CGMs and GLP-1s: Who's Using 'Em?

One morning I felt like absolute garbage and checked my blood sugar just out of curiosity (I keep a cheap monitor at home). It was super low, like under 30 low 🥴, and I don't have diabetes. Immediately got a prescription for a CGM, now using a Libre 3 and it's been great, though the app could be better.

It's amazing to see how different foods impact my glucose levels. Also, how lack of sleep and getting that 'second wind' affects it. The craziest was seeing my sugar spike when I had to drive in really bad weather... guess stress hormones dump glucose into your system!
 
I use a Freestyle Libre 2. It's not the top-of-the-line, but it works well enough, IMO.

It really hinges on your health conditions, what other medications you're on, and your GLP-1 dosage.

If you're a type 1 or type 2 diabetic needing insulin, a CGM is essential, period.
If you're on a high dose (around 10mg or more) or your finger-prick tests are consistently low, then think about getting one.

I'm pre-diabetic; my A1C was 5.7 before starting tirzepatide. I take a low dose of metformin (500mg slow release) daily, which my doctor wanted me to continue alongside the tirz.

I have a standard finger-prick blood glucose meter, which honestly, is probably sufficient. I once tracked my fasting BG every day, particularly before the shot and for a day or two after. Spot-checking is simple if you suspect low blood sugar. You don't really need a CGM to tell you that; it feels excessive.

Now, why I started using a CGM again this month... I have insomnia. I fall asleep fine, but I often wake up between 2:30 and 5:00 AM and can't fall back asleep, regardless of what I try. Standard sleep aids don't seem to help. I suspected nocturnal hypoglycemia might be the cause, triggering a cortisol surge and waking me up. So, I put my CGM back on to investigate. I'm on a low dose (2.5mg), so I didn't think it was likely a hypoglycemic event, but you never know. I see my bg consistently decreasing for a day or two post-shot. The lowest reading I saw was 82. I had a few readings in the 70s, but those seemed random. Conclusion: I'm not waking up due to low blood sugar. Maybe that's what's happening to you, though! So, it's worth checking.

My advice: If you're seeing consistent lows with finger pricks, talk to your doc about a CGM. Insurance might not cover it unless you're T1D/T2D, but you can look into discount cards. I paid about $80 recently for a month's supply of sensors using a discount card.

Side note: I agree with @Kelly1976 that it's interesting to see your glucose fluctuations. I think trying to fine-tune carb intake or meal timing based on CGM data is overkill since GLP-1s do most of the work for you. But it's still interesting to see how your body responds to foods, exercise, etc. I experimented before starting Tirz and it was informative. It helped me demonstrate insulin resistance to my endocrinologist.
 
My daughter has type 1. When she was first diagnosed, my husband and I decided to wear an over-the-counter CGM along with her in solidarity because she was bummed about having to wear one. Coincidentally, I also started Tirzepatide that same week.

Before the Tirz, my blood sugar levels were all over the place, and I was constantly hungry without understanding why. After the first dose, my blood sugar stabilized, and I only feel hungry when I actually need food. Seeing those results made me so happy! I haven't experienced scary lows, but my blood sugar is consistently lower on the medication.

*Edit: When my daughter's blood sugar gets low, she becomes hungry. So, it makes sense why I was always hungry before starting the medication! I also tested the Dexcom Stelo and didn't think it was as precise as the Lingo when I compared it to finger sticks.
 
That's pretty neat. It echoes what I'm seeing too. No more major ups and downs. Just a few small 'hills.' I'm also eating significantly less and following a low-carb diet, which definitely helps. For data geeks (like myself!), seeing the patterns is cool 😆

P.S. What a thoughtful idea to get a CGM to support your daughter!
 
I'm not diabetic or pre-diabetic, but a fasting glucose test came back slightly over 100, which worried me. So, when the Dexcom Stelo became available, I jumped on it. I wore the first sensor while waiting for my first GLP1 prescription (compounded semaglutide) and am saving the second sensor until after I increase my dose to see how the glucose patterns change.

My experience with the first sensor was interesting, especially regarding meal timing. Carbs consumed later in the day caused bigger and longer spikes than carbs consumed earlier. This helped me make better food choices, allowing me to see how my body reacted to different foods and habits.

I haven't had any low blood sugar events since starting semaglutide. I'm guessing the difference in my glucose levels will be similar to what @FitFam described.

I'm planning to use the second sensor next month. I'm excited to see the new data and compare it to the old data.
 
Unless you have T1 or T2 diabetes and are on insulin, hypoglycemia isn't usually a big concern. You'll feel bad, but your liver will help prevent dangerous lows by releasing more glycogen. Still, people can learn a lot about how different foods affect them by wearing a CGM for a while. It's a useful tool for those trying to change their eating habits by providing immediate feedback.
 
Dexcom G7... and I've also tried (for fun) the Dexcom Stelo, Abbott's Lingo, and Sibionics GS1... all worked well, but I'm sticking with the G7 (since insurance covers it).
 
It's so interesting to hear about everyone's experience with CGMs and GLP-1s! I'm starting to think about getting one, especially after reading about how much they can help with understanding your body's response to food. It's inspiring!
 
That's right, dramatic reductions in insulin needs are not uncommon with GLP-1s, especially when combined with lifestyle changes. Losing weight and improving metabolic health have huge effects.
 
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