What is the cardiologist's recommendation for pairing CGM with a cardiac risk assessment?

The specific panel I recommend every man using a CGM for non-diabetic metabolic monitoring should also run: ApoB (measures atherogenic particle count, this is your primary cardiovascular risk driver), Lp(a) (genetically determined atherogenic lipoprotein; measure once in your lifetime), hs-CRP (systemic inflammation, the accelerant of plaque instability), and fasting insulin (detects insulin resistance before glucose becomes abnormal). Together, these four tests and your CGM data provide a complete metabolic-plus-cardiac picture.

If you are 40 or older and have never had a CAC score, that is the next step: a low-radiation CT scan for $100–200 that directly images calcified coronary plaque. A CAC score of zero in a man with good glucose control and normal ApoB is genuine reassurance. A CAC score above 100 in a man whose CGM looks perfect is a clinical finding that changes treatment decisions, and that no amount of glucose optimization could have predicted. The CGM earns its place in a full risk picture. It does not constitute the complete picture on its own. (Blaha et al., JACC, 2016)

Cardiologist's calibrated position, Solid (1) for this combination. This is the clinical framework I apply in practice.

What to do: Within the next 30 days: order ApoB, Lp(a), hs-CRP, and fasting insulin. Schedule a CAC score if you are over 40 and have never had one.

For the full picture, read The CGM on Your Arm Doesn't Know Your Arteries.