To Your Good Health
Dear Dr Roach: I am a 71-year-old Type 2 diabetic woman, but I find the glucose monitoring systems requiring blood samples so painful to use that I dont test. At present, I get along by taking a 500-mg metformin tablet three times a day and having bloodwork done about twice a year. My last fasting glucose test result (1/19/18) was 134 mg/dL, and my HbA1c was 6.9 percent. Should I consider a continuous glucose monitor? I am overweight, so that is a factor I am working on. C.P.
Answer: A continuous glucose monitor checks and electronically records many blood sugar readings, as often as every five minutes, which can sometimes be read by the user in real time or can be downloaded by the clinician at the end of two weeks (at which point, another unit is placed). The units themselves look like large buttons and contain a very thin needle with a sensor that measures the blood sugar.
CGM systems are used most often in people with Type 1 diabetes, but some patients with Type 2 may be candidates for the system, particularly those whose blood sugars are known or suspected to go too low.
I spoke with an expert at my institution, Esther Wei, nurse practitioner and certified diabetes instructor, who would not recommend CGM for you, as it is unlikely that you would have low blood sugars being on metformin. Most insurances also require that their members be on both long-acting and short-acting insulin for them to cover CGM.
Your blood sugar levels are excellent, and your A1c levels are near the optimum advised in the most recent guidelines. Losing weight may improve several areas of health, but from the standpoint of diabetes, I wouldnt increase your monitoring if it is so painful for you.
Diabetes has become epidemic in North America.
