Been using Dexcom for 3.5 years. Over that time, I have found it incredibly accurate most of the time - but when it isn’t accurate, it can go quite the opposite extreme! on those accurate days, I’ll test less, but those bad ones - which are more frequent than I’d like - all bets are off!
I started dosing off the Dexcom almost from the beginning - at leats on some days. I can think of some times when that got me into trouble, though!! I had a severe low, due to a Dexcom error on more than one occasion.
For perspective, yesterday, the Dexcom was right on, and I wasn’t eating much because I’ve got a bad cold. i tested once yesterday all day - and the Dexcom sensor (which I calibrated at the time) was right on target. However - i just checked my last 90 days. During that time, I tested 365 times, or approximately 4x/day. Over time, I think that’s been a fairly consistent average for me. Twice a day would fail to be enough for me. I do not think I’m atypical on this, from everything i’ve seen and all the people with whom i’ve spoken – including my endo, who told me that his typical patients are still testing 4-6 times a day on average – even those who dose off Dexcom.
I definitely rely on fingersticks as well as my G5. I’ve had sensor insertions that were flaky, exercise results that were way off between the two, the time-lag problem etc etc. G5 is great, I do dose off it maybe 20% of the time but in general I like having the reassurance that I’m dosing to an accurate BG number.
The underlying problem is not the insurance coverage for cgm and test strips. The underlying problem is that they are priced at a level where many, perhaps most people can not afford them without a third party (insurance) paying for them. This problem is a direct result of the insurance market itself escalating the costs. The healthcare market in the USA is a lot like an alchoholic who has to drink every morning to get rid of the hangover from the previous night.
Much as I love and rely on my G5, there’s also this: going by Clarity I’ve been in the 5.7-5.9 range most of the year, but alas, that ain’t what my lab numbers show (currently 6.1 and I don’t think it’s officially been measured in the 5’s since I’ve had the disease). That’s a harder indicator of some kind of systemic discrepancy than just the usual Dex-vs-fingerstick variability. It could be that whatever that systemic error is, it’s getting swallowed up by the amount of noise in the system between dose calculation, carb estimation, variability in absorption at different sites, stress, other hormonal interference, phases of the moon and godknowswhatall for any given bolus decision.
My Clarity estimates for each 90-day period over the last year were 5.0, 5.0, 5.0, 5.1. My actual A1c results were: 5.4, 5.5, 5.0, 5.4. Approximately the same amount of error as you @DrBB. Not a huge difference when discussing A1c, and certainly well within 10% tolerance, still something to think about.
My fingerstick averages - even though only an average of 4x/day, were much closer to my eventual A1c results – That’s somewhat unexpected.
@Dave26 I don’t see anywhere in this discussion where you’ve been attacked, but if my post appeared that way to you I apologize. I was simply trying to make the point that if treatment is to be truly individualized, limiting options based on the best-case scenario isn’t a good idea. I believe Dexcom has stated that only 10-15% of T1s are CGM users. Based on your logic & with the cost of CGM, many subscribers may feel the same about paying higher premiums for your Dexcom use. That’s a slippery slope. When diabetes starts to follow all the “rules” for everyone all the time, I may be able to agree with your view. Until then, I’ll respectfully agree to disagree.
Terry-
I’m thrilled that they are finally getting it. So many people use it for dosing with great success. I am unfortunately not one of those that dose from my Dexcom and do have great concern that my number of strips will be reduced but I will wait and see. I think this will also be a big step the getting Medicare to pay for CGM coverage. Can only hope that the government and insurance companies will get the fact that there is no standard treatment for people with diabetes. What works for one, won’t work for the next.
I think good policy-making given this news will parallel what we try to do with diabetes each and every day – not too much, not too little. I hope this news will enable the good and minimize the bad. While I’m one of the lucky Medicare people who have supplemental coverage for my CGM, I’d love to see all seniors benefit from this technology. In fact I’d love to see everyone that’s interested could take advantage of CGM tech.
I think Medicare not covering CGM sensors is a huge life threatening situation. So many seniors live by themselves and don’t have the support system they should. A CGM is a life saver and such a miss right now. Every time I hear of a person dying due to an over night low, I am heart broken, when here is an super easy fix for it. And here’s hoping this is the step needed to get those who need it covered.
I’m not sure what to make of the news. My hope is that the downstream results will be mostly positive, but my spidey-senses say otherwise.
Am I the only one in the room that suspects that Dexcom will now begin to move toward some mechanism of forced sensor termination after 7 days as a direct result of this newly announced dosing indication? For those of use who routinely use sensors past 7 days for financial reasons, this could be impactful - in a bad way.
There were bills pending in Congress this year (one in the House, one in the Senate) that would have required Medicare to cover CGMs. Neither one made it to a vote on the floor. If you wrote your congresscritters about them, now might be a good time to relight the fire. If you didn’t, now would be an especially good time.
I think Dexcom will find a way to do this regardless of whether their technology can be used to replace fingersticks. They’ve done it with the transmitter, I don’t see any reason why they wouldn’t do it with sensors next. And yes, as someone who pays for the entire system myself, this would make it unaffordable for me and many others.
Jen, that makes me feel bad. I get Dexcom from insurance (with my co-pay %), but it doesn’t work well for me. It probably works much better for you, but you pay for it on your own. I wish there was a better way to do that.
A giant diabetic trading-post. Personally, I’d be all over the idea of swapping Dex sensors for some test strips!
Humalog for NovoLog! Lantus for Tresiba! Freestyle for Accu-Chek! Trade it all at the D-Post!
Someone will probably say this isn’t allowed. I know. I’m not proposing it, just wishful thinking of how everyone could help out their DBS’s (diabetic brothers and sisters!).
I am aware, through backchannels unfortunately, that a major company is developing a CGM specifically to be FDA approved for Type 2s and Type 1s (not that it should really make any difference…a CGM would obviously work exactly the same). I was given to understand that CGM approval for T2 is on the way in the next 24 months, and that could definitely help to clear the barriers for seniors, those on Medicare, and etc. Seems that CGMs and Insulin itself are probably the two best tools in the toolshed for diabetics, and it’s a shame that only 15% of 10% of diabetics get to use them.
ah ha. thank you. the dex thing and the pump are just things i will dream about. always interesting to hear about them, especially when they dont help as much as expected.
Is the G5 that accurate?
I’ve been using and loving my G4 for 5 years now, but I would never inject base off of it (especially if I just worked out or showered, that always seems to confuse it for a while).
I have used the G4 AP (artificial pancreas, the algorithm used by the Bionic Pancreas team at BU: http://www.betabionics.org) which only relies on 2 fingersticks/day to run, but the only reason I trusted that G4 during clinical trials is that the bionic pancreas is able to correct for any mistakes.
Is there any reason not to switch to the G5?
I’m lucky enough to have my insurance cover all my durable medical equipment at 100%.
