Trial week with CGM, what was yours like?

Has anyone else had difficulty getting used to using a CGM? My doctors office has a Dexcom 7 and partners with the local sales rep to let patients try it out. I’m on day 6 of 10 if the sensor will last that long. With this arrangement I have only the sensor/receiver, no software to download data and see what that provides. We will do a download when I return it.

I’m a little overwhelmed about what to do with all this information. Yesterday (day 5) was really the first day where I’d have an urge to look at it and I was able to resist because looking at it too often isn’t the point. I know the point is to use it as a trend tool.

At this point I would say I’m a little disappointed that it works they way they said it would, meaning that I still need to use a meter. LOL! Of course that’s not fair at all!
I’m really just looking for tips and advice on how to make the CGM experience more rewarding. How did you shift from many years of pre and post meal testing to this? Is the key to just get past the newness and only look at it when I would do a finger stick?

Other observations:
#1 - Generally the max difference from a finger stick seems to be about 25-30 points. If a meter is only accurate to 20% and the CGM is 20-30 points off of that, this doesn’t give my technical side great confidence.
#2 - The range is rated at 5 feet, but mine goes out of range several times a day while it’s in my pocket or on the desk in front of me. Maybe not a big deal and related to looking at it obsessively.
#3 - Seems larger than it needs to be. Feels and sounds kind of hollow.
#4 - It seems to read low before I feel low (good to err on the side of safety) but then it also stays low after I correct and feel okay. Does you body pull glucose out of your interstitial fluid during lows?
#5 - If I take novolog 15-30 min prior to a meal the graph remains nearly flat for 2 hours post meal and then begins rising.

Wish list:
#6 - Be accurate and reliable enough to replace finger sticks.
#7 - Alarm not loud enough to wake me up.
#8 - If it can’t replace finger sticks, put a meter inside the receiver so I don’t have to carry two pieces of stuff. See hollow comment above, use that extra space for one more microchip.
#9 - Make range about 20 feet so I’m not always tethered to this thing! It sometimes drops out while on my night stand, and I’d like to be able to walk around a room without concern of Dexcom range.
#10 - Alarm has no snooze function - alarm me again in 30 minutes if still high or low.
#11 - Ability to enter times & values for insulin & food and represent them on the graph. I’m a one touch ultra smart user and really miss this. Also put a time label on the horizontial axis of the graph. It’s blank which is just stupid!

Welcome to the world of CGM. it does take getting used to and some understanding. I’ve got to keep in mind that it’s a tool, not a magic bullet. Here’s my experience after using the Dexcom System for two years (not daily. I use it when my BG start spiraling out of control and it ‘helps’ me get on track - I say 'help" because I still have to do the work.)

#1. Don’t sweat the difference between the meter and the CGM. The meter measure blood NOW the CGM shows interstitial values which is where your blood was about 15 minutes ago. Focus on trends rather than the absolute number. This was a hard lesson for me to learn, but once I did I used the CGM to much greater affect. The question to ask when looking at your CGM is not “what’s my BG?” but “am I on the way UP, DOWN or level?”
#2. I’d like to see longer range too, but even with the occassional out of range blank spot, I’m still getting a hell of a lot more data than I do with fingersticks alone.
#3. Yeah, but that’s true of all the crap we carry around. One day I’ll have a Dick Tracy wristwatch/cellphone/pda/cgm/meter/pump.
#4. It takes time to catch up with your blood. Again, don’t focus on the absolute value and try not to compare how you are feeling to the number. I sometimes feel low at 80 yet don’t notice a thing when I’m as low as 65. This is more a human condition phenomenon than a CGM phenomenon, IMHO.
#5. My conclusion is - congratulations! Your timing and carb counts are right on! (But your Basal my be off.) Two hours is about when your insulin has peaked and is starting to lose its effect, so it makes sense that your BGs would start rising. The question is how fast? The CGM can tell you, but fingersticks won’t.

Wish List:
#6 - Check
#7 - ??? - My alarm(s) wake up me, my wife, the kids, the dogs, the neighbors, the guy on the tarmac directing the planes at LAX 10 miles from here. Not the first one, of course, but the next one.
#8 - Check. Although the latest firmware upgrade allows you to calibrate with ANY meter, not just the OneTouch Ultra.
#9 - Check.
#10 - ??? - My alarms are annoying and go off TOO much. If you don’t “OK” the alarm it goes off again in 10 minutes even louder than the first time, and louder the next time. It USED to go off when BG was going from high to low and then again on the way back up. Now it only alarms on the way down. (reversed for high).
#11 - The time axis is a long-standing request to Dexcom. I was told it was planned for the Dexcom 7, but I guess they forgot. As for the other functionality - yeah it would be nice, but personally I input that in my pump. With all those features, it may be difficult to make the unit smaller. (See #3.)

