Continuous Glucose Monitor

[DutchGirl]

Yes, and I hope I came across as suggesting some options you may not yet have explored, and not as some harsh drill sergeant

[Scott 2]

All good.

Got my Rx for 3 more G7 patches, picking them up later this week, pricing confirmed at $165. Only $55 a patch.

My wife wanted to see if the over patch (an extra sticker that holds the G7 on) irritates her skin. She used my account to try and get an extra. The ultimate response of support, was to send an additional G7, instead of another sticker. Dunno what they cost to manufacture, but it must not be much.

[mathiverse]

My wife wanted to see if the over patch (an extra sticker that holds the G7 on) irritates her skin.

I tried the G7s after reading Outlive and I'm one of the unlucky few who are allergic to the adhesive. I have a few scars as a result of the reaction since it wasn't immediately obvious what was happening since the first one or two I used caused no reaction (or little enough reaction that I didn't notice). But the later ones caused swelling, itchiness, redness that lasted for a week or two after I removed the patch and left some scars. There are a few options listed on the Dexcom website for those with a significant skin reaction. I haven't tried them yet, but I may since I have a few left. https://www.dexcom.com/en-us/faqs/sensitive-skin

ETA: Also, this may be obvious, but I'll say it anyway that the adhesive on the overpatch is the same as the adhesive on the device itself, so the reaction happens over the whole area the overpatch and device is on.

[Scott 2]

That's a good article, thanks.

[Bonde]

Thank you for confirming that one should follow sound nutritional advice.
It sounds like a cumbersome and painful project. It will probably increase the placebo effect. But I don't really understand the reasoning as the golden standard for diagnosing diabetes type 2 is hbA1c. I guess for some personal measurements will nudge one to a healthier diet. OTOH it could also induce stress as one realises that the numbers are bad but are unable to change habits (lifestyle intervention studies have notoriuos bad outcomes). Mental stress will increase stress hormone and in the long run increase the risk of diabetes. I wonder if any studies have shown positive outcomes for the kind of personal measurements compared to standard diet advice or none intervention.

Ten days with the same filament seems long and I would be cautious of infection. It is not totally the same but at hospitals venous catheters are changed every 3 days. I guess the producer must have tested safety.

[Scott 2]

I don't really understand the reasoning as the golden standard for diagnosing diabetes type 2 is hbA1c.

A1c is a screening tool. Diabetes is a progressed disease state. Reaching a diagnosis threshold, means irreversible damage is already done. The body can no longer produce enough insulin, to overcome the combination of behaviors and accumulated insulin resistance.

When someone changes their diet, to "reverse" their diabetes, that's a misunderstanding. They are better managing behaviors, to operate within limits of their body's insulin resistance. They are only slowing the decline.


Studies around a CGM for non-diabetics are extremely limited. It is not a medically proven intervention.

However, in my N of 1, the hard data offered unparalleled clarity. I try follow sound nutritional advice. Yet, I'm unreliable. The tool immediately flags where.

The CGM offers an actionable, leading metric. Detrimental behaviors raise an alert. The short feedback cycle allows rapid trials of corrective action. One can attempt multiple variations on a meal, in a single day. I find that a powerful teacher.

The process is a little invasive. I can understand why others would be hesitant. As the tech improves, I expect to see widespread adoption. Especially if wearable manufacturers crack the problem of measuring it from sweat.

[Scott 2]

You can see the filament in the third picture of this thread. It is tiny:

https://www.reddit.com/r/diabetes/comme ... dexcom_g7/

Assuming one follows instructions to sterilize the site, I think infection risk is extremely low. The adhesive, on the other hand, did get uncomfortable. Especially removing the patch. Outside of cost, that would keep me from wearing one non-stop.

[Bonde]

A1c is a screening tool. Diabetes is a progressed disease state. Reaching a diagnosis threshold, means irreversible damage is already done. The body can no longer produce enough insulin, to overcome the combination of behaviors and accumulated insulin resistance.

A1c is diagnostic (at least in Denmark) and is a proxy for the average plasma glucuse. Some studies have looked at pre-diabetic levels below diagnostic threshold as a high-risk group.
As I see it the question is whether direct monitoring or A1c are better at predicting diabetes. Glucose spikes are for sure bad but how bad. As you mention little is known about it and it is impossible to say that if you reduce spikes from daily to weekly how much are your risk reduced? 10%? 1%?

On a population level (I do not question that direct monitoring can help some individuals like yourself) I do not think that more measurements are helpful. We know the problem and do not need more measurements of it but instead better interventions. The companies that promote these tools should prove that they are reduce the risk of diabetes by improving people knowledge and self-care. However I am sceptical that a randomized study will find that as the tool more or less tell people what they already know about their diet but do not give them guidance of how to change their behavior, habits, societal bad nudges etc.

[Scott 2]

On a population level (I do not question that direct monitoring can help some individuals like yourself) I do not think that more measurements are helpful.

I agree. One needs to be proactive about their healthcare, before a tool like this makes sense. At a population level, our medical interventions tend to be much more reactive. This is a reflection of the public at large.

For the engaged person, a short term CGM is a very efficient allocation of medical resources. Especially if they put in the effort to track food macros for the 10 day period, so patterns can be teased out. But it assumes a base level of capability and motivation.

It's a also a deterrent. Having tasted the effort involved, diabetes looks that much harder.


The variable a1c misses, is insulin. The more your body needs to maintain blood sugar levels, the worse you are doing. It misses people like me - healthy a1c, but high normal fasting glucose coupled with high normal fasting insulin. With insulin resistance a factor in many diseases, worthy of attention.

I suspect a1c is used as a diagnostic, because it is cheap, stable and has a low false positive rate. One could fast/binge for a couple days before their blood work. That might substantially impact fasting insulin and blood glucose. In that sense HOMA-IR becomes less reliable.

An oral glucose tolerance test, including insulin measures, might be an even better test. But that's especially expensive, time consuming and invasive.


From what I can find, desirable is a fasting blood glucose of 80, with post meal spikes under 30. I'm not too caught up on that set of metrics though. If it felt really important to me, I'd start every day with Coco puffs.

However, there's a lot of behaviors I do on auto-pilot. If A promotes health better than B, I'd like to adopt B. That's where I think the value lies. Create a snowball of small, evidence based, minimally disruptive changes. Replace the faith based dietary assumptions.