I'm getting a CGM tomorrow to wear with my Medtronic Paradigm. Do you guys think there is anything I should know that can't be read in training manuals etc?? I'd like to know if you guys like it, hate it, where is the best place to wear it, things like that. Thanks!

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I like mine a lot. The manual and theory stress that it's to monitor "trends", not "BG" but, after you get the hang of it, you may notice that "conservatizing" your BG regimen will make it easier to manage your BG numbers which, in turn, helps keep them in line with the CGM? I have been using it for about a year and a half and pretty much solely in my abdomen. So far so good on that.

I have been using the MM CGM (with the paradigm pump) since February and I really like the CGM. I received my first A1C in the 5's% and can attribute this largely to the CGM and TUD. The CGM can be a great tool, but it is not perfect and has a big learning curve. I recently posted about how and where I wear my sensor here: http://www.tudiabetes.org/forum/topics/help-with-minimed-medtronic-...

 

Some other advice I would give you is to play with your lower level and upper level limits.  For instance, I had my lower level set at 80 and when I went hypo I would often drop somewhat quickly.  Therefore, when my sensor hit 80, my BG was often 58-66.  I found this to be too low.  I raised my sensor's lower limit to 81 and now it usually alerts me of a low when my BG is 66-72.  Also, as you begin to understand and work with the CGM better I would recomend that you drop your upper limit.  Over a 2-3 month period I slowly dropped my upper limit from 200 to 180 to 165, etc. and now have my upper limit at 135.  I might only keep my sensor under 135 for a whole day maybe once every 5 weeks, but I like to know when my BG is climbing.   

 

I would also recomend you use the predictive low/high alert.  They are surprisingly accurate unless you just bolused or ate. I have my predictive low set for 15 minutes.  If I act when my pump alerts me of an upcomming low and treat the impending hypo I can sometimes keep my BG above 70 the whole time.  Tightening limits and using predictive alarms causes my pump to vibrate at me many times throughout the day, but it also has led to the best control I have had in my adult life. 

The back of the arm was not part of the FDA application to get approval for the CGM, only the stomach, so they will not recommend it; however, many of the scientists and MD's, that I have discussed this with, note that the back of the arm seems to be the most consistent and accurate location for the sensor. For me I found that the sensor was moving too much below the skin when placed on my stomach.

I attended a presentation at a major diabetes clinical study university and it was recommended by a lead MD there that once you find a spot that works for you CGM, keep using the same spot. Because the sensor wire is so small and there is no fluid being infused in the skin, there is no need to rotate CGM sites.

Hydration and pressure in/on the sensor location can dramatically affect the accuracy of the sensor and the calibration. For example, sleeping on a sensor will lower the BG readings.

Restarting the calibration on an old site can correct many misreading issues.

Skin Prep is now what I use for the site, both infusion and CGM. I used to use IV3000 and mastisol. The skin prep only seems to be much more secure and last longer for me. Over the CGM I put a patch of "Hypafix", it comes in 4 inch rolls and really stick well, it breaths and does not come off from sweat.

Hope that helps.
I think the need to rotate sites is b/c the insertion needle, at least on the MiniMed, is rather brutal?
As per the clinical testing that is ongoing they have found that there is no real need other than comfort to rotate sites. The insertion site will heal no matter what is stuck in near it, unlike an infusion site.
I double-dog dare a "cllinical tester" to nail themselves with a MiniMed CGM inserter needle where they just pulled a sensor out. :-)
+1
Thing is brutal and I try to stay away from anything that even resembles a recently used CGMS site.
I do it once a week. No Problems. There are times when it hits something and is sore so I just move over a 1/2" or so.
acidrock23, I couldn't help laughing when reading your post. I so totally agree. I have to talk myself into inserting the CGM needle. I can't imagine inserting in the same site from which I just removed the previous sensor. Talk about courage! Woodward must be a former SEAL. No disrespect intended, Woodward. acidrock23, I just shared you post with my mate when he heard me laughing. and I told him you're no wimp b/c you run marathons. HehHeh! ;-)
Thanks for laughing however I have only run 1/2s and quite a few training runs until tomorrow! And, while it's challenging and can be painful, I am not sure I'd characterize it as the same sort of toughness. It sort of gives me the willies to even think about hitting the same spot?

I still am not thinking that it's very comfortable to go into the exact same spot? I agree that if your a little bit off, it's perhaps ok however the inserter also doesn't strike me as the most accurate gizmo so I don't take chance with it? I agree Woodward is extremely tough if he does it in the same spot all the time!!

There was somebody who reported having shots of vodka before inserting which might work but I still wouldn't do the same spot. I also tend to have some problems with pull-outs on day 6, the tape gets looser and it will bounce around and do some tearing, occasionally bleeding so that may also motivate me to give the last site a wide berth, as they tend to be somewhat flogged, red and puffy by Day 6? And lately, Medtronics seems to have done something to make them not last as long as I haven't had one last through 6 days with accurate telemetry for a while?
I have noticed the same thing. Older sensors last me 6 days consistently. Newer ones don't go much over 4-5. I have heard you can get even more time from the Enlite but I am doubting until I see..../....
Good luck on your race.
I'm not glad about it but I'm glad it's not just me. Thanks for the wishes MossDog! I'll think of all you guys @ the finish line, on my way to the beer tent!

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