Additional Wishes:

12 - Mac compatible software.
13 - Data export

I use Medtronic’s cgms and at first I checked my trends often. Now once a week I will download my readings and look and see where I need to tweak. It has helped me a lot with being able to adjust my basals. My 30 day average meter reading is 134 and my 30 day sensor reading is 122 so for me it is pretty close to being accurate. I love having the ability to see if my sugar is rapidly raising or lowering so I can adjust when it is needed to prevent that. I seem to have a reaction to the adhesive on the sensor but not on the infusion sets. I do wish it was louder, the alarms don’t wake me up but the vibration does. For me there is a 10 minute lag time with readings between cgms and meter.

I hang the Dexcom on my headboard right by my head.
I like my Dexcom because it makes me aware of how certain foods affect my bs. My goal is to try to avoid serious spikes after food consumption. It also makes me think twice before eating certain foods. A motivator. I like that it wakes me in the night before I’m a couple hours into a serious low.
Oh yeah. It did take me awhile to get the hang of it.
I agree with comments made by Terry and Cody.

I have left over sensors as I am not that thrilled with the CGM and now my new insurance company denied payment, but here are some posts where I have talked about the CGM

That’s too bad Karen. I had thought it was going better for you. Which one were you wearing? It has really helped me with trends, and I adjust my mealtime bolus according to weather I’m going up or down. As for the alarm, funny thing is it wakes up my husband, but not me! Well, he doesn’t find it as funny as I do!

I use the Minilink CGM that works with my pump and I have to admit that I am addicted to using it. There are the times when the numbers it provides are way out to lunch but for the most part it is pretty accurate. Most of the time and effort is takes place when I am setting up a new sensor but once I get it going I leave it in for 15-25 days or until the results are way out of line.

I don’t use the alarm because I have to admit it drives me crazy. The Medtronic CGMS does have a snooze but the alarm feature is still annoying. If I were someone who had issues with severe hypoglycemia then I would be all over this feature as this may be one of the best selling points for using CGM.

I really enjoy CGM because I have been able to cut down on the amount of finger sticks I do a day from 6 to about 4. I have studied my data to the point where I can keep my BG with in the green zone, 70-140 on a daily basis. I have done this by adjusting my diet, exercise and most importantly tweaking my basal rates. I look at the trends and not as much the BG number that it spits out. If I see that every night at 9pm my BG is above 140 I take a good look to see what I am doing that is causing this so that I can fix it and make it better. As Terry said it is not a magic bullet, but it can help improve overall control. The longer you use it the better you get at being able to determine how accurate it is at any given point.

CGM is still new but like insulin pumps, computers or any technology it will get better with time, at the moment we are the lab rats testing it out so that in the future it will be almost perfect!!

I wear the Minimed sensor and love it. There was certainly a learning curve to it. The longer I wear it the better it works for me. I don’t know the sensors themselves have improved? my body has adjusted better to them? or I have just learned how to use the technology more effectively.

  1. Most of the time I only have a 5-10 mg/dl difference (except during exercise).
  2. Range is 6 feet but won’t always reach accross my thin body but alarms when it is in the drawer and I am in the shower???
  3. Mine radio frequencies directly to my pump. Very nice!
  4. Since I have hypoglycemic unawareness this has been a lifesaver many times over for me.
  5. Remeber that when you eat, the sugar gets to the blood stream first before it is carried to the cells ie the interstitual fluid so it makes sense that it will take a little bit of time to get there depending on how much protien and fat is in the meal.
  6. I checked my BGs even more frequently at first to test the sensor but now I trust it more and have backed off a bit. They are working on that technology. I think (and hope) it can only get better.
  7. Mine doesn’t usually awaken me the first few times but it gets louder and louder and then vibrates. It will eventually get my attention.
  8. Like I said, mine beams to my pump.
  9. same as #8.
  10. Mine has a feature to set how often I want it to alarm and even when I cancel the alarm, it will alarm again if not in range.
    I download my pump every week and have made a lot of different changes in basals and insulin to carb ratios. I don’t have another A1c but my variability is MUCH improved. I love it. Hope it works well for you after you get the “bugs” worked out.

im using MM CGM system and i love it. I am addicted to it and i dont know what to do without it. I just love the idea that it gives me with the trend my BG is goin. my CGM played a great role in improving my A1Cs, now im at 6.2 and still workin down to 6 at least. since I started using it, May of this year, i havent gone too long without using it. im just giving myself maybe couple of hours break after i took the old one out and before I insert a new sensor but like David, i usually leave it on bout 10 days or more per sensor.

it is just a matter of getting used to it. once you get the hang of it, then you’ll get addicted just like the rest of us. I remember being so scared to use it the first time, those needles(inserter) are just too big, I dont even use the serter at first, but now, i dont even feel it during insertion.

I would say CGM is worth a try, for people who havent tried one. and for those who dont like it, i guess you wanna give it a second try. learning how this thing works is the key. but like everyone said, this is not to replace the fingerstick testing, this is just a tool to help us manage and take a good control of our D.