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We’re delighted to announce that Dexcom will be our Partner for the European Society of Preventive Medicine – ARK Partnership Launch Event taking place on 27th September 2023. 

As the prevalence of metabolic diseases continues to grow, there’s an increasing urgency for innovative approaches to diabetes management aimed at preventing complications and improving patient outcomes.

Dexcom is dedicated to simplifying and improving diabetes management for every individual dealing with this condition. Their cutting-edge devices provide precise, real-time readings without the need for invasive finger pricking. Furthermore, these devices can be tailored to meet individual preferences, featuring customisable alerts that significantly enhance the overall user experience [1].

What is Diabetes?

Over 500 million individuals globally are living with diabetes, impacting people of all age groups, genders, and spanning across nations.

Diabetes is a medical condition characterised by elevated blood sugar levels, and comes in two primary forms: Type 1 and Type 2. While both affect glucose regulation, their underlying pathophysiological mechanisms differ significantly. 

Type 1 diabetes is an autoimmune disorder where the immune system attacks and destroys insulin-producing beta cells in the pancreas, causing a severe insulin deficiency. Without insulin, cells can’t access glucose for energy, resulting in high blood sugar levels. People with Type 1 diabetes need lifelong insulin therapy for survival.

In contrast, Type 2 diabetes is characterised by insulin resistance and reduced insulin production. Cells become less responsive to insulin, making glucose entry inefficient. To compensate, the pancreas initially produces more insulin, but this can’t keep pace with demand, leading to elevated blood sugar levels.

Around 90% of people with diabetes have Type 2 diabetes. While there are several risk factors for Type 2 diabetes outside an individual’s control, including age, family history, and ethnicity, there are also many modifiable risk factors that increase an individual’s risk of developing this condition such as diet, exercise, stress, and smoking status [2]. 

Without proper care and support, people with diabetes can develop serious complications, such as amputations, strokes, heart attacks, and heart failure.

Recent data reveals worrisome trends: Type 2 diabetes is on the rise in people under 40, and there’s a significant and growing global population living with pre-diabetes, a condition where blood sugar levels are elevated but not yet at the Type 2 diabetes threshold [3]. Ignoring this early warning sign is unwise. It’s more cost-effective and beneficial for both individuals and healthcare systems to intervene effectively at this stage rather than managing full-blown diabetes later. Improving pre-diabetes monitoring is vital for the successful implementation of diabetes prevention measures.

How Continuous Glucose Monitoring (CGM) Can Improve Diabetes Care

In the past, diabetics heavily relied on the frequent finger pricking to monitor blood sugar levels. This process, while effective, posed significant limitations in terms of convenience. Many individuals found the process of pricking their fingers multiple times a day to be painful and intrusive, often leading to reluctance to monitor glucose levels effectively. Moreover, this method provided only intermittent snapshots of blood sugar levels, potentially missing critical fluctuations that could impact diabetes management decisions.

A CGM, or Continuous Glucose Monitor, is an advanced medical device designed to monitor glucose levels continuously throughout the day and night. Unlike traditional finger pricking, Dexcom’s CGMs provide a continuous stream of real-time data, updated every five minutes. This data is collected through a tiny sensor inserted just under the skin, usually on the abdomen or arm, which measures the glucose levels in the interstitial fluid (the fluid that surrounds your cells). CGMs provide real-time feedback on how your body responds to various factors like food, exercise, and insulin, which enables quick and more targeted adjustments to your diabetes management plan. 

Haemoglobin A1c (HbA1c) is a crucial marker for individuals with metabolic health challenges, such as diabetes. It provides insight into long-term blood glucose control by measuring the attachment of glucose molecules to haemoglobin over about three months, the lifespan of a red blood cell. Therefore, HbA1c can validate the efficacy of interventions for diabetes or those at risk, offering tangible evidence of improved blood glucose management through healthier choices.

What Does Research Reveal?

Dexcom’s commitment to advancing continuous glucose monitoring (CGM) technology is backed by extensive research involving thousands of patients, and the clinical evidence is compelling.

Numerous clinical trials have firmly established the substantial clinical benefits of real-time continuous glucose monitoring (CGM) for individuals with both Type 1 and Type 2 diabetes:

  1. In a clinical trial comprising 158 adults managing Type 1 diabetes, those using a Dexcom CGM experienced a significant reduction in HbA1c levels after 24 weeks, surpassing the outcomes of traditional self-monitored blood glucose management [4].
  2. A study in adults with Type 2 diabetes using slow release insulin who adopted real-time CGM for an extended period of 8 months saw a significant improvement in their time spent within the target glucose range. Importantly, discontinuing CGM led to a partial reversal of these gains, emphasising the significance of continued monitoring [5].
  3. Another randomised controlled clinical trial studied 158 adults with Type 2 diabetes, who were reliant on multiple daily insulin injections, using CGM on a daily or near-daily basis for a 24-week period [6]. This CGM adoption translated into marked improvements in glycaemic control via reductions in mean HbA1c levels. These findings underscore the potential benefits of CGM as an additional management tool for individuals with Type 2 diabetes who require insulin treatment, despite its current underutilisation in this group.

