Can a continuous glucose monitor help manage diabetes better?

Question

Hello doctor,

I am a 28-year-old male with type 1 diabetes, which I have been managing with insulin therapy and regular blood sugar monitoring since I was 14. Recently, I have been struggling with blood sugar stability, as my glycated hemoglobin (HbA1c) has increased to 8.2 percent from 7.4 percent over the past three months, and I have been experiencing more frequent highs and lows. Along with these fluctuations, I have noticed symptoms like fatigue, blurred vision, and increased thirst.

I am considering switching to a continuous glucose monitoring device to better track my levels in real-time, but I am unsure of its effectiveness in improving my control. Additionally, my recent laboratory tests showed a slight increase in creatinine levels (1.3 mg/dL) and microalbuminuria (45 mg/g), raising concerns about the long-term impact on my kidneys. Could you provide guidance on whether a continuous glucose monitoring device might be beneficial and if there are any other adjustments I should consider in my treatment plan?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Switching to a continuous glucose monitoring (CGM) device will be helpful in managing your diabetes more effectively. Continuous glucose monitors continuously monitor your blood sugar levels throughout the day and night, providing you with real-time data. These devices can alert you to high or low blood sugar levels. Using a CGM can lead to a reduction in glycated hemoglobin (HbA1c) levels and allow you to identify patterns in your blood sugar fluctuations.

Your recent lab results showing a slight increase in creatinine levels (1.3 mg/dL) and microalbuminuria (45 mg/g) indicate early signs of kidney stress, which is a complication of diabetes. A CGM could help you with blood sugar control, which is essential for slowing the progression of diabetic nephropathy (kidney damage).

High blood pressure can exacerbate kidney damage, so I suggest you ensure your blood pressure is well-controlled. Limiting sodium intake can help manage blood pressure and reduce kidney strain, while excessive intake of protein can stress the kidneys. I suggest you also seek advice from a dietitian.

Regular testing of your creatinine levels estimated glomerular filtration rate (eGFR), and urine microalbumin levels is important. Consistent meal planning, carbohydrate counting, and regular physical activity can contribute to better blood sugar control. Additionally, meditation and adequate rest can help reduce stress.

I suggest you take regular follow-ups with your doctor.

I hope you find this information helpful. Please let me know if you need further assistance.

Thank you.