I saw my DE today and she was showing me some of the reports of her other patients that are on CGMS with automode (where the basal insulin is adjusted by the pump automatically) and their graphs are so incredibly stable.
I’m not on CGMS because the sensors don’t work with me and give inaccurate results and also cost is another factor. I’ve very cautious with my diabetes management and my sugar is not always within the “good” range. I test about 7-8 times a day and interact with my pump often with temp basals and all that. I feel so sad I’m not able to get a better graph where the sugar is always within the range despite best efforts.
Is it even possible to have stable sugar levels without CGMS?
I think you probably can. I know several people that have had good control without a CGM and even without a pump.
I think the key is to first do a basal test to make sure your basal is set right. Everything else won’t be easy until you get that down right. Next you need to figure out your insulin carb ratio and correction factors and make sure you have those set right so you are dosing right.
I found the most successful thing I did before I had a CGM or pump was I prebolused.
That helped keep my numbers from climbing as much after eating.
Like I said some people have done really well without either. I kept between a 6.8 and 7.2 range without either and I honestly was very haphazard about dosing right. I have seen some people with much better control than that without either tool.
My prior experience with Medtronic was not good, and soon after I first received one of theirs, found that everyone else preferred Dexcom, at least at the time, maybe 10 years ago.
Right now, I use a Dexcom G6 CGM, paired with my Android phone, and have a smartwatch as well. The only issue I have had, is that when I first insert it, even after it is ‘ready’, it take a few hours of calibration before the numbers lines up with my finger testing. Afterward, I have few issues for the remaining 9.5 days of its use.
I advise that you not to throw in the towel because of this. Cost will always be an issue, but we have ‘tricks’ to decrease the cost somewhat, particularly with Dexcom (like resetting transmitters and restarting sensors so they can be used for a longer period of time like we did in the olden days). Although, Libre will be less expensive off the bat.
Does your DE have a ‘loaner’ Dexcom or Libre CGM that you could play with for a couple weeks? If not, I think you need a new Doc - call around and find one with a loaner CGM. Medtronic sensors are pretty widely accepted to be inferior tech. I wonder why your Doc is married to Medtronic and why they haven’t been able to recommend an alternate sensor. Thats sketchy. I would ask them that question directly because it sounds like poor medical practice, to me.
While its still possible (perhaps even likely) that inaccuracy issues pop up, I think you are capable of identifying that when it happens. Overall, I think you will benefit greatly from a CGM.
That’s a good point, I don’t drink enough fluids but when I’m on the sensor, I do make an effort to drink more water before I put one on and during the first 24 hours to get a good calibration. But it’s usually the calibration during the first 24-48 hours I have trouble with. Even with good sugar readings, the sensor is off. About 48 hours into it, the readings start looking better, at least it trends the right direction but still not precise (although occasionally it’s spot on). It’s starts dying again about the 4th day and the 5th day is a write off. So in reality when the sensor does work for me, it’s only good for 2-3 max 4 days. This was was link 2. Link 1 was no chance!
I’ve troubleshooted endlessly with Medtronic support and they ended up telling me I’m doing all the right things and perhaps I’m just one of the few people that don’t work with CGMS.
The sensor inaccuracy stressed me out so much I was waking up every few hours during the night measuring my sugars (without calibrating) to check whether the sensor was okay. Most of the time it wasn’t, and I found the sensor accuracy worst when I’m lying down.
Have the design for link 3 changed at all? Is it still the flimsy copper bit hanging out from the sensor? And the mushroom like transmitter?
To be fair, there are only really two major players for pump technology in Australia’s. Medtronic and tandem. Medtronic has been the dominant one and tandem only recently came into the picture. The reason why she swayed towards Medtronic was because of the auto mode (I believe equivalent to control iq), Dexcom g6 is not available in Australia yet and it is needed to get control iq to work. Yes we are slow..
I just have a very bad experience with Medtronic sensors, their pump I think is great although a bit out dated. The cgms experience with them just left me with a bad aftertaste. I did see a slight improvement between link 1 and link 2 but not enough to convince me rely on it. If link 3 is used for auto mode, surely it has to be reliable because it would put peoples lives at risk if the accuracy is off.
AHHHHH, always some catch. Dexcom is manufactured in the Philippines, now. Technically, right next door to you, compared to us in the US. Makes no sense. Look them straight in the eyes and channel Michael J Fox. Say, “Give me a Dexcom.”
lol if only that would work! Our diabetes technology is always somewhat behind the rest of the world. We don’t even have omnipods. Our choices are very limited.
Exactly! I’m at a cross road at the moment because I’m due for a pump upgrade. I had my mind set on the Tslim but my DE raves about the Medtronic link 3 like its the next best thing since sliced bread😅. So I’m trying to find out whether Link 3 is a massive improvement from link 2. The only thing stopping me from going Dexcom is the cost. The 3 month transmitter is very expensive. While the Medtronic transmitter is free with the purchase of a box of sensors. It’s only worth going Medtronic if the new sensors are reliable.
My endo raves about the Medtronic 670 and its “auto mode”, but it turns out he knows squat about the tech and doesn’t have a clue about what the pros and cons are for Medtronic vs TSlim vs Omnipod. He’s just repeating biased anecdotal opinions of a few patients.
It’s a shame Australians have so few pump choices, it sounds pretty much the same as the province I live in here in , where there are only two outdated models of Medtronic & Omnipod pumps covered by the insured pump program
No she isn’t, but she showed me some cgms graphs of her other patients on automode and they were convincingly a lot better control with the basal adjustment automatically kicking in.
It’s a shame that we are always so behind with diabetes technology. Years behind, that’s quite dissapointing.
Are you sure? Where was that reported? I am familiar with the manufacturing in Arizona and California as well as the call center in Taguig, in Metro Manila, Philippines but never saw an announcement of Dexcom having moved manufacturing of their product line to the Philippines. Just curious, in what city did they move their manufacturing to.
Our forum pages come up when I google. So, perhaps I am mistaken. It appears as if manufacturing kept their jobs in AZ. I recall concerns about hurricanes disrupting supply chains. I recall googling their careers page and seeing manufacturing engineering positions pop up in their overseas location. Maybe I was just reading between the lines. It looks like they have had a lot of disruptions/restructuring of their manufacturing, but perhaps that was all taking place within the US, not because they were moving overseas.
Although only my assumption, Medtronic has been good at ‘indoctrinating’ doctors, selling them on their product, even though there are better products around. All of my endocrinologists have worked at major medical centers, and as such they often recommend Medtronic, and it was only my own research that enabled me to suggest other options, but once suggested, the doctor was very accommodating.
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Our diabetes technology is always somewhat behind the rest of the world. We don’t even have omnipods. Our choices are very limited.
, where there are only two outdated models of Medtronic & Omnipod pumps covered by the insured pump program 
