Continuous Glucose Monitoring in Type 2 Diabetes

In this interview, CHMC co-chair Anne Peters, MD and Irl Hirsch, MD share some important practical pearls about the importance of continuous glucose monitoring (CGM) and how to better utilize this approach in patients with type 2 diabetes (recorded October 21, 2022).

[@jonuiuc]

I started using a libre 3 at the advice of my endocrinologist, it accompanied my tirzepitide, and I can attest, it really helps visualize the affects of sugars and has really helped my adjust my eating habits etc. I had tried the larger Libre 2 in the past but stopped because of the size and cost, but the real time ability of the the libre 3 and its smaller size is really much better.

[@alsjogren7890]

I have pre-diabetes. I joined Levels to get a CGM. I have learned a lot and have changed what I eat. I get no spike from ham and cheese sandwich. I added a plum because I heard that one plum is OK. The CGM confirmed that. I added with a sandwich instead of the plum, a peach because I heard that one Peach is OK. The CGM said NO. Some people differ. I found that Costco was much cheaper than Levels for a CGM. Costco transferred the prescription and now I can refill at any Costco.
We need to get CGMs off of prescription in the USA. They are over-the-counter in Mexico.
RUclips people seem to say that I can reverse pre-diabetes. I am determined to do that. What no one has said what reversing means. Yes, numbers back in the normal range. If I succeed will I likely retain insulin resistance? In other words, am I likely permanently stuck?

[@pushpadesai9797]

I see FBS118 and after exercise it goes 180?

[@petercyr3508]

CGM not recommended for type 2 because the ADA does not want patients to understand how bad and wrong the high carb recommended diet is and how unnecessary insulin stimulating meds are.
It is important to understand that glucose is so important, your liver makes all the glucose you need under the action of glucagon moderated by insulun. Any you eat is extra. Carbs are not a required nutrient. You literally do not need to eat any. Why do we eat them? It is a built in addiction from a time when food was scarce to make us store fat.