Minimed Continuing Glucose Monitoring System vs. Diabetic Alert Dog

Back in August I had a horrible time with my sugar levels dropping and the next thing I know I am being woken up after passing out. This happened a total of 6 times in 5 weeks. Twice I was found my 9 year old son. I decided to try the minimed system again. Two years prior I had done it and had the worst time with it. This time it started to go better but now I can not trust a thing it says!

A few days ago at work I was about to eat lunch and my CGMS said I was at 306. I then pumped for my food and for being high. Half way done eating I felt weird. I did a finger prick and I was at 56. This not being the first time that the monitor was completely off! I have given up on the set for now. I have seen many things about Diabetic Alert Dogs a.k.a. DAD’s. Does anyone have any insight on this??? I am so confused!

I can’t offer much info on a service dog. I would think that would depend a lot on the training of the dog and the dog itself, so it may be more challenging to evaluate the efficacy.

I never use my MM Revel/CGM for anything but tiny adjustments. It just isn’t accurate enough:) This is especially true if you calibrate when high or low, as the data tend to be skewed in that direction afterwards. I will also say that it took me months of experimenting with sites and insertion angles to find a pattern that gives me good but not perfect results.

There are 2 other CGMs though, Dexcom Seven and Abott’s Navigator. I have tried all 3 simultaneously. The only one that I would trust to make decisions off of is the Navigator. Hands down. The other two weren’t even in the same league in terms of accuracy and responsiveness. The transmitter was bigger and the pdm was not as nice as the dex, but accuracy was amazing. Unfortunately, they are still caught up in some mud with the FDA and can’t ship any devices or offer warranty replacement. Word is that they will hopefully resolve those soon but there are no guarantees when it comes to the government or corporate America…

Tom-Thanks for the info. I am so frustrated about the whole thing. Why is it that I would wear this device if I can never trust the results. Big waste of time and money. I guess I need to go back to 8 finger pricks a day. Yucky

I am one of the ones that the MM sensor works very well for. It has been very accurate for me. THat being said, I would NEVER bolus off of the CGM reading. I ALWAYS bolus based on a fingerstick reading, and that is the recommendation that the company gives you - to never treat or dose based on the CGM. You have to remember that there is a 20 minute lag time between interstitial readings and the fingerstick with the MM. Alot can happen in that time. It is all about calibrating only when you are stable with BG and the ISIG number on the pump and your BG are within range. You may want to call the help line and they will give you the specific advice on the Isig numbers and calibrating. They have been very helpful with this regard for me. Give them a call and it may help you solve some of your calibration issues. Again, the CGM shouldn’t be used for treatment or bolusing decisions and does not replace fingersticks.

I have had a similar experience with the MiniMed CGM system. It was very inaccurate. I have also been very involved with dogs, all my life. Bearded Collies - not that the breed has anything to do with it. I still don;t know how a dog can possibly alert you when your BG is low? Someone said it is from the odor you produce, i.e. sweating , that dogs can detect and will alert you. But, I question, how good is that if you are passed out? So how does a dog know to go and alert someone else? If I lie down on the floor my one dog will come and lie right next to me. He will not go and get my husband. If I am stumbling around trying to get to the fridge the dog will just follow-me. If I pass out in my sleep, the dog will continue sleeping too.
So yes, I would love to see how it works, I would love to have confidence in someone else, or something else that can alert me or alert someone else that I need help. Quite often my husband doesn’t even know.
If anyone else can shed some light on this I would like to know also. I do have very intelligent dogs but how smart can we train them to be ??
Sheila

It sounds like you need some more/refresher training on the CGMS. When used correctly it is amazing and very accurate but if used incorrectly it can produce crazy readings as you are seeing.



More concerning, if you thought you were at 306mg/dl you should have done a BG test and NOT ATE until your BG was close to normal. It is really dangerous to be eating more food (even with insulin) with 306 BG level and even more dangerous to be using a CGM reading to drive insulin dosage unless you have a strong track record of highly accurate tracking of the CGM and BG values and are in the near normal range.

We have a group called Diabetes Alert Dogs. Former discussions may answer some of these questions being asked, or you could start a new discussion.

