Managing CFRD With a Continuous Glucose Monitor

Being diagnosed with diabetes on top of cystic fibrosis can often be a disappointing and hard transition to process. Unfortunately, it happens to a lot of people living with CF since about 50% of adults develop cystic fibrosis-related diabetes (CFRD) in their lifetime.¹ Although CFRD is its own disease, it shares characteristics of both Type 1 and Type 2 diabetes, specifically insulin deficiency and insulin resistance, respectively.²

The hardest part of being diagnosed with CFRD is learning how to manage another illness with its own ins and outs on top of CF. Although CFRD is a struggle at first, there are some helpful devices like continuous glucose monitors that make it easier to stay on top of it.

What is a continuous glucose monitor?

A continuous glucose monitor (CGM) is a wearable device that tracks glucose levels continuously and transmits the data to your phone or a handheld receiver, providing a fuller picture of glucose levels throughout the day and night.³ The data is organized as a graph within an app on your phone or handheld device. There are no daily finger pricks or supplies needed to check blood sugar since CGM is transmitted in real-time.

How does it work?

There are a few different CGM brands and models available on the market today: Dexcom, Freestyle Libre, and Medtronic.⁴ However, all use a small wire sensor that is inserted under the skin to test glucose in the interstitial fluid, or the fluid in the layer of fat under your skin. The sensor is inserted with an automatic applicator that truly only feels like a pinch and then is held in place with an adhesive patch.

Once inserted there’s often a warm-up period where the sensor calibrates itself to provide an accurate reading. After the warm-up, the sensor sends the blood glucose data using a Bluetooth connection to the device in real-time at certain intervals, such as every 5 minutes. Every 10-14 days, the sensors are changed and a new one is inserted.

Benefits of a CGM

Studies show the use of CGMs is helpful in managing diabetes by lowering A1C and episodes of hypoglycemia, or low blood sugar.^4,5 While the use of continuous glucose monitors have just started to become more popular in cystic fibrosis-related diabetes, there is research to support their use in this population especially because CFRD has an effect on weight, pulmonary function, and Pseudomonas aeruginosa infections.⁵

CGMs make tracking blood sugars easier, convenient, and more comfortable. In comparison to your traditional glucometer, where you prick your finger with a lancet and use a new test strip each time, with a CGM you just open an app to check your blood sugar. This is especially important for those with CF who already do so much to manage their disease on a daily basis.

My experience with a CGM

I started using a CGM about 1.5 years ago to better manage my CFRD. At the time, I was doing insulin injections and also experiencing blood sugar lows throughout the day. Together with my endocrinologist, we decided we needed a better picture of the trends of my blood sugar since they tended to rise and fall rapidly. My doctor was also concerned I was becoming less sensitive to blood sugar lows which is extremely dangerous. She had just the answer to help me: a CGM!

Using the Dexcom G6

I have a Dexcom G6 which has the capabilities to organize blood sugar numbers in a continuous graph so that I can see trends and how my body reacts to specific foods or events. I can add when I eat, how many carbs in the meal, or when I take insulin and the information is loaded into the app for me.

Another huge benefit is that my Dexcom alerts me with a very loud (and sometimes annoying) alarm when I’m approaching a blood sugar low. The same is true for a blood sugar high, or a rapid rise or fall in my blood sugar numbers. The alerts help me respond proactively to changing blood sugar, instead of reactively.

Lastly, there are never any needles or extra supplies I need to check my blood sugar. I just check my phone quickly that I always have with me, and that’s that!

Do you have cystic fibrosis-related diabetes and, if so, do you use a continuous glucose monitor to manage your diabetes? Tell us about it!