a restaurant meal.

The real time information is wonderful of course, but if all you do is respond to current alerts you are missing half the power of using a CGM. The real time information is a snapshot of your blood glucose in response to your decisions about food, insulin and exercise. What it can’t tell you about is trends over time. Looking at trends and interpreting their causes is the best way of modifying behaviors that can have long-term benefits for your metabolic control.

The two companies supplying CGMs in theU.S., Medtronic and Dexcom, both provide web-based, downloadable reports for you to look at discrete, time-bound sets of information. To access these reports you will need a Carelink Personal Software USB for the Medtronic software and a cable for Dexcom’s Studio software. Both are included free of charge for new users; patients who have older versions of Medtronic CGMs will have to pay for a USB if they can’t find the original one shipped with the equipment.

The companies provide so many reports it can be overwhelming. That’s why the Joslin educators suggest using the following reports from each vendor to help you tease out what is happening with your blood glucose numbers.

For Medtronic

The Quickview summary provides each day’s glucose, insulin delivery, exercise and carbohydrate patterns.

The Daily Summary gives seven days of the average glucose level and insulin amounts per day.

The Sensory Overlay allows you to look at a weeks worth of glucose trends superimposed over each other.

Device Settings is a quick overview of the parameters you have set for your cgm.

For Dexcom

Hourly Stats provides 30-day average glucose readings for each hour in the day.

Daily Trends is comparative to the Medtronic Sensor Overlay report.

Glucose Trends is a day-by-day glucose trending from the cgm and any meter readings available.

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