Opinion on CGMS models


#1

During my last visit my endocrinologist recommended that I purchase a CGMS. A DexCom STS. I thought about it for all of 5 seconds before the realization of the cost made me think of lunch instead.

I don’t know if my insurance covers these devices or not but I have been thinking about CGMS a lot today. I have noticed that my BG two hours after a meal is fairly high, sometimes above 200. This has been happening for a few weeks now. My just before meal readings are still within range (80-90). Something strange is going on and I want to get to the bottom of this.

What made you decided to get a CGMS? What brand/model did you choose and why?


#2

Main Reason for CGM: scary nighttime hypos (waking at 30mg)
Additional reasons - i got to try one out for a week and loved the trending, i have been diabetic for 33 years(complication free) and although my A1C’s are decent last 2 were 7.3 and 6.6 , i tend to have lots of peeks and valleys-- i have 2 kids and need to be here for them.
Good Fortune - we could work it into our budget - i am working on gettig insurance to pay for it.
Brand Choice - Dexcom - i have an animas pump and price was a factor - i also did not care for the MM sensor when i tried that out—caused lots of irritation for me, and everyone i know using MM has to use extra tape to make it stay put. Dexcom start up pricing was better.
What i have learned - i wouldnt give it up—i would eat Peanut Butter and Jelly for a week every month if that meant i could afford it. I learned that i am/was terrible at carb counting and that it make a GIGANTIC difference in after meal peaks based on when you take your pre meal bolus - at least 15 minutes prior to eating is key. I learned that my BS are still very ping pongy - but that is getting better. I learned that even if i wake up at 90 every morning and eat the exact same breakfast and bolus exactly the same for a week straight, that my BS will react differently. Most importantly, CGM gives me piece of mind. I can go to bed and know i will not wake up incoherant.


#3

I am thinking about getting one as well and have been talking to my pump educator at my endo’s office about it. She is diabetic and has worn both the Dexcom and the Minimed CGM. She said she has found the Dexcom to be more accurate. She said she was also part of the clinical trial for the Abbott Navigator and that was good but it is not FDA approved yet. I’m leaning toward the Dexcom (but I also don’t have a minimed pump so don’t really have any other option).

As for the high blood sugars post meals, you might want to talk to your doctor about Symlin (go to www.symlin.com to check it out). It’s been recommended to me by several people and I’m thinking of going on it in the next couple of months. It is supposed to do wonders for blood sugar control.


#4

I started the Dexcom 7 a month ago. I have an Animas pump and I didn’t want the Guardian, so Dexcom was really my only option. What finally pushed me over the edge was waking up too many times at 300 and not knowing why. Now I know there are nights where I go low without feeling it. I’m sure a lot of those 300’s were rebounds.

I am having good and bad experiences with Dexcom so far. Sensors haven’t lasted as long for me as for some other people. I have also had some issues with accuracy. That said, on the whole it has helped me avoid unexpected major lows, and it has alerted me to highs so that I can at least get them down right away and not hang out for hours before I even realize I’m out of range.

If you get one, realize that there can be a big learning curve and it probably won’t be a perfect solution immediately. This is frustrating when we pay so much money for it, but my impression is that everyone’s body will interact differently with the CGM, and you have to tweak it until you find the best technique for you.

I started a blog about my experience at www.comradedex.blogspot.com. I know there are some others out there now too. (I haven’t posted for a while because we’ve been on vacation.)


#5

Which One
I went on the Medtronic Minilink 2 months ago. I chose the Medtronic simply because I already had their pump and I liked only having 1 device to carry.

Why

  1. When I recently went on the pump I started religiously testing my BG 2 hours after meals and was disappointed with the spikes.
  2. I often travel alone on business and having a reaction in the middle of the night in some hotel room of a strange city is quite unpleasant.
  3. I started getting into distance running and knowing my BG during a long run is priceless
  4. I’ve gone 31 years with no complications and I’d like to go another 31+

Satisfaction
I’d give up my fistborn child (OK, my front teeth) before I’d give up my CGM. It has proven to be far more valuable than I anticipated. On a 2 week trip to Taiwan, the high and low alarms woke me at critical times before things got really bad. It enabled me to quickly reduce those post meal spikes by 30 - 50 points. The peace of mind glancing down during a long car drive and knowing that I’m at a good level is wonderful.

Cost
The device cost is high (though more and more insurances are starting to cover it). But the sensors can last significantly longer than the 3 (or 7, depending on which one you choose) days recommended. I’m able to get 7 - 14 days of good readings on a single $35 sensor and I’m optimistic that my insurance will start covering these soon.


#6

OK everyone. I have been looking into the pump for a little while now and think it will help in my situation. I then started reading about CGM and thought that this would help even more. I won’t get to see my Endo until the end of september so I figured I will ask here. do you use the CGM all the time or do you only use it sporatically? When you say they are expensive, what are we talking here? a few hundred, a thousand, a few thousand? Just want to be informed when I go to visit my Endo.


#7

The minilink system from Medtronics is just under $1000 for the starter pack (I think the Dexcom is about the same). That includes the transmitter and 10 sensors (if you don’t have a minimed pump, which serves as a receiver, then I think you’ll need to pay more for a separate receiver). Replacement sensors cost $35/each. I’m averaging about 7-day use for each sensor, though I expect that to increase now that I’m over my learning curve (I removed 2 sensors earlier than needed and have gotten up to 14 days out of others). So 10 weeks after the initial purchase, it will cost around $140/month for continuous use. The transmitter has a rechargeable battery that will probably require replacement in a year or two, so that’s an unknown cost at this time.

I use mine almost all the time, though I sometimes choose to go a day or two without it in between sensor changes. Using only 2 sensors each month (50% of the time), would still be very helpful at detecting patterns and helping a person train themselves on how to better regulate things. I thought I had pretty good control on MDI and 4 glucose tests a day, then I got the pump. I thought I had pretty good control on the pump and 7 - 8 glucose tests a day, then I got the CGM. It’s really amazing what you can learn when you’re able to watch continuous updates of your glucose after a meal, all night, during exercise, etc. I’ve been able to significantly reduce my post breakfast spikes using the CGM.

It’s not perfect and those times when the accuracy isn’t as great as you’d like are frustrating. But overall, I’ve found it very beneficial.


#8

These replies were all very helpful. I will talk to my endo again about this and once I find out from the insurance company how much (if any) they will cover I will order one of these units. The only concern I have left is how I will get access to the data on the device. Both DexCom and Minimed software run only on Windows and I am a Mac user.