Continuous glucose monitoring (CGM) is a newer technology which allows very frequent monitoring/checking of blood sugar. To use a CGM, the user must insert a tiny filament into the subcutaneous space for up to a week at a time which is attached to a small transmitter which is adhesed to the skin. A signal is sent from the transmitter to a reading device. The CGM measures the sugar in the spaces between the fat cells. This reading correlates well with the actual blood sugar.
CGM gives the user the ability to monitor the blood sugar more comprehensively. The CGM monitors can be programmed to alarm if the patient is below or above a glucose threshold. We have used CGM extensively in Type 1 diabetes and it is sometimes used in Type 2 diabetes.
A1C is a blood test done by the lab, which reflects overall control of Diabetes, dating back 3 months. The A1C target according to ADA is <7% . This level is associated with a low level of complications of Diabetes. The target A1C should be individualized depending on a number of relevant factors such as age and duration of Diabetes.
The A1c should be done no more often than every 3 months. The A1C test measures part of the red blood cell hemoglobin. Red blood cells live 3-4 months, and one of the hemoglobin fractions in the red blood cell is the A1C. This fraction irreversibly attaches sugar which crosses the red cell membrane. The A1C, then, offers a 3-month barometer of overall Diabetes control
There is no treatment to prevent Type 1 diabetes. Type 2 Diabetes can be prevented by weight loss and exercise (see info on Pre-diabetes)
There is currently no treatment to “reverse” Type 1 Diabetes. Type 2 Diabetes can sometimes be “reversed” by weight loss and exercise.
