Indulging in local cuisine is a highlight of any trip. However, managing blood sugar levels while traveling can be challenging. Traditional finger-prick testing can be inconvenient and disruptive. Discover how innovative technology such as continuous glucose monitor offers a more practical solution for monitoring your health on the go and enjoying your travels to the fullest.
“Discover the world of continuous glucose monitoring (CGM) devices. Learn how these innovative tools can revolutionize diabetes management, improve health outcomes, and enhance quality of life.”
What are Continuous Glucose Monitors (CGM)?
Continuous glucose monitors (CGM) are sensors that measures glucose (sugar levels in our body) continuously through out the day and presents that result via an app on a smart device like your phone. The sensor is usually attached to the skin via a small needle usually to the back of the arm or abdomen. This real-time data empowers individuals to make informed decisions about their diet, exercise, and medication, leading to improved blood sugar control and overall health.
Why is it important to monitor the glucose level in our body?
Consistent elevated glucose levels are a significant risk factor for developing diabetes. By wearing a continuous glucose monitor (CGM) for even a short period of time, individuals can gain valuable insights into how specific foods and lifestyle choices impact their glucose levels. From this understanding, individuals can make informed decisions to optimize their diet, exercise routine, and overall lifestyle, potentially reducing their risk of developing diabetes and other health problems.
What is diabetes:
Diabetes is a chronic condition affecting millions of people in the world. It occurs when the body is unable to regulate the level of blood glucose. When our blood glucose is high, our body use insulin, a hormone created by the pancreas, to regulate this level. For those who are prediabetic or diabetic, this regulation does not function properly. When our blood glucose is constantly high, it can lead to damage of the eyes, kidneys, nerves and increase the risk of heart disease(1).
How do you know if you have diabetes?
There are different types of diabetes and are generally classified as Type 1 , Type 2, and Gestational diabetes.
According to Diabetes Canada, diabetes is diagnosed when(1):
- symptoms of high blood glucose is present and one of the test results below are present or
- if no symptoms of high blood glucose is present and two of the test results below are present (done on different days):
- FPG ≥7.0 mmol/L (≥126 mg/dL)
- 2hPG in a 75 g OGTT ≥11.1 mmol/L (≥200 mg/dL)
- A1C ≥6.5% (for use in adults in the absence of factors that affect the accuracy of A1C and not for use in those with suspected type 1 diabetes)
- Random PG ≥11.1 mmol/L (≥200 mg/dL)
FPG – Fasting plasma glucose test: a blood test that measure blood sugar after fasting for at least 8 hours. 2hPG – Two hour post load glucose test: measures the blood sugar level 2 hours after drinking a glucose solution or oral glucose tolerance test (OGTT). A1C – measures the average blood sugar level over the past 3 months. Random plasma glucose (PG) test: measures the amount of blood sugar at any time of the day
Prediabetes is diagnosed when
- FPG 6.1 to 6.9mmol/L (110mg/dL to 125mg/dL)
- 2hPG in a 75g OGTT 7.8 to 11 mmol/L (140mg/dL to 199mg/dL)
- A1C 6 to 6.4%
Non-diabetic blood sugar ranges (2):
- FPG <5.6mmol/L (100mg/dL)
- A1C 4 to 5.6%
- Random PG 3.9 to 7.8 mmol/L (70 to 140mg/dL)
How are Continuous Glucose Monitors different than Finger Prick Glucose Monitors?
Finger prick device are used to measure blood glucose levels and involves taking a blood sample. This gives the blood glucose level at that moment in time. However, finger prick device does not give information on how our glucose level changes with time unless we take multiple blood samples over a period of time.
Continuous glucose monitor gives glucose level at that moment in time and gives the continuous glucose level in interstitial fluids between cells which provides a better picture on how certain food or exercise can affect our blood glucose over time.
The difference between blood glucose level and interstitial glucose level is that there is a lag time when glucose is transported from the blood stream into the cells(3). When our glucose are rapidly changing, the two values may differ due to lag time.
Freestyle website provides a good video to explain the difference between blood glucose and interstitial glucose.
What continuous glucose monitors are available and what are their differences?
The two major brands of CGMs currently available are Freestyle Libre and Dexcom. The following table lists some of there differences(4,5,6).:
Note: Dexcom Stelo is indicated for non-diabetic use
| Current Available Sensor | How Long Sensor Last | Sensor Size | Glucose Reading Frequency | Water | Alarm |
| Dexcom G7 | 10 days | Small size, half the size of G6 (1.5x thicker than Libre 3) | Every 5 minutes | Water proof up to 8 feet | Yes |
| Dexcom G6 (requires separate transmitter) | 10 days | Twice the size of G7 | Every 5 minutes | Water resistant | Yes |
| Freestyle Libre 3 (not yet available in Canada) | 15 days | Smaller than two stacked pennies | Every minute | Water resistant | Yes |
| Freestyle Libre 2 | 14 days | Same thickness as two stacked quarters | Every minute | Water resistant | Yes |
| Dexcom Stelo | 15 days | Same size as G7 | Every 15 minutes | Water proof up to 8 feet | No |
What are the cost of these sensors?
The cost of continuous glucose monitors (CGM) can be higher than traditional finger prick blood sugar monitors depending on how often testing is done. However, continuous glucose monitor gives us better information and insights of our glucose level throughout the day. Even trying a sensor for 1 week or 2 weeks can give insights on how certain foods and activities such as sitting, walking, exercising can affect our glucose level.
Continuous glucose monitors (CGM) may be covered by third party insurance or provincial plans for those who are diabetic in Canada.
| Cost of Sensor | Transmitter Needed? | |
| Dexcom G7 | $87.99CAD | No |
| Dexcom G6 (1 Box of 3 Sensors) | $345 CAD | Yes, need transmitter to work ($41.79 for 1 transmitter which last 3 months) |
| Freestyle Libre 2 (1 Sensor) | $99.99 CAD | No |
| Freestyle Libre 3 (approved by Health Canada but not sold yet in Canada) (1 Sensor) | $117.95USD (~$167.92CAD) | No |
| Dexcom Stelo (not sold in Canada)(2 Sensors) | $99USD (~$143CAD) | No |
Above cost obtained from: London Drugs Pharmacy, Shoppers Drug Mart Pharmacy, Medix Supply
Disclaimer: The information provided on this site is for educational purposes only and does not substitute for professional medical advice. It is advised to consult a medical professional or healthcare provider if seeking medical advice, diagnosis or treatment.
Reference:
(1) https://guidelines.diabetes.ca/cpg/chapter1
(2) https://www.uptodate.com/contents/type-2-diabetes-overview-beyond-the-basics/print