I’m currently using a Dexcom and a T slim and I’m curious how many pumpers don’t use a CGM. I’d love to go without it for a little break but I’ve had both of them together since I started pumping. Sometimes I get sick of carrying a pump, a receiver, a phone, a wallet, keys yadda…yadda. But then I think I would be too nervous to sleep without the Dex. How can you try upping your basal and sleep without an alarm in case you go too low? Is that pretty standard procedure to have both a CGM and a pump?
I only have a pump…been that way for 19 years of my pump journey. I wish I could have a CGM, but my insurance company says no. I typically wake up in the middle of the night and test my bg. Also, thankfully, I am not hypo unaware anymore. So, it’s very rare if I sleep through a low.
There are several people here that pump sans CGM.
Sarah 
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I’m the same as @curlysarah. pumping for about 26 years of my 48 with type1. I test 8 to 10 times a day and usually once in the middle of the night. I don’t feel the need to have one, and I couldn’t afford it anyway. I really would hate to have something waking us up at night. I sleep poorly as it is.
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Me three. Also pumping for 26 years. I test a lot (hypounaware), and the CGMS was very difficult to calibrate when I tried one so I tested even more and found the device was rarely accurate! I suppose they have improved them but I’m not interested. Trends are great but I need to know what my bg is right now.
If I am upping my basal, then I would do extra testing until I am assured the change is solid. I don’t test during sleep unless I wake up feeling some symptom or had a really really rockin’ day, or if I’m sick.
I don’t know if it’s pretty standard or not, my own pump has the capability for CGMS i just choose not to use it.
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Thanks for the replies…I’m just trying to get an idea because my insurance is possibly going to be changing and I don’t think the Dexcom is really that accurate a lot of times. If I had to get up and test in the early morning I would probably not be able to fall back asleep. I did went go years without a CGM when I was on MDI’s with Lantus and never had a problem sleeping through a low. It just seems a little more dangerous with a pump for some reason.
I will give the opposite answer. I have only been pumping since 2000 and have cgm about 4 years+. Would have to look up date.
I am a longtime T1d and depend on cgm for night lows. I would rather be awakened that go way low and wake up with clothes and bedding sweat soaked as in the past. I also like not having to stick my finger as often. OK, I know plenty still do many sticks a day with cgm but I don’t. I am one of those who would rather give up the pump than the cgm, if I had to give up one.
PS. My dex is close enough and I do ck BG if I question it or want to be sure before treating.
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Don’t get me wrong…I would LOVE to have access to a CGM. About a year ago, I was suffering from severe nighttime lows that I was not aware of. I’ve woken up several times to someone sticking a glucagon syringe in me. So, I committed to testing A LOT more throughout the day and tighten my control. I regained my hypo awareness and now we all sleep more confidently at night.
I am hoping for the day that CGM’s are part of the standard of care for ALL diabetics.
Sarah
It would be interesting to see the #'s but I am guessing most pumpers do not also Dexcom due to cost (in fact, only 40% of T1’s use a pump as of 2011 ). If you have the means, Dexcom is great and you can always take a break from it when you get tired of the bodyware.
My brother has been on a pump for something like ten years and probably 95% or more of that time he never used a CGM. He said it was just fine. He uses his CGM now, but that’s because he now lives alone and he likes the safety (especially at night) the CGM provides.
I’ve only been on my pump for a week, but I’ve used a CGM for months now and would be very nervous without it! I like knowing where my glucose is at all the time!
What you are asking about is, in my opinion, ultimately a very personal decision. It depends not only on how you may happen to feel about using CGM, but also on how much use the CGM is to you in the context of how you, personally, experience diabetes.
While CGM has not been a panacea for me, I certainly value it in many different ways. But that’s me. What matters for you is how helpful … or not … CGM may be to you and I don’t see how anyone other than you could decide about that. No? 
To approach it from another direction, if you think you want to take a break from using your Dexcom, why haven’t you just gone ahead and done this? Certainly the next time you pull your sensor you could simply not insert another, no?
Of course, I am not trying to push you in that direction. I am just trying to dig a little deeper and possibly get a bit more clarity about what question you are asking?
Actually there is a logic–as a relatively recent MDI to pump convert it took me a bit to realize this, but the thing about basal insulin on the pump is that it’s constantly incrementing away, unlike that single shot you take of Lantus each day (ok, some people take two). That’s both good and bad. Good, because you can tweak the pump’s flow rate various ways in response to ongoing events, but bad in that it’s going to keep adding, adding, adding little bits of insulin and if your rate is too high and you’re not paying attention it will keep ticking a way and you can get in trouble pretty quickly. That’s why they usually start you off so conservatively when you’re getting it dialed in to begin with.
