Last one from Chi, “I know you recommend glucometers for monitoring blood glucose, but I’d like to know your thoughts on devices like FreeStyle Libre and Dexcom. Are they reliable or inaccurate?”
Chris: We’re talking here about continuous glucose monitors. They are, in some cases, reliable and accurate when they can stay on the patient. That is sometimes a problem. We’ve used them in our work with the fire department in Berkeley. How actionable the data is and how useful it is above and beyond just the checks that I mentioned doing with a glucometer is debatable. It depends on the patient. They can be helpful in situations where you’re seeing some really weird stuff that doesn’t make sense or you’re questioning whether you’re getting enough data from the glucometer, and then A1c, just a standard fasting draw.
But I don’t think they’re necessary or useful for the average person, even the average person with blood sugar issues. They are, I think, helpful when you’re testing various interventions, like we were at the fire department, or you’re doing population things to check and see, like, what effect exercise has, sleep deprivation or getting enough sleep, diet changes, etc. If you have someone wearing a CGM, it’s much easier to monitor all of those things. You’re not going to necessarily have them prick their finger after everything like that and you can’t get to see changes that happen overnight. It’s useful in that sort of setting, but in a just outpatient one-on-one care situation, maybe not as much.