The world of glucose monitoring is currently divided into two options, finger sticks, and wearable monitors. The choice here is easy. More information with less discomfort  is the clear winner. Studies have also overwhelmingly shown that A1C improves, and hypoglycemia and DKA reduce with the use of worn 24 hour glucose monitoring devices.

Among worn devices we really have two options:

1. Continuous Glucose Monitoring(CGM)
2. Flash monitoring. 

The key difference between a CGM and a flash monitor is how we receive the data. CGMs(like Dexcom’s G5, Medtronic’s Guardian sensor, and Sensionic’s Eversense) transmit data to a receiver.  That receiver might be a specialized device for that purpose, it might he a smart phone app, or even an insulin pump. Because blood sugars are checked every 5 minutes and the data is transmitted every 5 minutes, users can get real time alerts s blood sugars rise, fall, or reach set highs or lows. With a flash monitor this information stays in the transmitter until the user requests the info. The blood sugar is still checked every 5 minutes, so the full 24 hour blood sugar is available, but until we ask for it we don’t have the data. So we do not get real time alerts.

So what are the benefits of Flash monitoring? 

A recent study from a European analysis of over 60 million glucose tests and 50,000 readers showed that using a flash monitor in place of finger sticking and a glucometer showed an improvement of 1.3% in A1C! Hypoglycemia reduced by an average of 40% and time in range (70-180) increased by 40% per day! Knowledge is power! And used of flash monitors increased their blood sugar checks from 2-6 times daily on average to 18 times daily. Since there is no pain or mess checking blood sugar is no longer such a burden, so we are free to check more frequently. We can also observe trends over our entire day and address issues that may have otherwise gone unseen.

The question of whether to use a CGM or stick with finger sticks is pretty clear cut, and we are seeing barriers in terms of cost and insurance approvals coming down as data overwhelms short term cost barriers. This then leaves the challenge to providers to give the best education on using this technology and use the data to improve treatment outcomes. Integrated Diabetes Services offer education on CGM use and data analysis as well as a CGM trial program to give the technology a try and see what the added information can bring to your treatment regimen. Give us a call to schedule an appointment or get more information.

Study info: Real-world flash glucose monitoring patterns and associations between self-monitoring frequency and glycaemic measures: A European analysis of over 60 million glucose tests.