Ideal Glucose Meter

Diabetes Technology Glucose Monitoring
1

Hi everyone,

I'm type 1 and not very experienced. I'm hoping to get some help identifying a good, accurate, user friendly meter and (possibly painless) please. I realise there are many threads going on and I have read up on many of them and many different meters also. But to pick out an ideal glucose meter, I'm hoping to draw from other people's opinions and user's experience. Any input from your personal experience would be greatly appreciated!!

I lead an active lifestyle, spending most of my days outdoor, and have always found the fingerprick method to be cumbersome, even though I know that it gives more accurate readings compared to CGMs. Still, I'm quite interested in trying one of the CGMs because it seems more convenient. A part of me is still hesitant since I have heard of the numerous problems concerning calibrations, the readings being off for many hours before the sensor gets calibrated, and reading variations from one sensor to another.

I'm worried about the inaccurate readings in the first couple of hours when you install a new sensor and the constant calibrations that would follow.
- How do I know when would be best to calibrate my sensor to not botch all my future readings?
- How do I accurately calibrate it, because the blood reading you would take to calibrate is ahead of the CGM reading from interstitial fluid, right?
- Also is it painful to have a meter lodged on the abdomen?
- Did anyone have any experience with better A1C using one method over the other?
- I also heard that how your CGM readings correspond to your blood readings depends on where the CGM is placed, has anyone observed this?

Most importantly,
- Considering these problems, for those who have had experience with both the fingerprick method and CGM, do you find the CGM to be easier to use?
- Which is your ideal meter, any meter, CGM or not CMG, and why?
- Or just for fun, any ideal dream/fantasy meter?

Many thanks in advance for any input!!

2

A CGM is not a meter, and it's not a substitute for a meter; you still need to prick your finger and test your blood sugar. I don't use a CGM but from what I understand their most valuable asset is to show trends - when your blood sugar is heading up or down. You still need to test your blood sugar in real time.

As for meters I've used both the Aviva and One Touch and found them both very reliable. Since the strips are what is costly, you might want to check which is preferred by your insurance.

3

I like my CGM and I depend on it esp at night. I used to test 6 or 7 times a day with my finger stick meter but now 3 or 4 with my cgm. I find it works well most of the time.
I never depend on it though if there is a question, I always check with a finger stick.
You are required to test a fingerstick at least twice a day or the CGM will stop giving results.

I am so used to finger sticks I barely notice it anymore.

The sensors are not such a big deal to wear. The MM ones have a bigger needle than the Dexcom, but I never had any trouble with either one. The part that sits on your skin is pretty small anyway. I never use my abdomen because it moves around too much. I use the backs of my arms in the tricept area. They are out of the way and work nicely.

As for a finger stick meter, I use a onetouch because it beams results directly to my pump. Results are pretty fast and reliable.

4

As stated above, a CGM is not a meter and finger pricks are still required when on a CGM. I just retired my CGM bit had used one for 4 years. Here are my answers

:- How do I know when would be best to calibrate my sensor to not botch all my future readings? If you go to a CGM, there are a ton of rules, equations, etc. you will need to learn. For example, never calibrate below 70 or above 170. There are many more.

- How do I accurately calibrate it, because the blood reading you would take to calibrate is ahead of the CGM reading from interstitial fluid, right? That is one of the reasons that readings are often inaccurate on a CGM.

- Also is it painful to have a meter lodged on the abdomen? Wearing it is not uncomfortable; it has a flexible catheder like the pump. However, I always hated inserting it, As Acid Rock once said,, the needle looks a little like a 10 penny nail.. I have ti get my nerve up to insert it. Additionally, it is covered over to keep the sensor from flopping around, and I have had mine bleed two or three days after insert, which was not fun.

- Did anyone have any experience with better A1C using one method over the other? A lot of people seems to get better results on A1Cs. In my case, my blood glucose levels were so tightly controlled (A1C of 5.1) that I was using it to protect myself from overnight lows. I helped me see patterns and trends and was helpful adjusting basal settings.

- I also heard that how your CGM readings correspond to your blood readings depends on where the CGM is placed, has anyone observed this? Yes. Just like a pump, there are good spots and not so good spots.