Dexcom’s dedication to research and innovation underscores its mission to provide cutting-edge solutions that empower individuals to take control of their diabetes management. The clinical evidence consistently demonstrates that CGM technology can substantially enhance glucose control, ultimately improving the quality of life for people living with diabetes.

The Role of CGMs in Personalised Nutrition for Early Intervention Type 2 Diabetes Prevention

Personalised nutrition has gained significant traction in recent years as we move away from the one-size-fits-all dietary recommendations. CGMs have emerged as invaluable tools in this arena, enabling individuals to understand how different foods impact their blood sugar levels in real-time.

By tracking post-meal glucose responses, people can pinpoint which foods cause significant spikes and crashes, helping them fine-tune their dietary choices.

For instance, a person may discover that consuming white rice leads to a rapid blood sugar surge, while whole grains have a more controlled effect. Armed with this knowledge, they can craft a personalised diet that optimises their blood sugar control. CGMs allow people to make healthier eating choices and patterns that suit their unique biological makeup.

By using continuous or intermittent, “pulsed” CGM monitoring, individuals at risk of Type 2 diabetes in a clinical setting can effectively track glucose trends, enabling both patients and healthcare providers to detect pre-diabetes at its earliest stages. Armed with this timely information, proactive interventions can be initiated quickly. These interventions, which encompass personalised dietary improvements and increased physical activity, can be fine-tuned to align with an individual’s specific glucose responses. The provision of this tailored data can help design highly effective lifestyle optimisation programmes aimed at reducing a patient’s risk of progressing to Type 2 diabetes. 

Dexcom, CGMs and P4 Medicine

The field of medicine is undergoing a paradigm shift, one that is preventive, predictive, personalised and participatory – often referred to as P4 medicine [7]. This approach holds tremendous potential for alleviating the burden of chronic diseases by harnessing advanced technology combined with our increasingly in-depth understanding of human biology, and evidence-based interventions. 

A key player in this revolution is blood sugar – a pivotal and accessible health metric that serves as a valuable indicator of our physiological wellbeing. It’s like a window into our body’s engine, the metabolism, which involves many complex biochemical processes. When everything runs smoothly, blood sugar stays within a healthy range. However, when disruptions occur, blood sugar levels spiral into disarray, persisting at elevated levels.

This rise can lead to various issues, including increased insulin levels, weight gain, brain fog, and systemic sterile inflammation throughout the body. Over time, these problems can develop into chronic conditions like Type 2 diabetes, cardiovascular disease, or even cancer.

During the early stages of blood sugar imbalances, people often remain oblivious to the gradual deterioration unfolding inside their bodies. This is where wearable technology and tracking can be incredibly helpful. These tools provide individuals with actionable data revealing the impact of their lifestyle choices on the physiological state. Moreover, they empower individuals to make the necessary adjustments and see the direct impact of these changes.

Unfortunately, while continuous glucose monitoring (CGM) systems aren’t widely available to those without diabetes yet, the sooner you can act to manage your blood sugar, the better off you’ll be. Early intervention significantly diminishes the risk of disease progression.

For people already dealing with Type 1 diabetes (stemming from a damaged pancreas unable to produce insulin) or Type 2 diabetes (due to insulin resistance caused by uncontrolled blood sugar), technology becomes even more critical, as we’ve discussed above. CGM devices provide them with personalised, real-time data to closely monitor their health status and foresee impending dysfunction before it becomes serious.

CGMs also help determine the best interventions. By offering immediate feedback on how lifestyle changes affect blood sugar, it facilitates the personalisation of lifestyle treatments. Through diligent blood sugar control, complications linked to metabolic syndrome, like chronic kidney disease, nerve damage, or retinopathy, can be prevented.

Furthermore, involving patients in their healthcare journey empowers them with a profound understanding of their bodies. It motivates them to take charge of their lifestyles and to assume ownership of modifiable risk factors that have a significant impact on the metabolic and overall well being. In this collaborative, participatory model, patients become active partners, improving their overall health and quality of life.

We look forward to working with Dexcom to improve the lives of many, and thank them for their continued support. 

*If your glucose alerts and readings from a Dexcom CGM system do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions.