I have had type 1 diabetes for 43 years.
I just found out today that my insurance probably covers this..
For those of you who do continue glucose monitoring, what exactly is it (I'm taking a classs after thanksgiving on it)
Has it improved your control?
Is it worth the effort?
I am not a pump user currently...
THANK YOU.
Ame E.
can whoever oversess this board move this to type I diabetes board.. I still do not really know how things work here.
thanks very much.
Hi ame,
this link will show you the basics of CGMS, and pictures too !
http://www.integrateddiabetes.com/cg_home.shtml?i3
Basically you have a 'sensor' inserted under your skin, and it sends a signal via a 'transmitter' to a 'receiver'. On the receiver, you see an approximation of your BG, and can see if your level is flat, rising or falling. You can set alarms so you will know when it is lower or higher than a number that you set, or alarm if it is rising or falling quickly, if you turn on that option.
For me personally, I have used 2 different brands of CGMS, from Minimed, and Dexcom. I currently use Dexcom, and like it better.
My A1C definitely improved once I started. But more importantly, I had more feedback to what impact diet and exercise had on my control. So changes in my diet and exercise, and timing of my insulin led to the improved A1C.
For me it's worth the effort, and its hard to imagine not having it.
I would say most on this board are happy with their CGMS, but a few that have tried it and decided it's not for them.
thank you!
I got a CGM 4 years ago and wore it faithfully until last August. I gave it up and have been so much happier as a person--I found it extremely stressful.. Had a recent series of lows and suggested to my husband that I should use the CGM again and his opinion was no, I was much happier without it. I do get up at 1 am every night to check my glucose level. But we were getting no sleep with all the alerts from the CGM. See below.
For those of you who do continue glucose monitoring, what exactly is it (I'm taking a classs after thanksgiving on it) It is a sensor inserted into you body that reads glucose levels within a pump, but they are not based on blood but on other body fluids. I found mine were pretty accurate.
I am not sure, but I think a pump is required for a CGM.
Has it improved your control? Not really, as my A1Cs have been good since I started on the pump. I do have lows and the CGM was to prevent those.
Is it worth the effort?
See above. I have some very tight control limits. The alerts affected our sleep a lot, and I began to worry about the affects on our health. I took a vacation and have not gone back for 3 months.
Some swear by it and I did for years,but my break lingers and I am not sure if I will CGM again....
You might repost it.
Ame E. I have been type 1 for 37 years and just today started with a CGM. It is a Dexcom and so far I am still waiting for the sensor to "percolate". You have to wait 2 hours after inserting it before it actually starts to work. I too am not using a pump. I have been doing MDI for the entire time I have had D. I did not take a class to get the CGM and have not actually been "trained" on using it, but there are enough people here who know so I was not for lack of support. I have fairly decent control right now A1C was 6.1 last time I had it done, but I am hypounaware and am pricking my fingers 12 or more times a day and I figured a CGM would cut down on that a bit.
My insurance company covered it 100% so there is no cost to me at all. That made the decision a lot easier. I'll let you know what I think when I have had a chance to wear it for a bit. For now, the insertion did not hurt. The sensor is pretty comfortable, and that was something that concerned me because I tried one out in the summer that my CDE inserted and that experience was horrible. It was an Ipro model and I felt the sensor literally every time I moved. This sensor is pretty comfortable. I'll really know after tennis on Wednesday night but for now I am not regretting it.
thanks. I don't have a pump... this is a CGM without a pump... good to have your feedback... I was excited to find out I could have a CGM without a pump...
I have had a pump since 2008 and a CGM since 2010 and like both of them a lot. The Dexcom works without pump and the Medtronic does too but almost everyone who's used both likes the Dexcom better but I prefer the Medtronic b/c it's an all in one unit.
Knowing my BG all the time has been very useful for me. It's helped me lose weight and exercise more effectively and has improved my A1C from 5.8 (each time w/ the pump pre-CGM) to the low 5s although it moves around a bit more w/ the CGM, which is ok w/ me. I've had very good experiences with the Medtronic but almost everyone reports the Dexcom to be great too. And I think the Medtronic needle is a bit more wicked...
I have been diabetic for 46 years. I use both a pump and CGMS. Began in Jan 2008, Medtronic pump and CGMS combined. Medtronic pump good, Medtronic CGMS only fair for me, I had a lot of inaccurate readings especially during the night, using this CGMS became to stressful and I quit using it after about a 1&1/2 yrs. My A1C at the time did decrease tho, from mid 8's to lower 7's - in part due to pumping, but also when the CGMS worked I was able to adjust insulin needs based on the CGMS results. In late 2010 I switched to the Dexcom. I have absolutely loved this CGMS. Yes, it has problems and does not always give accurate readings. But the data it has given me has allowed me to now maintain my A1C between 5.5 to 6.0, So yes, it is worth the effort and yes, between the use of the pump and the CGMS my control has markedly improved.
It's provided at the site where I get my diabetes care. I have no idea who exactly puts it on. After the class, I will have more of an idea of whether or not I want to do the CGM and then talk to the guy who knows about supplies covered and find out which brands are covered.
Thanks for responding.
I am so impressed with everyone's A1cs... MIne is 8... getting mine to below 7 would be a miracle..
Glad to hear it... Thanks for writing back.
Ame E.
If your insurance covers and it and you think having constant data about your BG readings could be useful (especially alerts to highs and lows), I would definitely give it a try. There are plenty of people who do shots, but also use a CGM.
I have tried both the Dexcom and the Medtronic CGM (the one that's integrated with my pump). In my case, I got lots of inaccurate readings and found that having a CGM made me LAZY (in that I would rely on it for readings to inform my boluses, which I know you shouldn't do, but....). Also, pumping for me is a necessity and between my pump sites and CGM sites, I was getting some serious skin and scar tissue issues.
In the end, the inaccuracy of the CGM just didn't make it worth the cost and loss of pump sites. BUT, that's just me. Also, the new Dexcom just came out (the G4) and the reviews are really positive, especially with regard to improved accuracy.
I am a firm believer that everyone living with T1 has to find what works best for them in terms of monitoring and insulin delivery. For me, finger sticks and a pump work best. But we are all different, and you may very well find that CGM+shots is the right combo for you.
Give it a try!
Thanks ame e. I did not know that.
One thing that I noticed with a pump and then a bit more with the CGM is that really small adjustments, like +/- .1U/G carb or .025U/ hour will make a difference in my ability to keep BG reasonably stable. I was suprised to see that when I'd make really small changes, I could be higher or lower as needed and that the little bits did go a long way towards cooking my numbers to where they are.
I went on the Dexcom CGM in 2009. Prior to that my BGs and A1c’s had been on a long rise. My A1c’s went from consistently mid 6% range to as high as 8.5%. It was a long and difficult struggle to bring down my average BG and A1c. I credit starting on the Dex with dropping my A1c by a full 1%.
The Dex CGM virtually eliminated hypos while I slept. This was a huge improvement for me. Looking back to my time before the Dex, I had many unexplained large BG rises after the least little bit of first food in the morning. I’d eat 10 grams of carbohydrate and my BG would rise to 250, even if my morning fingerstick was normal. This was, of course, the counter-regulatory rebound due to extended low blood sugar overnight.
I’ve worn a CGM 24/7 since September 2009. I would feel blind if I had to give it up. I just received the Dexcom G4 system two weeks ago. It appears to be a more accurate system and it also appears to give many less false low alarms. Its audible alarm choices are a big improvement over the previous 7+ model.
I’ve never worn a Medtronic CGM. It combines the pump and receiver into one unit. I don’t like this design since the pump/receiver is buried under layers of blankets as it attempts to wake you up to treat a low. Some people like this integration since it reduces the number of devices they need to keep track of. I appreciate this sentiment but the ability to detect and alert to overnight lows is an essential function for me.
I would not want to live without a CGM. Your experience and diabetes may vary! Good luck.