How Can a Professional CGM Help You?
By Arvind Sommi
CGMs provide information that you can use to improve your blood glucose. If you don't currently use a CGM, your healthcare team can offer you a “professional” CGM to use for a week or two so that you can see how to increase your Time in Range. Read more about what a professional CGM is and if it could be right for you.
Unlike blood glucose monitoring using multiple fingersticks and blood glucose meters, continuous glucose monitors (CGM) can continuously collect information and insights, giving people with diabetes significantly more information about their glucose trends and where they are heading. Additionally, CGMs can calculate Time in Range (TIR) throughout the day.
Considering that over 37 million Americans have diabetes, there is tremendous potential for improving their health by giving more people the opportunity to benefit from using a CGM, even on a temporary basis.
Although the benefits of CGMs are well documented, many people are unable or unwilling to use them for a variety of reasons: they might be unable to afford a CGM, struggle to obtain a prescription, lack insurance coverage because they are not on intensive insulin therapy, not want to hear alarms, or have hesitancy around wearing a device all day. Fortunately for these individuals, there is an alternative option called professional CGM that could be beneficial.
What is Professional CGM?
CGMs are classified as either personal or professional depending on who owns the device. Personal CGMs are owned by the person with diabetes while professional CGMs are owned by the healthcare center. In a professional CGM (Pro CGM) program, your healthcare provider gives you a CGM for a short time (usually one to two weeks) to better understand your glucose levels. After these few weeks, you return the sensor and equipment to your health care provider and you review the data together.
Dr. Nuzhat Chalisa, an endocrinologist at Morris Hospital in Chicago, described how Pro CGM is used by healthcare providers. “I use Professional CGM with 90 percent of my new diabetic patients as it provides me and the patient with a quick review of their glucose profile and patterns,” she said.
Having access to your glucose data can help healthcare providers recommend medications and lifestyle changes that best fit you, which in turn can lead to better glucose control. Chalisa noted that Pro CGM is particularly beneficial for people who have a harder time managing their glucose levels such as those who experience post-meal hyperglycemia or frequent hypoglycemia. Additionally, as insurance coverage increases for Pro CGM, more health care providers can consider implementing the program into their regular practice.
If you are considering a CGM system but are anxious about what it might feel like to have a device connected to your body, using a Pro CGM may help calm your fears. “Patients are amazed at the amount of information you can get from CGM monitoring. For some, it is an eye opener on how their glucose varies throughout the day with their diet and activity,” said Chalisa. “Most patients are agreeable to, and request personal CGM after I share the information obtained from the download on professional CGM.”
What Are Your Options for Pro CGM?
Blinded vs. Unblinded
There are two different types of Pro CGM: blinded and unblinded. It is called blinded because you cannot see your glucose data as it is being collected. Only your healthcare provider can download the information to review with you. Blinded Pro CGMs can be helpful since you won’t be changing your behavior in response to immediate feedback, giving your medical provider a clearer picture of your day-to-day glucose highs and lows. Conversely, an unblinded CGM allows you to directly observe the effects of your diet, physical activity, stress, and other factors on your glucose levels.
“I would prefer unblinded CGM as it really helps the patient modify their behavior based on their glucose profile,” said Chalisa. “However, the blinded professional CGM is a great tool to get quick information on their glucose profile, especially when evaluating a new patient.”
Three Models Approved in the United States
The three Pro CGMs currently approved for use in the United States are the following:
Abbott Freestyle Libre Pro - This blinded professional CGM is usually worn for 14 days, does not require calibration with a finger stick, and is placed on the upper arm.
Dexcom G6 Pro - This professional CGM is unique in that it can be provided as either blinded or unblinded. It is usually worn for 10 days, does not require calibration, and is placed on the abdomen.
Medtronic iPro 2 - This blinded professional CGM is usually worn for 6 days, needs to be calibrated 3-4 times daily, and is placed on the abdomen. Although this device is still FDA-approved, it is older than the other two and is no longer being marketed in the United States.
If you are interested in learning more about professional CGMs, consider discussing what your options are with your healthcare provider or an endocrinologist.