See updates below
I started on the Minimed Paradigm 722 with Continuous Glucose Monitor on Thursday and it has been 3 days and 4 nights so far.
The insulin pump:
Very easy to bolus and correct high BG readings. This is about the only positive thing I can say about the insulin pump. When I was on Lantus + Humalog, I never bothered to correct if my BG was <=200 mg/dL. I always relied on my Lantus to eventually bring it down to an acceptable range. I am aware of the damage caused any time sugar levels are above normal and that my goal should be to limit these high BG excursions to as small a time period as possible - but I always reasoned to myself that when I try to take a Humalog shot to correct my BG I invariably ended suffering a hypo a few hours later and then overcorrecting that hypo. I’ve been on too many such rollercoasters and they are something I try to avoid - even if that meant higher BGs and higher A1Cs. And I hate hypos. Really really hate them.
I am still not used to the pump connected to me 24/7. I experience a lot of discomfort when the tubing tugs at my skin or shifts. I changed my infusion set yesterday and was aghast to see the wound when I removed the canula - unlike an invisible hole of an injection site there is a big gaping hole in my skin! How long does it take to heal? And can I use the same site again? This sight alone almost made me give up the pump immediately. I’ll give it some more time.
All spontaneity when playing with my kids is lost. This is another big reason I’m contemplating giving up the pump. I have 2 small children - barely toddlers - and I can’t play around with them like I used to. I have to mind my tubing whenever I pick them up. I cannot pick them both up like I used to - I can only carry one on the side that is not connected to the pump. I can no longer lie on my back and have my kids on my chest - I tried that and my insertion site got a couple of kicks and made me wince. Just writing this makes me feel like removing my pump and going back to multiple daily injections.
What a waste! That’s all I can say about the CGM. And here’s why:
It’s not accurate. I know, it is supposed to be used to see how the BG levels trend, and warn when the levels exceed the limits you set. I can know the trend if I just checked my BG more often. I still have hypo awareness and I don’t need the CGM to warn me about those. As for hyperglycemia - I check my BG after meals until I see the levels dropping anyway.
What good is the warning when the readings are so wrong? My CGM warned me that I was having a low and displayed 65 mg/dL . I did not feel like I was at 65 so I checked with my meter - 109 mg/dL. My CGM readings showed a steady 135 mg/dL 2 hours after lunch. I doubted the readings and checked with my meter - 244 mg/dL! These are just a couple of instances - there have been many more during the brief time I have been wearing the CGM. I especially hate it when the CGM shows a smooth line of 134-136 mg/dL after eating when in reality I’ve reached >250mg/dL.
My conclusion is that CGM is not useful to me. It is definitely not useful when my goal is to achieve tighter control because the readings are so unreliable. And the postprandial readings are always lower than the actual readings and expose me to high BG by giving me a false sense of control.
I’m going to talk to my doctor and get rid of the CGM. In addition to being a pain to insert and remove, it is totally useless to me in my quest to achieve optimum control with my insulin pump.
I hate the pump. The only useful thing is the ease of bolusing. I hope to achieve tighter control because I hate giving myself injections of 1 unit and could never achieve the tight control I always wished for. I’ll stay with the pump for at least 6 months to see how it affects my HbA1C and how much of a hinderance it is when I interact with my kids.
I see no use for the CGM. If only it was accurate and reflected actual BG levels. Plus it’s a pain to insert and remove.
Thank you all for the comments and suggestions. I have had some more time to get used to the pump and I find that it is indeed a very good thing I did by switching to the pump. In my 3 days of CGM readings, I discovered some patterns there during which my basals needed to be adjusted - couldn’t have realized this without the CGM readings. Though I still feel it is inaccurate, all I was looking for was how the steady BG levels varied during the day and night. I removed the CGM yesterday and I’m thinking that I’ll put another sensor in and monitor the levels for a week or so until I get my basals sorted out. I’m getting more accustomed to having the tubing on me and the occasional tug doesn’t bother me so much anymore. I have put a small piece of tape to hold the tubing after the insertion site so that it stays in place and doesn’t stress the canula. My BG control is already much better than during my MDI days - the highest I’ve seen so far is 291 mg/dL. I’m still playing around with my carb ratios and insulin sensitivity to get the bolus wizard right.
I can see that my post shows a lot of frustration with the pump and CGM - that was how I felt about it and I’m not going to change what I wrote. But I will add updates or, if the content is substantial, new posts as I learn to live with my pump.
Once again, thanks for your support.
I guess I will stick with the CGM for now. Reading the blog mentioned below and the comments there convinced me that I should not be so negative about the CGM or the pump. Go have a read at http://misanthropicscott.wordpress.com/2007/12/05/continuous-glucose-monitoring-with-medtronicminimed-updated/