Omnipod and CGM

My daughter has been on Omnipod for a month now and we are loving it! Her BG is so much better than it was before. We have also ordered the Dexcom CGM. Does anyone here use that in conjunction with their pod? If so, do you only do finger sticks twice a day to callibrate the CGM or do you still do finger sticks at everymeal and in between for snacks/checks? She currently checks 6+ times a day.

I’m glad to hear that OmniPod is working out for you.

Caleb uses both OmniPod and DexCom. For the most part, I am finding we are still doing as many fingersticks but for different reasons. When Caleb is stable and I know that DexCom is reliable, we will skip a few fingersticks throughout the day. When there are rises or lows, however, I find we may be doing more than normal to validate DexCom’s alarms. At school, he pretty much keeps to his same schedule. I’m not completely comfortable with the school nurse or Caleb being able to discern when it is wise to skip a fingerstick. I’m in close enough contact that I can suggest it, and over time I think we will get into a groove that will allow for it. That said, there are times when the nurse just peeks at the CGM to get information and thus avoids an extra fingerstick. But overall, we are still doing about the same.

I agree w/ what both Lorraine and Nate have said. I use the pod w/ a Navigator, and I follow the same finger stick method for the most part. If my sensor ever gets off (sometimes I can’t callibrate it the best because I’ve been exercising, etc) but then I realize how much the sensor is off and can adjust all of my insulin dosage, etc, from that.
When in doubt about a reading, I of course always check with a finger stick.

Olivia,

The Dexcom is really flexible with calibrations so what I find myself doing is a finger stick before each meal and calibrating then (that’s usually when your sugars are going to be most stable anyway). My Dex has been reliable enough that I’ve cut out my AM fingerstick (since I never eat breakfast anyway!) and usually don’t do a bedtime fingerstick either. Of course that often leaves 14 or 15 hours between dinner and lunch with no fingersticks when it wants me to calibrate but I don’t usually bother until lunch. Not the best method, clearly you should be checking anytime you bolus and definitely calibrating at least as often as it tells you but this is what’s working with my lifestyle right now. I’ve got to say going on the Pod helped my blood glucose but didn’t really help my A1C, when you cut out all the lows your A1C can go up! The Dex has dropped my A1C from around 7 to just above 6 since I started using it in September. It’s been a Godsend. Once you get it you’ll probably find that at first you check more often to see if it’s right, but then you start to rely on it and you’ll fall into a new routine. Good luck with it.

When I first stated the Navi I have to agree that I DID check more often than without it :slight_smile: Just had to make sure it was being truthful to me (I had previously worn the minimed when it first came out, and it sucked…bad…and I could never trust it). So I had trust issues w/ this one, but quickly got over them. Now when I’m wearing it, and I calibrate well, I can def. count on it and can then prick my fingers less–which is muy bueno in my book.

I use the Navigator/Omnipod combo, and like others, I still do a fingerstick with all meals/snacks. With all the systems on the market, while they CAN be trusted to be fairly accurate, our insulin dosages are still figured by blood glucose levels and not interstitial tissue glucose levels, so I find my control is more accurate if I have a precise fingerstick measurement. None of the device manufacturers recommend dosing insulin based on the CGMS reading…but of course, some of us do that from time to time!

I went from checking 12-14 times per day (before CGMS) to checking, on average, 6 times per day a full year later. I test on my PDM when I expect that I will bolus or eat, and I test on my Navigator only when I need to calibrate. I find the numbers are generally within a point or two of one another unless my BG is rising or falling rapidly. Then I might see a difference of 20-30 mg/dL.

Let me ask a related question:

“Which bg meter do you use?”

I use OneTouch UltraMini and felt lucky when bad press about Freestyle surfaced recently. Now I face the decision to stick with the OneTouch UltraMini or switch to the PDM’s built-in Freestyle bg meter. I don’t want to sacrifice accuracy when I calibrate my DexCom. Am I paranoid? Did you all switch to Freestyle when you got the OmniPod?

I’ve been using Freestyle for almost 3 years now - since Caleb was diagnosed.

Lorraine,

Do you sometimes do 2 finger pricks in a row and find them to be more than 10 mg/dl apart?

The bad press was about people on certain types of medication. Unless you’re on them it doesn’t apply to you. I started on One Touch and used it for 10 years before the O-Pod so I’ll always have some loyalty but the freedom of not having to carry around a separate meter won me over. My O-Pod tests are almost always right on with my Dex (or vice versa) so I don’t think I’ve lost much. It’s worth it for the reduced baggage to carry with me.

That’s actually within the margin of error for all meters. The higher you go - the wider the margin too, since it’s a percentage that it can be off, and still be considered “accurate”

That’s how we felt. My son loved his Accucheck only because it drew up the blood so easily and it was so obvious that it was doing it - even though it needed slightly more blood. But we are all happy to not have to carry the extra meter everywhere, so we’ve adjusted.

I’ve used Freestyle for years and years. It has been my preferred brand and meter since at least 2003. And Freestyle was the preferred strip when I was on a Cozmo in 2008, and is the only strip I can use with my Navigator CGMS.

Like Rebecca said, the “bad press” about them and other strip brands was overblown because so few people actually met those medication + strip combination qualifications that caused problems.

Thanks for sharing your bg meter preference. I will become a convert too. I googled ‘OneTouch FreeStyle accuracy’ and came across studies that found the FreeStyle to be more accurate. Another nail in the OneTouch coffin.

My complaint with One Touch actually is the sample size. I went back on a One Touch Ultra during a Dexcom trial (before you could choose your meter with Dex) and was so disgusted by the amount of blood it asked for.

I have done quite a few and they were exactly the same, others have been materially the same. The only time it’s been significantly different is when his fingers need to be cleaned! :slight_smile:

I have problems with sample size too. I know that squeezing is not good for accuracy. I am warming with fingers with warm water but it is still hit or miss. I am looking forward to smaller sample size.

I’m using Dexcom in conjunction with Omnipod and am very happy with the combination. As important than the actual numbers I receive from the Dexcom are the trends which will govern my behaviour and the actions I will take to correct. I still check from 4-6 times a day with finger sticks (Freestyle built in to Omnipod) although given how accurate the Dexcom can be, it’s probably overkill. I generally only calibrate twice a day and Dexcom is normall spot on. Calibrating the Dexcom the right way is very important - the best advice I’ve seen for this is contained in the below link. Calibrating when you have stable BG levels and are not very low (or high) are the high altitude parameters but the link will give you clearer more detailed guidance. Good luck.

http://www.tudiabetes.org/group/dexcomusers/forum/topics/how-accurate-is-your-dex?page=1&commentId=583967%3AComment%3A698596&x=1#583967Comment698596

I try to calibrate the Dexcom CGM whenever I test before meals and at bedtime. I am absent minded and sometime forget to calibrate when I test before I eat. Somewhere I heard that calibrating too frequently can confuse the CGM, but I don’t know if that is true or a myth.

Brad