PATIENT EDUCATION
Insulin, CGM & Diabetes Technology
Modern diabetes technology can show glucose trends, support insulin dosing and, in some systems, automate part of insulin delivery. The right device depends on the type of diabetes, treatment needs, safety, cost and personal preference.
Select a topic below to view more information.
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Understanding CGM Readings
What you'll notice or feel
- A continuous glucose monitor (CGM) shows glucose estimates throughout the day and night.
- Trend arrows may show whether glucose is rising or falling.
- Sensor readings can differ slightly from a finger-prick value, especially when glucose is changing quickly.
- Alerts may identify high or low glucose before symptoms become obvious.
Common causes
- CGM measures glucose in fluid under the skin rather than directly in a blood sample.
- Food, insulin, exercise, illness and stress all influence glucose trends.
- Sensor pressure, insertion issues or device lag can occasionally produce unexpected readings.
What it could be
- A useful glucose pattern that can help guide treatment decisions.
- A sensor reading that needs meter confirmation when symptoms and the displayed value do not match.
Initial self-care
- Use the device according to its manufacturer instructions and your diabetes plan.
- Look at patterns over time rather than reacting to every isolated reading.
- Confirm unexpected readings with a meter when advised for your device or when symptoms do not match.
- Keep alerts practical so alarm fatigue does not lead to ignoring important warnings.
When to see a doctor urgently
- Severe low-glucose symptoms, confusion, seizure or loss of consciousness.
- Very high glucose with vomiting, ketones, difficult breathing or marked dehydration.
When to see a doctor
- You are unsure how to interpret trend arrows or time-in-range data.
- There are frequent unexplained sensor lows/highs.
- CGM alarms are interfering with sleep or daily life.
Starting or Reviewing an Insulin Pump
What you'll notice or feel
- Insulin is delivered continuously through a pump rather than by long-acting injections.
- Meal doses still need to be planned and delivered.
- Infusion-set problems can cause glucose to rise more quickly than with long-acting basal insulin.
- Pump settings may need adjustment for meals, exercise, sleep and illness.
Common causes
- Pump therapy replaces much of the usual background and mealtime injection pattern.
- Incorrect settings, missed boluses or infusion failure can cause high or low glucose.
What it could be
- A need to optimise basal rates, carbohydrate ratios, correction settings or device use.
- A technical problem rather than a medication problem.
Initial self-care
- Keep backup insulin and a method for giving injections available.
- Know how to recognise infusion-set failure.
- Follow your written plan for unexplained high glucose or ketones.
- Do not change multiple pump settings at once without a structured review.
When to see a doctor urgently
- Persistent high glucose with ketones, vomiting or abdominal pain can progress rapidly and needs urgent action.
- Severe hypoglycaemia or loss of consciousness.
When to see a doctor
- Pump glucose patterns remain outside target.
- You are having recurrent site failures or skin problems.
- You want to know whether pump therapy is suitable for you.
Automated Insulin Delivery / Closed-loop Systems
What you'll notice or feel
- A CGM communicates with an insulin pump through an algorithm.
- The system can automatically adjust background insulin based on glucose trends.
- Meal announcements or boluses may still be required depending on the system.
- The technology can reduce some of the day-to-day burden but does not eliminate diabetes self-management.
Common causes
- Automated systems combine sensor data, insulin delivery and software algorithms.
- Performance still depends on correct device use, insulin availability and appropriate settings.
What it could be
- A potential treatment option for selected people using intensive insulin therapy.
- A system that may need optimisation if there are frequent highs or lows.
Initial self-care
- Learn the specific system’s safety rules.
- Keep backup insulin-delivery supplies.
- Do not assume automation can compensate for a failed infusion set or empty insulin reservoir.
- Review downloads with the diabetes team rather than changing settings based on one difficult day.
When to see a doctor urgently
- High glucose with ketones or severe illness despite an automated system.
- Severe hypoglycaemia or device failure when insulin cannot be delivered.
When to see a doctor
- You are considering a closed-loop system.
- The system is frequently exiting automated mode.
- Time-in-range remains poor despite correct use.
Frequent Highs, Lows or Glucose Variability
What you'll notice or feel
- Large swings between high and low glucose.
- Frequent correction doses.
- Post-meal spikes followed by low readings.
- Night-time lows or dawn rises.
Common causes
- Insulin timing or dose may not match meals or activity.
- Over-correction of high readings.
- Exercise, alcohol, illness, sleep and hormonal changes can affect glucose.
- Device settings may no longer match current insulin needs.
What it could be
- A treatment-pattern problem that can often be improved by reviewing data systematically.
- Hypoglycaemia risk if correction or basal insulin is excessive.
Initial self-care
- Keep 1–2 weeks of glucose/device data when possible.
- Record unusual meals, exercise, illness or missed doses.
- Avoid repeated “stacking” of correction insulin unless your plan specifically accounts for active insulin.
- Treat lows according to your agreed plan.
When to see a doctor urgently
- Severe low glucose, seizure or loss of consciousness.
- High glucose with ketones, persistent vomiting or difficult breathing.
When to see a doctor
- Variability is frequent or unpredictable.
- You are spending substantial time below or above target.
- The pattern is affecting driving, exercise, sleep or confidence.
Choosing Between Meter, CGM, Injections and Pump Therapy
What you'll notice or feel
- You are unsure which technology is appropriate.
- Finger-prick testing feels burdensome or misses glucose trends.
- You are considering switching from injections to pump therapy.
- Cost, skin tolerance, work or lifestyle may influence the choice.
Common causes
- Different diabetes types and treatments require different levels of monitoring and insulin technology.
- Personal preference and ability to use the device safely are important.
What it could be
- A need for shared decision-making rather than a one-size-fits-all technology choice.
Initial self-care
- List what problem you want technology to solve: lows, variability, convenience, exercise or tighter monitoring.
- Consider ongoing sensor/pump supplies as well as the initial device.
- Ask about training and technical support.
- Do not buy unregulated devices or modify insulin-delivery systems outside approved guidance.
When to see a doctor urgently
- Any insulin-delivery failure causing rapidly rising glucose and ketones.
- Severe hypoglycaemia.
When to see a doctor
- You are starting insulin-intensive treatment.
- Current monitoring is not giving enough information.
- You want to review CGM or pump options.
YOUR CONSULTATION
What to Expect at Your Visit
- Review of the type of diabetes, current insulin regimen and main goals for technology.
- Download of meter, CGM or pump data to look at patterns rather than isolated readings.
- Assessment of hypoglycaemia risk, carbohydrate counting, exercise and daily routine.
- Review of device technique, infusion sites, alarms and backup plans.
- If pump or automated insulin delivery is being considered, training and safe troubleshooting are essential parts of treatment.
- Technology is selected to improve safety, glucose control and quality of life—not simply because it is newer.
* IMPORTANT: A Note Before You Go
CGM, insulin pumps and automated insulin-delivery systems can provide powerful information and reduce treatment burden for suitable patients, but they still require education, backup plans and regular review.
This page provides general educational information and cannot replace an individual medical assessment.
NEED AN ASSESSMENT?
Arrange an Endocrinology Consultation
For non-emergency assessment or follow-up, appointments are booked through the hospital’s central appointment desk on 0422 432 4433. For severe or rapidly worsening symptoms, seek urgent medical care rather than waiting for a routine appointment.