Continuous Glucose Monitors

Continuous Glucose

About Continuous Glucose Monitors

A Continuous Glucose Monitor (CGM) is a wearable device that continuously tracks blood sugar levels, day and night, allowing users to see patterns and trends. CGM units sound an alarm if blood glucose levels are changing rapidly, helping people avoid hypoglycaemia or hyperglycaemia.  Currently there are two systems of Continuous Glucose Monitoring (CGM): Real time CGM and Flash monitoring.

Each system requires a sensor or a tiny electrode to be inserted under the skin. This is attached to either a transmitter or small disc. The electrode measures the level of glucose in the interstitial fluid in the tissue every 3 to 5 minutes.  Depending which system is used, the sensor usually needs to be replaced every 6 to 14 days.

Real time CGMs

A real time CGM actively sends the glucose readings to a device, such as a mobile phone or insulin pump, and alarms can be set to alert when the sensor glucose level is too high or too low.  

As measurements are taken every 3 to 5 minutes, the direction in which the glucose level is trending can be seen and some systems can alert up to 20 to 30 minutes before the sensor glucose is expected to be too high or too low, allowing some action to be taken beforehand.  When used in conjunction with some insulin pumps, insulin delivery can either be stopped, decreased or increased based on the sensor glucose reading. This can have the added benefit of helping to prevent hypoglycaemia and hyperglycaemia with minimal input needed from the person living with T1D.

Read more about how hybrid closed loop pumps work with CGMs below.

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Flash glucose monitoring

Flash glucose monitoring systems store the readings on the disc which is attached to the sensor. To see the collected information, you can swipe the disc with a phone or meter to ‘pull off’ the data. The disc can store data for the last 8 hours. This type of CGM is good at identifying day to day glucose patterns or trends but it cannot warn of impending highs or lows.  

With all CGM systems, finger pricks may still be required from time to time, either to calibrate the sensor or to check the accuracy of a reading before taking action, such as treating a low blood glucose or giving extra insulin.

The Continuous Glucose Monitoring Funding Initiative

The Continuous Glucose Monitoring Funding Initiative

CGM is not a cheap monitoring option and can cost between $2,600 and $5,000 a year. JDRF has been a strong advocate of access to CGM for many years and played a key role in developing the Diabetes Coalition, which lobbied government for the first round of funded CGMs. This helped establish the CGM Funding Initiative under which the Australian Government provides eligible people with access to fully subsidised CGM devices. In February 2020, the Government announced an expansion of the CGM Initiative allowing 58,000 more people to gain free access to these devices.

The CGM Initiative is administered by the National Diabetes Services Scheme (NDSS). To be eligible to access the subsidy, you must be assessed by an authorised healthcare professional and meet certain criteria. The full eligibility criteria for each group are available on the NDSS website.

What is JDRF doing to increase access to CGM?

Key to any increased access to technology is being able to show decision makers the value that technology brings to the person using it.

The Australasian Diabetes Data Network (ADDN) established by JDRF has captured data from 3,915 young people, under 21 years of age, who commenced using CGM after the introduction of the government subsidy. The observed improvements will be part of presenting the value that CGMs can bring to the lives of people living with T1D.

That is why the increase in funding for the CGM evaluation project, secured in June 2020, will be so valuable. The funding, which extends the evaluation program until June 2024, allows us to continue the important work of presenting the incredible impact CGM can bring, while also establishing evaluation as an important consideration to technology generally. The Department of Health agreed to consider our proposal externally to the Budget process. The decision to champion the initiative at a time of considerable COVID-19 health spending reflects the value of the evaluation and the relationship JDRF has with decision-makers.

Access to CGM: Answering your questions

JDRF has played a key role in advocating for increased access to technology for all people living with type 1 diabetes (T1D). We get a lot of questions from the T1D community about JDRF’s position on CGM and our advocacy efforts in this space. You can read our answers to some of your most frequently asked questions in our blog post.

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