Karachi: Continuous glucose monitoring (CGM) can help patients identify foods, activities and daily habits that cause blood sugar spikes, enabling them to improve diabetes control and reduce the risk of serious complications, health experts said, warning that one in four Pakistanis is diabetic or prediabetic.
Speaking at a diabetes awareness seminar organised by Memon Medical Institute Hospital (MMIH), leading diabetologists and physicians said the technology could also help selected people with prediabetes understand how food, physical activity, stress and sleep affect their glucose levels.
Unlike conventional finger-prick testing, which provides a blood glucose reading at a particular moment, CGM uses a small sensor placed under the skin to measure glucose levels in the fluid surrounding body cells throughout the day and night.
Glucose trends appear on a smartphone or compatible monitoring device, showing whether levels are rising, falling or remaining stable, while many systems alert users to dangerously high or low glucose levels.
MMIH Head of Diabetes and Endocrinology Dr Nadeem Naeem said CGM was transforming diabetes management by revealing patterns that occasional testing could miss, including glucose spikes after consuming sugary drinks, refined carbohydrates, rice or bread, and whether walking or other physical activities helped bring levels down.
“When patients can see how their blood sugar responds to different foods and daily activities, they are better able to modify their eating habits, improve physical activity and follow treatment plans that keep glucose levels within the recommended range,” he said.
He said CGM could also detect high blood sugar after meals and low levels during sleep, helping doctors adjust medication, insulin doses and meal plans. HbA1c, which reflects average glucose levels over approximately three months, was important but insufficient on its own, he said, as it did not reveal sudden fluctuations. CGM also provides “time in range” data, an important indicator of diabetes control.
Modern glucose monitoring sensors have been associated with HbA1c improvements of up to 1.5 percentage points compared with conventional finger-prick monitoring in some patients, he said. Better glucose control, together with appropriate medication and lifestyle changes, could reduce the risk of heart disease, stroke, kidney damage, vision problems and diabetic foot disease that may eventually lead to amputations.
For people with prediabetes, he said, CGM could encourage healthier habits and help prevent progression to type 2 diabetes, although its routine use in prediabetes is not yet established as standard medical care. He also expressed concern over children’s deteriorating dietary habits, irregular sleeping patterns and increasing consumption of unhealthy foods, which were contributing to obesity and metabolic disorders at younger ages.
MMIH Chief Executive Officer Brig Dr Malik Waqas Ahmed Awan said diabetes was emerging as a major social and economic challenge for Pakistan.
“Every fourth person in Pakistan is either diabetic or prediabetic. This is no longer a problem that hospitals and doctors can address alone. The entire society must play its role in preventing and controlling this disease,” he said.
Dr Awan said increasing outpatient numbers reflected growing awareness, but many affected people remained unaware of their condition and sought medical attention only after developing complications involving the heart, kidneys or eyes, making treatment more difficult and expensive.
He called for greater public awareness, early screening and improved access to modern diagnostic and monitoring technologies, including CGM.
Prof Dr Qamar Masood, section head at Aga Khan University Hospital, expressed concern over the increasing incidence of type 2 diabetes among children and adolescents, linking the trend to unhealthy eating habits, sedentary lifestyles and excessive screen time. He cited the growing culture of ordering fast food online, staying awake late at night and playing mobile games instead of participating in outdoor sports.
“Children are increasingly developing obesity, fatty liver disease, sleep apnea and type 2 diabetes, conditions that were previously seen predominantly in adults,” he said.
Without healthier eating habits, regular physical activity and adequate sleep, Pakistan could face a substantial increase in diabetes and other noncommunicable diseases, he warned.
Dr M Ibrahim, a consultant physician at MMI Outreach, advised people to walk for 30 to 45 minutes daily, reduce their consumption of sugary and fatty foods and undergo timely screening. He emphasised the “Know Your Risk” approach, saying people with obesity, a family history of diabetes or other risk factors should seek medical advice rather than wait for symptoms to appear.
Dr Sana Jabeen, consultant in internal medicine at MMI, said many patients ignored early warning signs, including persistent weakness, burning sensations in the feet and slow-healing wounds. Some patients presenting with these symptoms were subsequently found to have HbA1c levels between seven and nine percent, she said, adding that delayed diagnosis could lead to avoidable complications.
The experts agreed that CGM could be a valuable addition to conventional diabetes care but stressed that the technology itself does not lower blood sugar. Its benefits depend on patients and physicians using the information to guide medication, healthy eating, regular exercise and other treatment decisions.
Participants called for a coordinated national response involving early screening, public awareness, healthier lifestyles and improved access to treatment and modern glucose monitoring technologies.