Hello, hope you can help. Trying to get my a1c down (currently 7.4) and looking at option of dexcom or similar system CGM. I live in UK so unsure if available over here but question is that would you still recommend even if not on a pump. I am type 1 on shots. Many thanks, Chris
Hi Chris. We do have CGM here in the UK - Dexcom, Medtronic Guardian and I’m pretty certain the Abbott Navigator is out here too. I’ve used Medtronic CGM combined with a pump for 3 years and love it. The NHS are very unwilling to fund it but there have been a few successes.
I trialled the CGM while I was still on injections and it was good, but not as good as combining it with a pump. The CGM gives you constant data and the pump gives you the ability to fine tune your response to that data. eg when I used the CGM and injections I’d see I was a 7 and rising but couldn’t do anything because I’d have to take a whole unit of insulin. Plus I wasn’t going to inject more than about 5 or 6 times a day. With the pump I can take 0.1 of a unit of insulin at the push of a button. Is there any particular reason why you’re thinking of CGM but not a pump?
I wrote about the pros and cons of CGMS last year, hopefully you might find it a useful read - http://www.shootuporputup.co.uk/2009/04/16/to-cgms-or-not-to-cgms/
I would recommend to use a CGMS to find problems of your MDI treatment. Maybe some problems are easy to fix with other insulins, higher waiting times and so forth. You can also verify your basal rate and your carb factors with the CGMS. At the same time you will collect valuable data that can help to convince your doctor and insurance company that you need a pump to achieve better control (for having a strong dawn reaction etc).
Here is an example of the data you can get from the Dexcom CGMS:
Thanks for getting back and information re pumps and cgm. I tried the pump last year and didnt get on too well with it. Regualr kinks in canula and finding good sites that didnt involve having a tube stretched up my arm or down my leg was part of reason. (ab was limited due to few fatty reas from over injecting). Hba1c was borderline at 7.5 but got funding to try it anyway. Am aware CGM i will prob have to pay myself but after reading your comments on not being able to do much if you see levels rise has made me think again. How long have u had type 1? How do u find the pump socially/practically/sites?
I used the DexCom 7+ while being on shots and LOVED it. I was able to get my A1C down to 5.2 from 5.8. I am ambivalent about pumps but I am a huge fan of the DexCom 7+.
Chris, I’ve had T1 for 26 years, diagnosed aged 4. I’ve had the pump and CGM for 3 years.
I agree with Holger that even without a pump CGM could be worth a try to identify any problems you might be able to fix with MDI. Most hospitals nowadays have a CGM - have you asked your diabetic clinic if you could use theirs for a week? That would give you some useful info on trends eg you’re always high overnight etc and you could see if CGM works for you.
I don’t think I have any major problems with the pump. It irritates me occassionally if I want to wear a dress and I’ve got to go through the palarva of hiding it in my bra but other than that I love it. I rotate between my stomach, thighs, back and buttocks for the infusion sets and tend to use my back for the CGM sensor. Did you try different types of infusion sets to avoid the kinked canulas - I have real problems with Quicksets kinking in my stomach but Silhouettes works great in my stomach. I found I had to try a few sets in a few places before I got the right combination.
I tend to wear my pump clipped to my waistband and most people don’t notice it. There’s more on my thoughts on the pump here - http://www.shootuporputup.co.uk/2009/04/28/pumping-for-beginners/
Blogging about diabetes @ www.shootuporputup.co.uk
Thanks helmut, your response has encouraged me to give it a go! How accurate/reliable is dexcom7. I have heard prev cgms not that great. Chris
Forgot to ask, how easy to fit. how comfortable, also to sleep with? Do u unplug anytime i.e sport/swimming etc or does it have to be on cont. Many Thanks Chris
I’m also on MDI and I am looking into the Dexcom 7+. I think it looks like the best option out there.
I called Dexcom about 3 weeks ago and they were supposed to get back to me within the week, but I haven’t heard from them. I’ve been meaning to call again for the past few days, but keep forgetting to. Thanks for the reminder!
I was also on the pump for 3 years and I had issues with it and went back to shots about 2.5 years ago.
Thanks for comments. Its reassuring to know not the only one on MDI looking at using dexcom. Also appreciated what you said about pump - spoke to dexcom guy in UK today who was great at all the technical stuff and is difficult to find fault really so i am going to give it a go. Will have to pay for it which is pain but like you said appears best option. Are u in UK? What probs did u get on pump that made u stop? Chris
Hi Chris UK
I am in USA. I had
- allergic reaction to the catheters
- issues with Humalog in tubing (kept clogging)
- pump would malfunction on me (I had to use my warranty 2 times in 3 years)
- I went into ketoacidosis 4 times in 3 years on pump
- I no longer trusted it with my life as it is a machine and machines malfunction.
With no trust, there can be no dependency and no relationship.
There are so many great things that I learned with using the pump, but in the long run- it just wasn’t for me. I didn’t trust it and I will not sway back to it, no matter how many people tell me the perks. Every time I say things like this, pump-lovers jump on me… haha. Oh well. To each his own.
i take shots and i just got the dexcom 7+ im charging the battery right now ill let you know what i think abou it.
I agree, had same prob also with humulog. Trust thing is important and stakes are high so really understand brave decision to pull. Great T shirt by the way! Chris
For me the dex is so accurate that I have gone from 12 finger pricks per day to 2 calibrations.
I wear the dex 24/7. There is no way to unplug. The dex is very comfortable. I don’t feel it. I have to look or to feel to be able to tell where it is.
Thanks helmut, your comments very helpful and appreciated! Spoke to Dexcom UK rep today and fixed up to start within 2 weeks. Will have to pay for it but hoping money well spent. Chris
Chris, it took me a while to master the dex. At first I did not figure in the delay which sent me on a roller coaster. Then I had calibration problems. Eventually I figured out that I had to wash my fingers. I only calibrate when my bg is steady. If the diff is more than 10 mg/dl then I retest. Many times the second bg test is way closer to the dex and the 2 bg tests differ by more than 10 mg/dl. Before I started with the dex I had no idea that consecutive bg tests can be very far apart. Good calibration is absolute key.