Several years ago, I wore a CGM for some months (insurance wouldn't cover it, but a kind friend gave me the meter), and my A1c *did* go down about a point. If I went into the kitchen to make a cup of coffee and felt like grabbing a handful of nuts, first I'd check the meter. If it said 75, I'd have the nuts. If it said 100, I wouldn't. I think that made a difference.
Thanks David for this helpful article. Can we request a monitor from our doctor? Will we have to purchase? What is the approxiament cost? I do think it would be helpful to wear the device and as you suggest lowering our A1c by a point would be excellent. I can clearly see the value.
You have some great questions! While continuous glucose monitoring systems are expensive, some healthcare plans are now covering them. The last time I checked, the initial cost was more than $1,000. Then, you have the continuing costs of the sensors. But your doctor can prescribe one for you, and if you and your doctor work well together, you can get one to keep. To get one to use for a week or so at a time, like Dr. Crowe's patients can, is also possible. But only if you have a very up-to-date doctor.
Just another example of how the medical profession (except Dr. Crowe!) and insurance companies discriminate against Type 2's. While it is true that Type 2's experience fewer extreme lows or highs than Type 1's, those are not what cause the complications. It's the day-in, day-out higher than normal BGs that cause the complications. And just because Type 2's are often older at diagnosis than Type 1's still does not mean they don't deserve quality of life.
At least I kept the rant short, LOL!
After 4 years on the pump, my a1c went from 6.5 to 7.9!! 
I finally told my endo, I need to have one variable to monitor my insulin and that would be me, and I went on a pump vacation. About a year later, I was stuck at 7 and struggling to find the mystery highs, so my cde suggested a dexcom. In just 3 months, my A1c went down to 6.7 and currently holds at my target of 6.3. As a type1 for 42 years, the recommendation is not to go below 6. Given my exercise, they felt 6.3 was the perfect mark. I think it is a failure of the physicans not to advocate for type2 to have the same access!! My primary had never heard of CGM, until I showed it to her! It's ridiculous not to allow this device, that will most certainly ward off complications, access to all with diabetes!!!!!
Indeed they are very expensive, and Medicare will only cover a 2-week trial, I think, once a year. So if you are on Medicare (and low income as so many of us are, you can just forget the benefits of a CGM. I wore once for a clinical trial I took part in, and indeed it was a wonderful help...as long as it lasted. I'm a type 1.
IN MY 64 YEARS AS TYPE 1 I HAVE NEVER FELT BETTER ABOUT MY CONTROL AND SEEING AT THE TOUCH OF A BUTTON WHERE YOU WERE,ARE, AND WILL BE , IS THE BEST EFFECTIVE NEW WAY TO PREVENT THE HIGHS AS WELL AS THE LOWS AND CONSEQUENT PROBLEMS . IT IS REMARLKABLE TO SEE THE GRAPH DEPICTING THE LOWERING B.G. AS I TREADMILLED TO NORMAL IN 15 MINUTES. I WOULD PRESCRIBE THE DEXCOM 7 FOR ALL WHO ARE SERIOUS ABOUT ACHIEVING A HEALTHY BODY , MEANING OPTIMUM WEIGHT AND AN A1C OF 6.5 OR LESS.MY NEXT A1C WILL BE 5.5 WITHOUT THE VERY LOW LOWS OR CRAZY HIGHS THANKS FOR YOUR GREAT ARTICLES. ELLIOT BROWN, JOSLIN MEDALIST STUDY PARTICIPANT AND SUPPORT GROUP LEADER IN OMAHA, NEB.
I have had my CGMS for about three weeks. Great little device. However, often, there is a wide range between the number from the CGMS and the result of my finger test. Not sure why?? Also, I am confused as to why no fruit. Is that not part of a balanced diet? Help. Thanks
Actually, fruit is quite high in carbohydrates. And carbs raise our blood glucose the most.
Interesting that you refer to a "balanced diet." I really don't think that this term has any useful meaning. For example, a truly balanced diet would be 1/4th each carbohydrates, fats, protein, and alcohol.
As to your other question, it sounds to me that you've got a problem with your device that you need to discuss with your doctor.
I need to clarify my previous comment. I am not opposed to eating all fruit. While most fruits, particularly tropical fruits like bananas, are very high in carbohydrates, not all are high. In fact, avocados have essentially no carbs and are one of the very best foods for us to eat. Lemons, limes, green peppers, and some other fruits also have very few carbs and belong in our diet.
Thanks for the clarification. I think one of the most confusing aspects of this disease is dealing with all the info concerning food. When I spoke to my dietician about my food plan (seemed to be high in carbs) she said they were healthy carbs. When I talked to her about significantly reducing carbs she said that I would be missing essential nutrients..etc., etc.,. I guess we just have to do our own investigating and do what's right for our own bodies. Thanks again for your response.
First recommendation, Visit with a C.D.E. EXPERIENCED WITH THE CGMS, THEY HELP US UNDERSTAND WHAT IS IMPORTANT TO MANAGE WELL. THE CGMS READINGS TRAIL THE GLUCOSE METER AND , IF THE FINGERSTICK IS DONE WITH WAEHED HANDS AND IF THERE IS A BIG DIFFERENCE, I TEST AGAIN. I HAVE LEARNED THAT THE CALIBRATED CGM WAS MORE ACCURATE THAN MY FIRST FINGERSTICK. MY 64 YEARS HAVE NEVER BEEN AS RELAXED DUE TO THE ABILITY TO KNOW WHERE I AM, WAS, AND AM HEADED BY JUST PUSHING THE BUTTON AND SEEING THE DIFFERENT GRAPHS ON THE DEXCOM SEVEN IT HAS CHANGED MY LIFE FOR THE BEST IS YET TO COME.
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David, Are you saying that you agree now that eating fruit is ok? I thought you had a "No Fruit, cept certain berries" policy! -Barry
Barry,
Thanks for asking. I don't eat much fruit except avocados, green peppers, lemons, limes, and berries (especially blueberries). I do make sure not to eat fruits that will give me more carbs than I set as my limit for a meal. That limit is just as Dr. Bernstein recommends: 6 grams of carbs for breakfast and 12 grams each for lunch and dinner. So the fruit and whatever else I eat at that meal have to fit together within that limit.
David
so you don't eat "real" fruits, like apples, bananas, pears, peaches, etc. because those would surely go beyond those Bernstein limits...
I suspected that, but it sounded in your review that you agreed that eating fruits were ok!
I think we have to take quantity into consideration too. One slice of a pear is probably (I'm too lazy to look it up with my slothlike Internet connection) better than 2 cups of blueberries (which have the most carbs of the common berries). As always, we should use our meters to decide.
I grow raspberries and find a cup of raspberries is pretty benign when taken with a meal.
When my apple trees are bearing, I also sometimes add one slice of apple to yogurt or kefir. That's different from eating an entire Pound Sweet.