Imagine 288 Fingersticks a Day: The Power of CGM
By Michael Hattori
Michael writes about his diagnosis with type 2 diabetes, and how he used a CGM to put his type 2 diabetes into remission
My name is Michael, and I have type 2 diabetes. In remission. This means that my body no longer experiences unusually high blood sugar levels, and I don’t have to take diabetes medications.
Diabetes remission would not have been possible for me without the help of a miraculous tool called a continuous glucose monitor (CGM). Let me tell you how and why.
I have been a nurse for almost 22 years. Although most of my time has been in the operating room, I started my career taking care of people with diabetes, most of whom were faced with complications from diabetes. I realized early on how immensely complex and challenging diabetes is – I never imagined that I would be diagnosed with type 2 diabetes.
Well! About six months ago, my weight had reached 200 pounds (I’m 5’3”), my appetite was growing, I began experiencing extreme thirst. The huge amounts of water I was drinking seemed to do nothing but drive me to the bathroom seemingly every five minutes. Now, as a nurse, I knew exactly what was happening. But it couldn’t be happening to me!
At first I thought, “Oh, this will go away. It’s temporary.” But after several weeks of symptoms, I realized I needed to do something. I asked one of my colleagues at work to check my blood sugar, and it was 298 mg/dl. I could not believe it. We checked again, and it was 300 mg/dl. Lab tests a few day later showed a fasting glucose of 305 mg/dl and A1C of 10.5%. I had diabetes.
Now, you may be thinking, “You’re a nurse, for crying out loud! How could this happen to you?” But the fact is, I’m also a human being, just like you. Having worked outside of diabetes care for over 18 years, I was as uninformed as most people, and just as frightened.
One of the general surgeons I work with was standing next to me, and I asked him what he thought I should do. He was genuinely shocked, and said, “I think we need to get you on metformin, an SGLT-2 inhibitor, and a DPP-4 inhibitor.” Fortunately, my friend and colleague, Jennifer, immediately interjected, “No! You have to try this CGM first!”
I had no idea what a CGM was, but I soon found out. And it changed my life – saved my life, really.
Jennifer said, “This [CGM] is the greatest thing ever! It measures your blood sugar every five minutes, 24 hours a day, and you don’t have to stick your finger to see the results!” I was intrigued, as I had heard rumors of such devices (and also hated sticking my finger). She said that it had become her “best friend” and that it helped her mother, who had type 2 diabetes for 20 years, to manage her blood glucose. The next day I spoke with my primary care provider, and one day later I had a Freestyle Libre CGM sensor on my arm and the determination to manage my type 2 diabetes with diet and exercise alone.
Over the next six weeks, I came to rely on my CGM as my personal blood sugar “GPS.” It allowed me to see how every single thing I did affected my blood sugar, and not only during waking hours, but also while I was asleep. I kept a log of everything I ate; the CGM helped me to see how it affected my blood sugar, both immediately and over many hours. Can you imagine how powerful a tool that is for people with diabetes? To see in real time what effect food has? And not for just one point in time, like a fingerstick, but every five minutes after you eat. Imagine, if you are taking insulin, how valuable that information would be to help with dosing. No more guessing – incredible!
I had also heard about intermittent fasting but was skeptical until I started reading and found agreement that it is not only effective in helping to manage blood sugars and lose weight, but that there are other long-term health benefits. Jennifer had been doing intermittent fasting for over a month and was very positive about it, so I decided to give it a try. One of the main reasons I was willing to try it was because I had my friend, the CGM, as my guide. Being able to check my blood sugar at any time provided me with the safety net I needed to try something as radical (to my mind, at least) as fasting. And guess what, it worked!
I am now a huge advocate of intermittent fasting. But– and this is a big but – it is not for everyone. Anyone using insulin or medications that might cause low blood sugar (hypoglycemia) must consult with their healthcare professional, and also preferably a diabetes care and education specialist, before starting any kind of fasting program.
Along with helping me with my diet, the CGM gave me immediate feedback on exercise. I knew that exercise would help manage my diabetes, but I had no idea just how big a difference it could make. I’m not talking about hours of hard, furious sweating and exhaustion; all I did at the beginning was walk. The diabetes care and education specialist who led my class told us that even a 10-15 minute walk after a meal can bring your blood sugar down significantly. Many of the people in the class were skeptical, but she made us promise to walk at least ten minutes after every meal, and to check our blood glucose before and after the walk. Everyone was amazed at how much it really did bring down blood sugars.
For those of us with CGM, we could monitor our blood glucose throughout the walk, without any fingersticks. For me, a 20-minute brisk walk after dinner would often bring my blood sugar down 60 points or more. It was so gratifying to be able to watch my blood sugar go down and down. It motived me to make walking part of my daily routine – I still try to walk at least ten minutes after every meal, especially dinner.
Having so much CGM knowledge at my fingertips 24 hours a day gave me the power to make informed decisions about exactly what and how much to eat, to experiment with favorite foods, and to see, in real time, the benefits of exercise. How could you ask for a better tool? Within a month, I was able to get my fasting blood sugar down from over 300 mg/dl to less than 150 mg/dl. After three months it was under 120 mg/dl, and after four months under 100 mg/dl, with an A1C of 5.2%. I lost 35 pounds and still plan to lose 20 more.
I don’t think I could have achieved this without a CGM. My CGM gave me the equivalent of 288 fingersticks a day! A CGM puts that huge amount of information right at your (now not sore) fingertips. Of course, it’s up to you to use that information. But as they say, knowledge is power, and this gives you the power to manage your diabetes, and not the other way around. The CGM is the ultimate tool to show you just how your behavior affects your blood sugar, all day long.
Diabetes was a wake-up call for me to improve my lifestyle, and the CGM was the tool that allowed me to do so quickly and effectively. I am now in remission and intend to stay that way.
I am now on the path to becoming a certified diabetes care and education specialist, so that I can share my story and help others understand and manage their diabetes. Surprisingly, the CGM is not available to all people with diabetes. I can’t imagine a single person with diabetes who wouldn’t benefit from this amazing technology: it is like going from seeing through a tiny pinhole to having a full 360-degree view. And the view is incredible!
Click to read my article, Type 2 Remission: How I Got Here and How I’ll Stay Here.
This article is part of a series on time in range.
The diaTribe Foundation, in concert with the Time in Range Coalition, is committed to helping people with diabetes and their caregivers understand time in range to maximize patients' health. Learn more about the Time in Range Coalition here.
Michael Hattori has been a Registered Nurse for 23 years (including 19 years in the Operating Room), and is currently training to become a Certified Diabetes Care and Education Specialist after being diagnosed with type 2 diabetes in 2019. He has since achieved remission, but still closely follows the AADE 7 Self Care Behaviors to keep on track. He is a huge fan and major advocate of continuous glucose monitoring (CGM) and attributes his remission in large part to CGM.
Michael is an avid chef, photographer, musician, and fiber artist in his free time.