Answer 1 is incorrect. 21.74% chose this answer. “Re-assure them blood glucose never equals sensor glucose, so this difference is okay.” This answer is incorrect. Although it is true that sensor glucose does not equal blood glucose, there may be other factors contributing to consistent elevation in glucose trends. We would want to probe into other potential considerations before jumping to the conclusion that it is only the difference in measurement.

Answer 2 is correct. 39.37% of you chose this answer. “Review current medication and supplement use.” This answer is correct. Interfering substances such as acetaminophen and ascorbic acid (vitamin C) can contribute to higher glucose readings than actual glucose. The interfering substance depends upon the CGM manufacturer. The 2024 ADA Standards of Care reports the importance of reviewing medications and supplements used by persons with diabetes to identify possible interfering substances. They also recommend blood glucose monitoring if there is a concern of inaccurate data. Visit Section 7 of the 2024 Standards of Care to review the table of CGM manufacturers and potential interring substances. 

Answer 3 is incorrect. About 21.86% of respondents chose this. “Discuss changes in diet and factors contributing to elevation in sensor glucose readings.” This answer is incorrect. Although sensor glucose and blood glucose values are more likely to significantly differ after a meal, KS reports consistent elevation in sensor glucose values. Diet factors contributing to elevated sensor glucose readings would likely contribute to elevated blood glucose readings too; we may just see a delay. Diet factors alone would not explain the consistent difference in elevation.

Finally, Answer 4 is incorrect. 17.04% chose this answer. “Inquire about sleep habits and potential compression of glucose sensor.” This answer is incorrect. Compression of the sensor during sleep can contribute to false sensor glucose readings, but we most often see sudden decreases (low) in glucose values. This is suspected to be due to local changes in blood flow/concentration of the interstitial glucose caused by direct pressure on the sensor. Screening for compression lows is important when reviewing CGM data but does not provide the best answer for consistently elevated glucose trends.

We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!