Starting MM CGMS! Any tips or tricks for a new user?

Unless there’s a snag with insurance clearance, I should be starting the MM CGMS in about one week! Finally! I know that there’s a learning curve with the new technology, so I figured I’d ask the current users if there are any “tips and tricks” that you would recommend? Looking back, anything you wish you’d known when you started? Can you keep sensors going for more than 3 days? You get the idea…

I look forward to hearing some great advice from the pros!

Here’s my schedule (usually): Monday morning insert new sensor after shower; wait until before lunch to start it (it has to “wet” for at least 2 hours, but since I eat breakfast after inserting, I wait 4 hours). Restart sensor as “new” sensor when it expires on Thursday. Remove sensor when it expires Sunday (I don’t like to keep them in longer because that leaves scars on me). Recharge transmitter.

Don’t do your first calibration unless you’ve got no active insulin in your system and you haven’t eaten recently (i.e. don’t calibrate when you’ve just eaten something to bring up a low). Other calibrations aren’t as detrimental - but make sure you’re blood sugar is pretty even when you do calibrate.

If you’ve got the fat, go in at more than a 45 degree angle with the inserter. Your trainer will probably mention this to you.

Use a dressing adhesive over your transmitter/sensor. It’s impossible to keep in without that.

Don’t think this thing is going to be accurate as you’re rising or falling quickly. It can’t keep up that fast.

I find my best spots are my stomach and the love-handle region on my back. Others find their arms and butt work best. It’s much trial and error to find the best spots.

After insertion, leave the needle in for a few minutes - this should help to stop any bleeding. If you start to pull it out and see blood coming up the cannula, leave it in for a few more minutes.

That’s about it. Good luck - hope it works for you because when it works, it’s awesome.

Spend the time learning to calibrate the CGM. The MM CGM is a bugger to calibrate when BG are rising or falling to rapidly. Don’t put in a meter every time it ask you in the pump. Rapidly raising or lowing of BG during calibration will make it unreliable and not accurate.

The sensor and transmitter will not stay on my stomach so I have used my arm for the last two months with great success.

I use layers to adhere the sensor and transmitter. First, a layer of mastisol. Second, an IV 3000 with a hole for the sensor, Third, the sensor, wait five minutes. Fourth, another coating of mastiol under the transmitter and around the sensor. My last step is another IV 3000 patch over the sensor and transmitter.

Be patient, It will be frustrating for a while and again a few times here and there. The alarms will drive you crazy so you may want to adjust the setting to better match your needs.

You should be able to get two cycles out of each sensor. Just turn the CGM connection off, wait 10-20 min. then turn it back on and start it up as a new sensor.

Hope these items help. I’m still working on the CGM use and function. If you have an questions post them and maybe someone can help.

First of all, good move! CGMs are very cool. Now, that being said, there is a learning curve, so be patient. Will you be using the SofSensor? Kind of scary to put in. See if MM offers you a meeting with an educator; my educator used one herself and had great tips!

  1. Though the FDA approves 3 days for the Minimed SofSensor, 7 days is just fine. After the “Sensor End” message comes up, I just clear it and start a “New Sensor”. So I go Sunday to Sunday-ish with my infusions.
  2. Calibrating at either end of the spectrum of BGs is bad. It really helps out to do it when you’re at a good range, and have not eaten or taken insulin recently (before meals, right before bed, etc).
  3. Make sure they send you IV-3000s! Man, I used to get mad when I ripped them out accidentally. Cover the whole site with a prep.
  4. The other thing I have noticed, and only b/c I am a very sensitive skin type is to be careful to keep the whole area clean. I actually put down a pre-cut piece of Tegaderm or the like EXCEPT where the infusion syringe goes. You can shower with it connected and everything, but take a little isopropanol (rubbing alcohol) and clean under the sensor where you can, it will eliminate chance of nasty things like sneaky fungi or other yucks.
  5. RE_ORDER early ! The companies can be slow to re-send supplies, so don’t wait until its too late! (I guess the same applies to most pump supplies, huh?).

Best of luck, I totally love mine.

Re: love handles insertion. Went through 2 sensors yesterday trying to insert with Sof-serter in my love handles. Normally I have got it right first time, but thus time just not. Really frustrating, either the angle I was putting them in or the extraction of the need caused the little sensor tube to pull out!

Eventually got it right on the top of my bum, but jeez it was frustrating and knowing that I’m wasting big bucks each time!!

I just started on MM CGM 8 days ago (pump was started yesterday). One thing I have noticed is that I must keep well hydrated to help keep it accurate. I am so new and still on a steep learning curve so half the time I love it, the other half the time I don’t…probably to be expected. Good luck Tim

Thanks for all the great tips! My “blinded” trial for BCBS is done tomorrow night (its a formality I’m told), so by the end of this week or early next I should be approved and starting!

Still on the CGMS?

Wow, all great tips. I too get 6+ days from a single MM sensor. After 6 days, I generally take a break from the sensor for a couple days, then start up again. The alerts will drive you crazy, but I find that they keep me very alert to whats going on. I never start a new sensor before bed, only because that means waiting 2 hours to calibrate. Weak Signal, or Lost Sensor alarms will teach you where the good sites are, especially for sleeping. The transmitter is very small, and can easily be lost. Set a routine of where you keep it when taking a break, and be especially careful with it when traveling. I set one on a table at a hotel I was staying at, and the housekeeper thought it was trash, and discarded it. I did get a new one, but it cost me dearly$$$. I also use the CARELINK software, which allows me to work very closely with my CDE on basal rates, etc. Even after 45 years with T!D, I need an occasional shout, nudge, or suggestion. All done via e-mail. Love that allot. CMOP=Critical Measurements of Performance, and the CARELINK reports show me how I am doing 24/7, and help me set goals.
Curious how your doing Tim.
Best of luck!!
Jed

Jed't
I was on MM CGM for about 6 months is was fine in beginning then started having problems. When I called they always had me finger stic witch I had no problem with its just insurancw Anetna Medacare didn't cover a whole lot. I eventually stopped the CGM due to supplies ran and out and cost. I am a type 1 and also suffer from Multiple Sclerosis. I support the CGM my last A1c in Dec 2011 was great. Good luck with CGM