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 - Introduction
04:58 - CGMs in Women’s Health
07:33 - OTC Data Sharing Issues
09:52 - Pregnancy Glucose Targets
16:20 - Accuracy and Variability
20:10 - Anxiety and Eating Disorders
24:41 - Counseling and Follow-Up
28:29 - Prescription and OTC CGM Picks
37:24 - False Lows and Sensor Errors
41:23 - Alarm Settings and Logging
44:06 - Interpreting Metrics and Limits
46:44 - 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 Option
https://www.stelo.com/en-us

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BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health.

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