I cannot help you with your Service Dog question .
I am a MM CGMS gal and agree, with what others are experiencing : overall I am a happy camper. I have used the information as " setting trends " and altered my settings , basal and others, not as a guide to avoid taking finger pokes .presently the CGMS is guaranteed for 6 days of proper use …I am trained by my Pump Nurse and am glad I received the initial training from her in 2006 . …it would be hard for me to follow instructions of" how to " by reading a manual .I wish you well !

My main goal with the CGMS was to get trends and help set my basals at a good rate. Not to mention be able to look at a real time result. Straight from the MM website: The MiniMed Paradigm Real-Time System helps you take immediate corrective or preventative action to keep your glucose levels healthy and prevent diabetes-related complications.

I did have a minimed pump nurse come out to my house in September to start me on the system for the second time. She gave me about an hour of training and was out the door. In fact I have emailed her with some issues and she just says to call the 800#. I never thought of this system as a escape from finger pricks. At this point a finger stick is the only thing I can trust/rely on.

With this all said… I am trying to look at all options and maybe a DAD is one of them. I no longer feel my lows. I need something to assist me when I am crashing, not after the fact when I am on the floor. Oh and if I am on the floor they do make phones for the service dog to use (Kinda cool huh). I would register with the local fire dept.

I had issues with MM cgm working well for me so i did go with a diabetic alert dog. That is because my insurance did not pay for the cgm i could not afford to pay for another one out of pocket like i did for the cgm from MM. I find that yes my diabetic dog does alert better verses the MM cgm. infact she tells me when my blood sugars start to move up or down as well as when it is low or high. I also used to miss the beeping from the cgm after a while. My dog is very persistent so i feel like the dog turned out to be a better choice for me overall. My A1c has also dropped 3 points in within the month of having her. I have dropped a total of 6 points in the past 3 months. I am also in general less stressed and happier than before.

Tarra,
Thank you for the positive feedback. That is amazing that you have dropped your A1C so quick. Way to go!

I do have to check my blood sugars frequently even with my service dog when she alerts. She does not distinguish between high and low blood sugar alerts. I also never relied upon the CGM to have accurate readings of my blood sugars and always tested to be sure.

I agree with John a diabetic is a lot of work and i really suggest anyone who is interested think about the overall expense and the time that is involved. I do work with my dog on a regular basis. If you feel you can make the commitement i say go for it. I personally would try the dexacom it seems to be highly recommended. The reason i went with the diabetic alert dog is that i have always had dramatic quick swings in my blood sugars with in minutes. The doctors even with cgms could not figure out what causes this to happen. I found that the dog is helpful to me in that she does catch these quick drops quite well. I have had so many bad lows i tried the cgms in the hopes that it would catch the major drops but it did not catch enough of mine to keep me safe. There was a time i dropped quickly and i was too weak to move and the dog retrieved my test kit and glucose tabs for me which was a life saver since my roommate was not home that morning like he normally would have been.

Diabetic alert dogs are a costly investment but for my lifestyle and the way my body reacts it was the best choice for me. I got her from a kennel that trains diabetic alert dogs so that made the process easier but there is a lot of good and bad things that comes with having a dog with you at all times.

Really, an hour of 1:1 training should be more than enough to get going /w the MM CGMS system and the people at the 800# are really very good though it can take some time to reach someone during prime time.

As others have said the key is to calibrate the sensor when your BG is normal (80-130 or so) and stable and to avoid calibration anytime your BG is low/high or changing significantly. If you do that it will serve you well and provide very good feedback on trends. Once you are in control and stable it will start to provide you with a very accurate BG proxy.

I have been using it for ~6 months and I can routinely use its numbers to administer insulin to make fine adjustments as small as 10mg/dl. I don’t advise that anyone do this until they can prove to themselves that the CGM numbers are tracking close to actuals but, again, once you get there it is amazing.

Just knowing what I have read in this thread I would strongly caution you against investing in a service dog at this point. They take a massive amount of rather technical work to keep in good condition in addition to all of the other needs of a dog. They are expensive to keep; vet bills, food, medicine, and mean a long term commitment to the animal long after they may not be able to provide service to you.