Replies to This Discussion

Permalink Reply by Schmutz on April 23, 2011 at 7:03am

Hi Quazz...this is a good post as I'm wondering the same things for myself. I am considering doing it myself but is it that much more of a change or advantage...I'd also like to know the thoughts of those on CGM's which units they use and is there a cost difference between them, pros & cons of units? Sorry to Tag along on your post! Thanks~Schmutz

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Permalink Reply by acidrock23 on April 23, 2011 at 7:18am

I found that with 14 or so tests/ day, I can get very good data but I like the CGM better because the constant data is really useful. Another benefit of the CGM that I don't recall in the marketing stuff is that, at least with me, it provides motivation to avoid "upsetting the applecart" that I don't get with the more reactionary approach of testing. 10-12 tests is pretty useful but a CGM is giving you a couple hundred tests/ day and the amount of data really fills in blanks to allow fine tuning and, at least for me, less work because I don't get "oopses" very often.

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Permalink Reply by Schmutz on April 23, 2011 at 7:27am

Acidrock....with the cgm how often do you test your bg in a given day? Agree with the reactionary part, I would like to wear one when I'm doing my outdoor hunting trips and stuff where I'm exerting much more physical activity and keep my bg's more level vs big drops and then going up again. Is your cgm accurate and which one to you use? Thanks!

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Permalink Reply by acidrock23 on April 23, 2011 at 8:19am

I still test my bg pretty frequently, 12-14 times/ day but more to confirm the CGM is accurate. I have the MM 722 and it usually seems to be very close. It lags behind a bit if the BG is changing rapidly so it's not foolproof but after you get used to it, it is a very useful tool.

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Permalink Reply by TaupeLime on April 25, 2011 at 2:19pm

hey Acidrock,

my dr told me that CGM isnt all that accurate and efficient since the technology is new (in one way, its logical, yet on the other hand, ive got the feeling that it might be to aid Accu-Chek, whos sponsoring them)

so whatre your thoughts about that? plus i heard that its not too convenient when it comes to outdoor activities like swimming and so on... but then again im not sure

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Permalink Reply by acidrock23 on April 25, 2011 at 6:12pm

I think they've been around for a while. They are definitely different but not bad. Once you get used to it, it's sort of like a tool to keep an eye on things, sort of like BG meters, whose accuracy also can be questioned? I'm not sure a CGM will be tremendously efficient if your BG is all over the place but if you feel like you are getting the hang of it and want some more data, it's a great device. For a lot of people, the AM is challenging and a CGM can help you start every day pretty smoothly too. Those were big things for me.

I was not a huge swimmer before but I agree they are not really convenient for swimming. I had a rare opportunity to try surfing lessons a few years ago and just went on the day my sensor ran out and took it off during. The infusion set lasted about 45 min but it was ready to fall out too.

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Permalink Reply by Trisha01 on April 23, 2011 at 7:59am

Good morning,

I test 20 (more if needed) times daily, with or without the cgm. When someone, as myself, has no hypo awareness (x's 8 years), I'm going to cover all bases to stay and to feel safe. Peace of mind is what it is about. CGM's are great. CGM's, from my expereince, do not catch all of what I call the quicky movers - down or up. The hypers won't kill me right away, but the hypos could. Technology is great, but can't be expected to do all the work.

I currently use the MM CGM (as of this past Thursday), and also am a former Navigator user.

Trisha

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Permalink Reply by Korrie on April 23, 2011 at 9:46pm

I began with the MM CGM, was ok at the beginning, but I could not always trust the numbers and had to continue to do finger sticks to verify. Switched over to the Dexcom, have been very pleased. While I will still do finger sticks when my "diabetic radar" goes off and I don't think the Dex is reading or trending correctly, I have cut way down on having to do finger sticks when I am plugged into the Dex as the accuracy is wonderful for me. I honestly have trouble now being unhooked from the Dex, as it has helped me tremendously - instead of riding the wild adult roller coaster with huge drops and hills, I am more likely to be on the kiddie coaster with minimal swings in the sugars, still have dips and rises, but I catch them faster.
(Some days I finger stick as little as 3 or 4 times in a day, other days I may test 10 - in part it depends on the age of the sensor, my activity level and any changes in diet such as eating out where measuring carbs is difficult)

So, yes, if cost was not an option, I would stay on the CGM.

