How does continuous glucose monitoring work?

CGM samples glucose on a schedule of anywhere between every minute and every five minutes, and then creates a trace of motion by connecting the dots with a line on the monitor’s screen. This trace records the meanderings of our blood sugar over the course of time, and creates the illusion of continuous reporting of changes in our blood sugar. Oh right.

Except CGMs don’t really measure blood sugar at all. CGM sensors estimate your blood glucose by looking instead at the glucose level of the water between your cells, what is called interstitial fluid. In this water, like in blood, there is also glucose; and the glucose level in your i-fluid is very close to the glucose level in your blood.

As blood sugar rises, so too does i-fluid glucose. As blood glucose drops, so too does i-fluid glucose. Never quite as quickly, but always in the same direction.

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