As over-the-counter continuous glucose monitors (CGMs) become more common, clinician guidance matters more than ever. In this episode of BackTable Women’s Health, Dr. Nicole Faulkner welcomes Dr. Nicholas Canelo, a family medicine physician and founder of the Perlman Wellness CGM program, to discuss how to effectively guide CGM use in OBGYN practice, from preconception and PCOS to pregnancy and perimenopause. They highlight the importance of interpreting data trends, setting realistic glucose targets, and supporting patients through the practical and emotional challenges of CGM use.
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Timestamps
00:00 - Introduction04:58 - CGMs in Women’s Health07:33 - OTC Data Sharing Issues09:52 - Pregnancy Glucose Targets16:20 - Accuracy and Variability20:10 - Anxiety and Eating Disorders24:41 - Counseling and Follow-Up28:29 - Prescription and OTC CGM Picks37:24 - False Lows and Sensor Errors41:23 - Alarm Settings and Logging44:06 - Interpreting Metrics and Limits46:44 - Provider Dashboards 48:42 - Final Thoughts
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More about this episode
Given the lack of well-established blood glucose targets outside of type 1 diabetes, Dr. Canelo reviews commonly used ranges for individuals without diabetes, those with prediabetes, and pregnant patients with type 1 or 2 diabetes. He explains how to interpret CGM data, including the time in tight range, coefficient of variation, and the importance of focusing on overall trends rather than isolated glucose spikes. They also discuss the potential drawbacks associated with CGM use, including anxiety and eating-disorder risks. Practical considerations include sensor inaccuracies, false lows readings, and optimizing alarm settings. Dr. Canelo emphasizes the importance of having patients log meals and other events while wearing the sensor and scheduling follow-up after the initial 15-day wear period to ensure accurate interpretation and effective counseling. Finally, they compare OTC and prescription CGM options, including costs, clinician access to patient data, and insertion tips.
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Resources
Stelo - Over the Counter CGM Optionhttps://www.stelo.com/en-us
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