Trouble with CGM

Hi everyone, I’m new here. Just wanted to see if anyone else is having trouble with MM CGM. Got mine several months ago, and can’t seem to make it work. Painful insertions, inaccurate numbers (off by more than 100 points sometimes), adhesive is worthless, lots of bleeding. I’m having so much trouble I end up not using the thing most of the time. This was supposed to be the “magic fix” to make diabetes more bearable. I’ve been dealing with D long enough to know there is really no magic fix, but I’m really frustrated to have so many problems. Is anyone else having these issues, or is it just me? Endo said cgm just doesn’t work for some people. Is that the truth?

My son has the MM CGM, he said the tape comes loose and he always puts some medical tape over it. I gave him a roll of Opsite Flexifix and that has been holding. He said he will have pain if the insert hits a nerve, and he’ll sometimes have bleeders. And sometimes it will be off by up to 100 pts, other times within 5 pts. Sorry to hear that you’re having so many problems with yours. I have the DexCom CGM, love it, and really wish MM would improve theirs, for your sake, his sake, and everyone else who uses it.

Sorry he’s having problems with the MM CGM. I get those bleeders also if I inject in certain places. I believe MM has a new sensor that will be available within a year. The introducer needle will be shorter and the inserter will not allow you to view the needle. It’s also SUPPOSED to be more accurate.

Hi Sarah and welcome. I use the MM CGM and there is certainly a learning curve. I would recomend that you join the CGM group and review some discussions relating to your troubles.

I generally wear my CGM for a week and inserting a new one is often the least favorite part of my week. I also cover the device with a tagaderm-like product. It helps keep the device in place and you can wear it in the shower. Also the tagaderm will contain any bleeding you may get. I also think a little bleeding is the sign of a good sensor.

Calibration might be the hardest part of the learning curve. My CGM instructor told me to calibrate "before" as in before eating, before bolusing, before exercising and before bed. The main point being that you want to calibrate when your BG is stable and in a normal range (80-140)ish. I usually calibrate 4 times a day so that the CGM does not "force" me to calibrate when my BG is unstable or high/low. My CGM is very accurate with average numbers (80-140) and loses its accuracy toward the extremes. If high or low I would recomend a fingerstick (NO calibration) and then the appropriate correction.

I read on a post that the CGM uses your last 4 calibrations to develop its algorith to convert the ISIG number to your BG reading. So if you calibrate with an improper BG you will need to do 4 more calibrations to purge the bad one. A new calibration can be done 15 minutes after the last one (when it clears from pump).

I hope some of these tips and tricks work for you. But, unfortunately like your endo said a CGM may just not work for everyone.

I will agree with your endo, and I do wish all could run a trial of both the MM CGM and the Dexcom before buying. While I have switched to the Dexcom, and am very pleased with the results I get while using the Dex, I to began with the MM (having one pump/cgm receiver is nice), and had a big learning curve to get the thing to work part of the time. I learned so much by reading the posts from others about what does and does not work, and then was able to modify as needed to make it more suitable for me. Things like I learned to ice the area before insertion, as I always would bleed and it also diminished the pain. To insert the night before and start in the morning (even with the Dex it likes that for me). When to ignore the readings (night times were the worst for me with MM, no clue why, but I never got accurate numbers. Days ok, nights forget it).
Good luck. I understand MM is coming out with new sensor, maybe will be better if you can upgrade to that one.

You probably could benefit from a session with MM rep or event group class. Lots of things to do. As to variations, there are weird occasions where the CGM goes off the charts too high or too low and those are usually associated with reapidly rising or falling BG. In other words, it drops from 100 to 65, but the CGM goes to 35 or 100 to 140, but the CGM goes to 300. However, discarding those crazy numbers, once I got the hang of it, I find the CGM to calibrate within 5-10 of meter and, looking at averages for the past 31 days, CGM and meter are within roughly same range and both then predictive of a1C.

I have spoken at lenght with MM they assure me it must be user error, imagine that. : ) I have given Capin’s advice a try and the thigh seems to be working better for me. I have been experimenting for the last couple weeks and it seems to be more accurate if I let it “soak” overnight and calibrate first thing in the morning. The down side is I still have not been able to get more than three days from a sensor - numbers were ok, but it starts to itch terribly by day three. I’m also disappointed with cgm catching lows, the alarms are always way after the fact (thirty min. or more sometimes). I am not a very nice person during hypos so I guess I need to fine tune things a bit. What # do you have as your low threshold?

Glad placing the CGM in you leg is working out for you. I find the CGM’s accuracy is mostly correlated with my calibrations. I let the sensor soak for 20 minutes before I plug in the transmitter. The CGM will take the full 2 hours to adjust before I get the BG now message. The CGM is not always that accurate untill I calibrate for the second time and then it is usually pretty accurate. I have had some senors get itchy like that and when it gets to a point I believe I am fighting a losing battle and the sensor will become too much for me to bare soon.

I have my CGM low threshold set at 81 and a 20 minute predictive alarm alert. Through trial and error I have that when my CGM hits 81 my BG is usually 67-73. I previously had my low at 80 and my BG would usually read 60-66. That was too low for my comfort. That change from 80 to 81 for the sensor low has really helped me and I would encourage you to run your own trials. I plan to treat anything 70 or lower and possibly treat higher depending on my needs.