The initial expense is horrible to get the CGM set up. You do not need to wear the sensors 24/7/365, and should be able to order what MM (or Dexcom) considers a month at a time. They usually have about a 6 month or so expiration date, and even using them for a 1 or 2 week on, then a 1 or 2 week off should give you good numbers and allow you to see blood sugar changes that finger sticks just do not catch.

Any way you can try before you buy? Best way to figure out it will work before you spend big bucks on something that will sit in the closet. Good luck!

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Permalink Reply by Terry on April 23, 2011 at 11:30pm

I love my DexCom CGM but I test quite often, 15-20 times per day. CGMs are best at indicating trends; the numbers are not always accurate and I always finger-stick to deliver insulin or decide if I need to eat or not. CGM number can lag capillary blood by as much as 15 minutes. If the number is changing rapidly, I like to get the latest info with the fingerstick before I make an insulin decision.

One of the best things about the CGM is its ability to wake you up when you're going low. It's saved me from countless early morning lows that rebound into the 200s for hours after breakfast.

The sensors are expensive but you can often get 14 days on a 7 day sensor on the DexCom.

If I had to trade off test strips for the CGM, I would not test less than 10-12 times per day.

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Permalink Reply by Quazz on April 24, 2011 at 10:47am

Seems like my 10 - 12 sticks a day is a bit on the low side.....:)

All in all it looks like there is quite a lot of value to be gained from the CGM. I have read a lot about the Dexcom but unfortunately we don't get them here in South Africa, only MM. I think I will hang on until the new Enlite 6 day sensor is released and give it a try.

I have been back on shots for the past 2 days as I have had a problem with my pump and am waiting for a new one. I have realized that not being plugged in all of the time I have lapsed in terms of finger sticks as I had to keep "feeding" the pump numbers in order to do corrections etc. Now that the pump is not attached I tend to forget about "D" between meals and not test (naughty). I also don't like the idea of 8 or so injections per day anymore.

The CGM is just another tool in our box. I will give it (the Enlite) a bash and let you know how it goes.

Thanks again.

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Permalink Reply by Capin101 on April 25, 2011 at 9:10am

I am using the MM CGM and have found it very valuable. I test my BG just about the same amount as before (11 times a day).
My Pros with the CGM:
1. Nightime alert of lows. I can keep great BGs overnight with much less fear of lows.
2. Checking PP spikes. I have changed and eliminating some foods from my diet based on how my PP spike hit. For example, bananas hit my BG after 45 minutes which is too fast for my humalog to accurately cover.
3. Attack a hyper much earlier. I can now start to attack a hyper at 140 in some cases, instead of at maybe 200 when I would find the hyper with a finger stick. I spend a lot less time hyper with my CGM.
4. Checking/correcting basal rates. Much easier with CGM.

My Cons with the CGM:
1. Lag time. 15 minutes-ish. A lot can happen in 15 minutes.
2. Accuracy. My CGM is usually pretty accurate except for extremes (less than 60 and greater than 200). But the MM CGM is calibrated off of fingersticks. BG meters have a +/-20% error acceptance. I do not feel comfortable enough to take action off the CGM reading alone.

If trying to conserve cost by using less strips: At a minimum I would do a finger stick before every bolus with the MM CGM and this will not be sufficient for more challenging days.

If I had to pay for a CGM out of my own pocket I would do my best to find a way to make it work.

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Permalink Reply by Hope on April 25, 2011 at 1:44pm

I love my CGM but I am not sure I would use it if it were not fully covered y my insurance. The sensors are $30+ a piece which really adds up. I do get great data though, and I do not check with fingers sticks as often when I am using it lately (4-5x day compared to 8-10x when not using it).

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