Advice on making the switch from minimed cgm to dex com?

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Permalink Reply by Rickst29 on October 24, 2009 at 1:23pm

I'll SWAG that nearly everyone who does such a switch does so for accuracy and/or speed at catching Hypos, not Sensor pain. BUT, I do remember, even 3 years later, that inserting the MM Sensor was vastly more painful than inserting Dexcom's. (And the current Dexcom Sensor is even thinner.)

For me, inserting the Dexcom is less painful than inserting my infusion sets. (I use AccuCheck Ultraflex, a nylon infusion set-- so it's wider than the steel ones going in, but less painful during wear.) While wearing the Dexcom, I don't even know it's there-- I often have to look or feel before going to bed, in order to find which side I'm wearing it on! But during the actual wear, I wasn't much bothered by Minimed either: it was only the insertion which had me sweating in fear, and each time finding:

YEEOWW! My fear was completely justified, every time.

But there's two things which might be very bad about insurance paying for your switch. First, both of your CGMS components are still in warranty (i.e., the Minilink and the "feature" on the pump). Insurance almost certainly won't pay for new components, so the startup kit is Out-Of-Pocket (as you already guessed). More serious, and you might not be aware of it, is the vastly higher cost of Dexcom Sensors.

The cash price of a Dexcom "7-day" Sensor is currently $60 each (i.e., $240 per box of four). But Dexcom charges more for Sensors when they'll have to mess around with insurance claims, insurance fights, and/or insurance paperwork: $100 each (i.e., $399 per box of four).

Some insurance companies, including mine, are in-network with Dexcom. My own, Wellpoint, doing business as ('D.B.A.') Anthem Blue Cross of Nevada, pays only a capitated amount, near the cash price, and Dexcom "eats the rest" as part of the deal. At $60, before Dexcom changed the 'with insurance' price, you could have made the argument that $60 for a "7-day" Sensor is cheaper than $35 for a "3-day" Sensor... even though, for people who keep their bG's pretty stable, Minimed's Sensors actually last longer than the Dexcom ones do.

But you say that you've got 'great insurance', so it definitely ISN'T WellPoint. Start by asking them if they would cover the Sensors, if you found it to be quicker at catching lows for you., as so many others have reported in themselves. Ref John Walsh, the famous CDE. (If you want it, you probably need to focus on the possibly better effectiveness, or visible signs of reaction to the Minimed Sensors-- NOT merely enjoying less pain during use or insertion.)

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Permalink Reply by Stacey on October 24, 2009 at 7:59pm

I actually owned the MM cgm before switching to the Dexcom. I got the MM around summer of 2007 and was not happy with its results & found it painful too so I gave up on it (and on cgms I thought). Then I heard about the Dexcom around fall of last year so got in contact with a rep. I was able to turn in my MM transmitter to Dexcom to cover any copay or deductible I owed. I'm not sure if they still do that but I would ask. Also if your insurance paid for the MM sensors they should pay for the Dexcom ones but may have to go through a vendor instead of getting it directly from them. I get my sensors from Edgepark & they have been great. If you think of any other questions, feel free to send me a message :). If pain is the biggest issue for you with the MM sensors, you will notice a HUGE difference with Dexcom!

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Permalink Reply by Rickst29 on October 25, 2009 at 12:37am

I agree with Stacey-- if your insurance is not currently a capitated "in-network" provider with Dexcom, you should ask them to work through Edgepark, or maybe CCS Medical Supply, to get into your hands at a lower cost.

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Permalink Reply by Jan on October 30, 2009 at 9:11am

My niece used the Minimed sensor three times without incident (Sis did numb with EMLA and she did allow EMLA to sit on for a good hour to hour and a half). No pain on insertion. But after the first few times she was very sore after EMLA wore off. Sis must have hit a nerve or something on her final insertion. She would not use the sensor after that. We basically waited for Minimed to reduce the size of their introducer needle (Rep assured us they were going to do so "soon.") Finally stopped waiting for Godot and she started the Dexcom 7 Plus recently. What a difference! Sis does not fear insertion of Dex, that she will hurt her daughter. Niece asked Sis to forego the EMLA the second time and says it feels like pump site insertion. No pain ever. Love the 7 day wear and the easy restart without removing transmitter, recharging and putting back on body. Easy to calibrate. Have had issues with accuracy but just got another new Receiver. Dex tech support stands by their product. Coincidentally, last two days Dexcom has been mega-accurate. Dex fits into her lifestyle. Only improvement will be when Dexcom integrates with Animas pump. Hope when they do, we will also be able to keep a separate Receiver as well, so we can get readings while asleep without pulling out her pump.

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Permalink Reply by Shannon on October 30, 2009 at 9:23am

I just recently went through this process. You should talk to the people at DexCom to see what they can do for you. They might be willing to let you buy the receiver at a vastly reduced price, and just let your insurance pay for the sensors. They're great people who are (I think) willing to work with their customers.

I wrote a blog post about my experiences with MM and DexCom. It might give you some additional insight into the differences.

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Permalink Reply by Sophie on October 31, 2009 at 7:23am

Wow, thanks guys! so do you keep the Dexcom receiver in your purse? I've heard there are issues with going out of range... how have your experiences been with that?

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Permalink Reply by Shannon on October 31, 2009 at 7:53am

I keep it in my purse when I'm walking around. At work, I keep it on my desk (on whichever side the sensor is on) when I'm sitting down; I hand carry it to meetings, etc. and just put it on the table. At home, I clip it to the waist of whatever I'm wearing (who cares if it's visible, right?). At night, I keep it on my nightstand.

Every now and again, I'll get an out-of-range error, but it's rare.

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Permalink Reply by Jan on November 1, 2009 at 4:32pm

DN carries her receiver in one of those tiny Coach purses at school. Works fine. At home we basically run around the house after her and put the Receiver near her (by the time she gets home, she has to do homework, etc., later at night, so more sedentary). She does not like to wear it, though you can fit it in a jean's pocket. I hope, when it integrates with the Animas, we can also get a separate Receiver. If I have to pull out the pump to look at BGs at night, it may wake her up at some point.

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Permalink Reply by etta v on November 1, 2009 at 4:37pm

I keep it in a LowePro bag that fits it quite nicely and protects it.

I have the luxury of always dressing casually so I either clip it on my back belt loop near the transmitter or hand carry it (in yoga class, for example).

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