It’s also why a CGM is a handy thing to have, though I didn’t have one for my first two years pumping. I finally did get a Dexcom this spring because I was going on a trip involving a 5-6 hour time change and had no idea how that was all going to work out between basal settings, jet lag and metabolism. It saved my butt a few times. I also bike-commute most days and have been struggling with hypos due to the exercise in the evening, so I’ve gotten really dependent on it for trying to resolve that problem–not that I have resolved it, mind you. But I did have one day without it when my sensor got yanked out at work and, y’know, it wasn’t the end of the world. I got along fine for my first two years’ pumping without it.
FYI, and FWIW, I’ve found my Dex to be within 10pts of fingersticks (Contour Next+), and often less than that most of the time.
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I pumped for 22 years without a CGM and six years with one. I love the near-real time data stream that the CGM provides. It has improved my ability to control my blood sugar level, a lot.
We all know that one of our big challenges is to try to match food digestion with insulin action. Bolusing in advance of the meal can be a potent tool. I’m sure many have noticed that there’s a degree of varibility in all the factors that affect this contest. Every meal is not absorbed at the same rate. Even the same meal eaten at the same time of day can vary. Insulin does not absorb and get working with the same speed each time. Exercise is another wild card that can change things when it comes to the meal insulin matching game.
Enter the CGM. In the last six months I’ve learned to wait for the insulin to deflect my blood sugar curve downward before eating, a phenomena written about by Sugar Surfing author Dr. Stephen Ponder. He calls it “waiting for the bend.” This technique alone has allowed me to chop off many a post-prandial BG mountain-top. While I could do this with fingersticks, it would require much more of my attention and be more difficult to execute. The CGM allows me to use this technique without much effort.
Everyone has their own style and we each balance our diabetes protocol needs against our overall quality of life. For me, I would quickly choose to give up my pump if I had choose between the pump and the CGM.
The CGM blood glucose curve is valuable to the extent the wearer actually observes and uses the data. True, if you only use it for the high and low alerts, it’s still a great tool. But if you observe and respond to the CGMs data rich trendline, you can reap large benefits. For me, micro-bolusing and micro-carbing can only be incorporated with using a well-calibrated CGM.
I’m not the typical diabetic and I understand that. You need to make the choices that make sense in your life’s context. Taking a CGM vacation may alert you to its real value or you may discover that its absence makes your life easier. Good luck with whatever you choose!
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I don’t want one. Too much expense, clutter and I dont want another device with another site. My HMO doesnt even cover pumps well, and that is with the new ACA Gold Plan. I’m to busy digging up money for a new pump.
MY bg drops overnight, so I actually have to set it a tad high because it will drop before morning. I also get 200 point drop per unit in the early morning hours.
No, I dont think it is the norm. I hope one day they come up with something that is affordable for all and doesnt take two sites.
I used a Dexcom several years ago, for a year or so, and there was very little accuracy, so I stopped. The newer Dexcom is reputed to be much more accurate. I have MVP/Medicare now and CGM’s are not covered. I also have hypo unawareness rather frequently. I test 12-15 times per day to help compensate.
There was a bill presented to Congress to require Medicare to cover CGM’s. An impressive number of Congressmen and Senators are supporting the bill, but perhaps not enough, yet. I wrote to my Congressman and Senator. Both of them are now in the list of supporters.
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I guess irrational John is right, all I have to do is try leaving the sensor off and see how it goes. I went for over 20 yrs. without the CGM on MDI’s. The thing is with me (as probably a lot of you) some nights I run low and 80% of the time I run high while sleeping.
Laura, there are at least three pump + CGM combos, that require only one site. The Dexcom/Animas combo is popular, Dexcom/Tandem is a combo too, unless it has not been approved yet. Medicare also has a CGM combined with the pump.
<Your infusion sites should be at least:
•2 inches (5.0 cm) away from your sensor site>(Medtronic)
Two sites Richard. :-).
Until the day they combine the infusion sets with a sensor…The only ‘nice’ thing is people are getting weeks out of the sensor after they insert them. We dont get that from our infusion set sites…
I was on the pump for 13 years without a CGM. Been using Dexcom last tow and a half years because I a hypoglycemia unaware. Whatever works, go for it.
I’ve been pumping for 19 years. Only had a CGM for 8 months. I managed to survive all those years, plus another 18 years on MDI. You don’t NEED a CGM to survive. It just makes it a lot nicer to get warnings when going high or low. To tell the truth, I turn off the alarms at night, quite often. I can selectively turn off just the HIGH or the LOW alarms (or both). I do so when I know that I’m running a bit high, have taken insulin and know that I will come back down to a good number. No need to be kept awake with alarms. Alarms also disturb my wife’s sleep, so I avoid them by turning them off. If I am concerned about my bg’s going haywire at night, then I will leave the alarms on. Also, because I sleep on the sensor a lot, the sensor will read lower than it should, so when accuracy is an issue, no sense having the LOW alarm enabled.
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i’ve had a pump but no cgm since year 2000