Most importantly,

- Considering these problems, for those who have had experience with both the fingerprick method and CGM, do you find the CGM to be easier to use? As we know that both methods must be used with a CGM, here is why I stopped using mine. I became obsessive about looking at my meter, making adjustments if I was running high or low, etc. I worried all the time. There were nights when it beeped so much that we could not sleep, even when I was not really low. This lack of sleep was affecting our health. And I hated the procedure for insertion. Unlike a pump, this can be a three hour process, if all goes well. It can be a great tool, but I am happier without it.

- Which is your ideal meter, any meter, CGM or not CMG, and why? I use the military pharmacy system, and they carry accucheck products, so I have always used accucheck.

- Or just for fun, any ideal dream/fantasy meter? One that was more accurate, as even a meter can standardly be off 40 points. One that could accurately read glucose levels without blood, say with saliva....

Good luck--I hope this helps.

5

Hi BCH, welcome to TU. I like to think of a CGM as an additional tool as it does not replace fingersticks. My CGM allows me to often catch highs and lows much earlier than when I would "feel" them, but it is certainly not a perfect technology. The main factor being that the interstitial fluid that it is reading is 10-15 minutes behind a fingerstick. But it is very beneficial to me so I can see where my BG is trending. If your are looking for a CGM to replace fingersticks, then you will be disapointed. I believe I could not maintain the control I do without my CGM.

I was required to take classes online and one in person with my first sensor. They preached to me to calibrate when my BG was stable or "before" before a meal, before exercise and/or before bedtime.

The CGM can be painful on insertion, but I barely notice it afterwards. Its similar to wearing a large bandaid? The location of the sensor has not lead to more or less reliable data for me.

IMO I think you have to find a meter that you like and that all of the meters on the market are pretty similar. I believe the best this is the best tip to improve your control: Test your BG often. I look at BG readings as data. Without an ample supply of data, maintaining optimum control is likely impossible. I test an average of 12 times a day. I cannot say what is the right amount of testing, but you need to test enough to get enough data to make informed decisions. The other advice is to consider an insulin pump.

6

Dear all who have replied, thank you very much for your rapid and extremely helpful response! This will really help me learn what to expect with and without a CGM and how to best manage by blood sugar. I greatly appreciate it.

If anyone else has any experience they wouldn't mind sharing, I would love to hear also. Thanks so much!

7

I really like my freestyle meter especially with the no coding. Haven't tried a CGM yet but I really want to get one just to see if it will help me get better control. I think you have to choose a meter that is right for YOU. They are all pretty much the same but some might be easier to get supplies for through your insurance and some might be quicker. Usually my doctors office gives me one if I need it so I just take the free meter. :)

8

The CGM is sort of like a "babysitter" in that if you make your BG smoother, it works better, creating sort of a self-perpetuating loop for me where I'm like "oh, should I go to 5 Guys with the coworkers or eat 1/2 a peanut butter sandwich here?" I know the answer without a CGM or fingerstick and, while I've dealt successfully with 5 Guys, well, most of the time, I'll be like "nah..."

I have the Medtronic and usually (not today though %$#!) get pretty decent results by calibrating when I'm relatively input-free, in the morning, eating light breakfast on insertion-day. I'll test when I get up, if it's ok, I'll insert, being able to scroll back to make sure DP is "in-line' and then have 2 hours to calibrate. I usually "cheat" by eating plain eggs on insertion day, without the veggies I usually go for, reasoning that a bit more moderate food will behave flatter. I also try to sneak in an extra test maybe 1/2 hour, 45 minutes before calibration time that will make sure that things are doing ok and give me time to "nudge" it if it needs it. These little details generally work ok and also provide things I can do other times, sort of like "working out" with BG management.

I get quite a few days like:

, where all the data is close, the numbers are good and it helps me stay on track. It's also *extremely* useful for exercising and has carried me through 6 1/2 marathons and 2 marathons with generally decent results for races (the line on my home page background is one of those days, I ran up but kept things in line with moderate bolusing and staying on top of it with the CGM, finishing the race in good BG order, although the rest of me was sore!). Even if you're not doing that, it's handy to be able to think "I know my data is good, I'll just take a small snack along and run to the store, no need to burn test strips."

I have days where it gets "off", often the first day can be odd, but once it settles in, it seems very reliable to me. The general line is that the Dexcom is better than the Medtronics one but I like the compactness of the Medtronic CGM. I still test about 12-14 times/ day b/c I am sort of OCDiabetes about it and like to keep things in line.

9

neat! interesting comments and info.

thanks for sharing acidrock23