Novis Health of of Raleigh, NC has just updated its functional medicine treatment for diabetes, which provides patients an all-natural and integrative alternative to traditional therapies.
The Value of CGM in Type 2 Diabetes Reversal
Continuous glucose monitoring or CGM involves the use of an enhanced glucose monitoring device that demonstrates numerous benefits in comparison to intermittent blood glucose testing. More specifically, recent advancements in CGM technology offer [1, 2]:
· Real-time data for people with type 2 diabetes or prediabetes
· Substantially improved accuracy, cost, and size
· The ability to upload blood glucose data to cloud platforms
· Digitally-based coaching tools and software that enables biofeedback and behavioral changes to be easily made
Due to these advantages, CGM is rapidly increasing in popularity [2]. The more conventional method of self-monitoring blood glucose (SMBG) and A1C testing has several limitations that have proven to be detrimental for some people with diabetes. In particular, this form of monitoring is inadequate as only a few sets of SMBG data can usually be obtained throughout the day due to the pain and inconvenience that is associated with finger pricking, the cost of the test strips, and the timing requirements for measuring blood glucose. Furthermore, it is often difficult to observe an accurate relationship between SMBG data and food, physical activity, or stressors (e.g., biological or environmental).
Similarly, although A1C is a beneficial measure of overall diabetes control, it does not offer real-time or retrospective information that can be used to make accurate decisions regarding disease prognosis, medication management, pertinent lifestyle changes, or other important factors that influence treatment. This means that even though SMBG and A1C are still commonly used for diabetes management, these methods remain poorly effective at changing patient behavior, decreasing A1C scores, or reducing the occurrence of diabetes-related complications [3]. With the introduction of CGM monitoring, most of these issues can be avoided.
Interestingly, the first CGM devices that were released during the late 90s, were not frequently used due to their bulky size, painful insertion requirement, numerous finger prick calibrations, and the costs. However, numerous advancements have shown that improved CGM technology enhances blood glucose regulation and lowers the rates of low blood glucose (hypoglycemia), particularly in individuals who have type 1 diabetes [4, 5]. Fortunately, the newest CGM models have begun to offer improved blood glucose management for people with type 2 diabetes as well.
Indeed, the sensors can be inserted in a painless manner, they are small enough to be easily concealed under clothing, and they can be left in place for 10-14 days. Most importantly, the newer CGM devices are FDA-approved for accurate glucose monitoring in place of finger pricks to make more precise insulin-dosing decisions [2]. Furthermore, real-time data can be continuously uploaded to a cloud platform through the use of a smartphone. Additionally, the cost of the devices is gradually decreasing, thereby making them more affordable and accessible to a larger number of patients. This type of real-time data is also the key to potential type 2 diabetes reversal.
In particular, the ability to obtain minute-to-minute blood glucose information with CGM, provides healthcare professionals and patients with a detailed overview of glucose control that can be used to implement vital behavioral changes that support effective glucose management. Conversely, SMBG and A1C does not offer continuous data that could be used to make split-second decisions that can maintain optimal blood sugar regulation or even prevent the onset of diabetes in people who were pre-diabetic [3].
The real-time biofeedback that CGM offers gives individuals with type 2 diabetes information regarding the types of foods and activities that have a substantial impact on their diabetes status. This immediate biofeedback helps patients make significant and long-term changes that may gradually induce the reversal of type 2 diabetes [2]. The findings from several clinical studies support these implications as patient adherence to proper dietary habits and exercise recommendations typically increase when individuals with type 2 diabetes use CGM systems [6, 7]. Another important note is that the observed improvements that occur in response to CGM use also reduce A1C levels as well as the occurrence of hypoglycemia without the need for intensified treatment (e.g., anti-diabetes medication) [8]. Therefore, CGM is a promising approach to better diabetes management and even reversal for some people with diabetes.
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References
1. Janapala RN, et al. Continuous Glucose Monitoring Versus Self-monitoring of Blood Glucose in Type 2 Diabetes Mellitus: A Systematic Review with Meta-analysis Monitoring. Cureus. 2019;11(9):e5634.
2. Kompala T, Neinstein A. A new era: increasing continuous glucose monitoring use in type 2 diabetes. Am J Manag Care. 2019;25(4 Spec No.):SP123-SP126.
3. Malanda UL, Welschen LMC, et al. Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. Cochrane Database Syst Rev. 2012;1:CD005060.
4. Peters AL, Ahmann AJ, Battelino T, et al. Diabetes technology-continuous subcutaneous insulin infusion therapy and continuous glucose monitoring in adults: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101(11):3922-3937.
5. Foster NC, Beck RW, Miller KM, et al. State of type 1 diabetes management and outcomes from the T1D exchange in 2016-2018. Diabetes Technol Ther. 2019;21(2):66-72.
6. Taylor PJ, Thompson CH, Brinkworth GD. Effectiveness and acceptability of continuous glucose monitoring for type 2 diabetes management: a narrative review. J Diabetes Investig. 2018;9(4):713-725.
7. Haak T, Hanaire H, Ajjan R, Hermanns N, Riveline J-P, Rayman G. Flash glucose-sensing technology as a replacement for blood glucose monitoring for the management of insulin-treated type 2 diabetes: a multicenter, open-label randomized controlled trial. Diabetes Ther. 2017;8(1):55-73.
8. Park C, Le QA. The effectiveness of continuous glucose monitoring in patients with type 2 diabetes: a systematic review of literature and meta-analysis. Diabetes Technol Ther. 2018;20(9):613-621.