Continuous Glucose Monitoring (CGM) Singapore

Continuous glucose monitoring (CGM) is a method of checking blood glucose levels continuously throughout the day and night. It uses a small sensor worn on the body to track glucose levels in real time, reducing the need for frequent finger-prick tests.

CGM provides convenience by allowing automatic data collection and better insights into how glucose levels change in response to food, activity, stress, or medication. This helps people with diabetes understand their patterns more clearly and make more informed decisions about their health.

Continuous glucose monitoring works by measuring glucose in the interstitial fluid (the fluid that surrounds the body’s cells) under the skin using a tiny sensor. The process can be broken down into key steps:

1. Sensor insertion – A small sensor is placed under the skin, usually on the upper arm or abdomen.
2. Glucose measurement – The sensor measures glucose in the interstitial fluid at regular intervals.
3. Data transmission – A transmitter attached to the sensor sends readings wirelessly to a receiver, smartphone, or insulin pump.
4. Real-time tracking – Glucose levels are updated every few minutes, allowing you to see current values and trends over time.
5. Alerts and insights – The system can notify you if glucose levels rise too high or drop too low, helping you make timely adjustments.
6. Sensor replacement – Sensors are disposable and must be replaced regularly, and transmitters also need periodic replacement to ensure accuracy and proper function.

Continuous glucose monitoring can be considered by people with diabetes who need regular and detailed tracking of their glucose levels. It is often recommended for:

• People with type 1 diabetes, because they rely on insulin replacement and need continuous tracking to adjust doses safely and reduce sudden highs or lows.
• People with type 2 diabetes on insulin or with unstable glucose levels, as CGM provides detailed patterns that help fine-tune treatment and lifestyle choices.
• Those with hypoglycaemia unawareness (a condition where the usual warning signs of low blood sugar are not felt), since CGM can give early alerts before levels become dangerously low.
• Children and adolescents with diabetes, as CGM can support parents and caregivers in monitoring glucose more effectively throughout the day and night.

Key features and benefits of continuous glucose monitoring include:

The main types of continuous glucose monitoring devices are real-time CGM and flash glucose monitoring (FGM) systems. Both systems use sensors that must be replaced regularly, and some real-time CGM devices also require transmitter replacement.

Real-time CGM

Real-time continuous glucose monitoring provides automatic readings sent directly to a display device, smartphone, or insulin pump. Key features include:

1. Continuous updates every few minutes
2. Customisable alerts for high and low blood sugar
3. Options to share data with healthcare providers

Example available in Singapore: Dexcom

• Sensor replacement: typically every 10 days
• Transmitter replacement: typically every 3 to 12 months

Flash Glucose Monitoring (FGM)

Flash glucose monitoring measures glucose continuously but requires you to scan the sensor to view results. Key features include:

1. No routine finger-prick calibration
2. Data available on-demand when scanned
3. Typically longer sensor wear time compared to real-time CGM

Example available in Singapore: FreeStyle Libre

• Sensor replacement: typically every 14 days

While continuous glucose monitoring offers many advantages, there are also limitations to consider. These include:

• Accuracy – CGM measures glucose in interstitial fluid, which can lag behind actual blood glucose, especially during rapid changes. Finger-prick tests may still be needed in certain situations.
• Device maintenance and cost – Sensors must be replaced regularly, and some systems also require transmitter replacement. This results in ongoing expenses for continued use.
• Skin irritation – Some users may experience redness, itching, or discomfort at the sensor site.

For many people, however, the benefits of continuous glucose monitoring outweigh these limitations, especially when used with medical guidance.

At ATA Medical, we provide continuous glucose monitoring along with diabetes-related screenings and treatments at the following cost:

At present, Dexcom is the only continuous glucose monitoring device subsidised for individuals with type 1 diabetes, with up to 80 per cent of the cost covered at public healthcare institutions. Other CGM devices are not subsidised under national healthcare schemes.

Consistent monitoring of blood sugar helps reduce the risk of long-term complications and supports healthier ageing. To complement diabetes care, we also offer longevity packages and comprehensive health screening with personalised guidance from our doctors to give you a clear overview of your health and support long-term wellness.