I have found that my CGM usually is just begining to trend down when I am going hypo. I think the lag time between SG and BG may be the reason for the discrepencies with my hypos.

The specific policy for my carrier provides a $1,500 annual cap on DME, but has no deductible. While the transmitter is considered DME, the disposable sensors are treated as drugs for copay purposes by a simple definitional change in the specific medical policy. In other words, the sensors are actually DME, but are treated as drugs for copay purposes only. This way, I pay the same copay as for a drug, In addition, if I use the carrier’s PBM, I receive a 90-day supply for $60 which works out to $240/year. All of this took some research, but it was doable. I have no idea whether that is the case with your carrier or specific policy, but the research function was critical.

If you can afford it, i would switch to the dexcom - I trfied both and for 1000 dexcom will sell a kit with a montghs worth of sensors - its a modest investment for one’s health! Dexcom is hands down the best CGM

Here’s the update on the “thigh trial”, outer thigh got me 3 days, inner thigh didn’t last even 2. I actually watched it slide down my leg in the shower, such a disappointment. It even had tape on it, but just wouldn’t stick. I’m now trying out the back of my arm (had to have a little help getting it in). After 1 day it’s still sticking and numbers are fairly accurate. But boy am I getting some weird looks from people, I don’t mind explaining all my equipment, but I don’t really want to be the poster child. The arm may be a winter only thing, we’ll see. Anyone else using the arm?

For me, the one key to getting successful readings with the MM CGM is location! It will only work in my upper stomach. And even then, it’s always a gamble.

I don’t care what MM said, sometimes the position just gives off readings. I find on some of my “bad” spots, that it can rise and fall based on something as silly as if I’m standing or sitting. e.g., if I’m standing, the sensor reading will drop off and show my BG as falling drastically even if it’s not. While if I’m sitting it will get back on target. And sometimes the exact opposite is the case. And sometimes a sensor is fine for a few days and then starts doing this, and other times a sensor is terrible like this a few days and then fine after that!

The whole thing can be pretty ridiculous! And yeah, you call MM and they’re of no help what so ever and just say “user error”. Or they’ll gripe at me for ever looking at the ISIG.

All that said, I’ve had my CGM for 2 and a half years, and while it’s a headache to learn the tricks, it was so worth it. I cut back my insulin use and learning what my BG was doing over night or while exercising was beyond valuable. I’m going through a phase of not wearing it right now though. I’m wondering if my transmitter is kaput, because the last several sensors I tried gave me problems constantly and weren’t lasting as long. But I’m doing okay without it right now… hearing they might be improving the sensors finally makes my day. I really hope this happens this year.

Good luck!

There is a cure to MM sensor issues

It is called DEXCOM!! No I dont work for them.

Dickengel, you seem to be a big supporter of dexcom. I’ve seen you endorse their cgm on this and other post as well. sounds like you have a story to tell…give us a run down of pros and cons and your comparison between MM and dex. Are you a doc or just a seasoned PWD?

I am not a Doc. I am a PWD of 32 years pumping since 1990 and CGMing since 1st of this year. I tried both before buying in December. First the minimed and it hurt putting in the sensor and this from someone who tells the Red Cross blood donating nurses - Ive been poked and proded for 30 years - you can’t scare me with a needle. Well the minimed hurts on insertion and right away the trainer was looking for blood and she found it. Took about 10 minutes to get it to stop. Anyhow after using both units, the MM the week before Christmas and the dexcom for christmas week and the week after, i felt that the Dexcom was much more comfortable, and much more accurate. I really wanted the MM because it was integrated, but went with the Animas Pump and Dexcom CGM because they will integrate in time. After wearing it for 4 months, I am pleased with the choice of dexcom and no longer want it integrated. I keep the Dexcom out to check frequently and its easier with it not being tethered to me by the infusion set. Under the covers at night I do not hear the alarms so with the Dexcom, I put the receiver on the night stand and quickly hear it vibrate. When driving I like to keep it in the console and these are all things that would be difficult to do if it was the integrated MM. I also bought one for my wife and without it teathered, It is easy for me to review her numbers. This should be a plus for parents of little ones. So for the most part, I am a big fan of Dexcom! Is it perfect - nope not yet but its the best we got Additonally these old diabetic eyes have trouble with fine fonts and the Dexcom is far easier to read than the MM… One other thing, the alarms were a pain to silence on the Minimed - had to push 2 different buttons in the proper sequence. The Dexcom is a breeze by comparison. I am glad we have more than omne company which should drive competition and bette products as they each try to one up the other guy!

thanks for the info. I’m definitely leaning toward the dexcom when my insurance will cover it again. (Just got the MM CGM last July) I think that will probably be at least 3 more years. I’m crossing my fingers that the Animas/Dex will be integrated by then. I really need the integrated system becasue I"m constantly on the move (stay at home mom with small children) I hear you need to be within 4 ft of the receiver for it to work properly, not sure how that would work with me running from room to room all day long. I guess I could buy more pants with pockets : )

Sarah

I have used both CGMs and can tell you that the Dexcom is so much better than the Guardian/Revel. Since I was sporting a MM pump 3 years ago I went with their CGM. Used it 18 months and finally got so frustrated with its inaccuracy and failure rate that I threw it out and told them not to send me a replacment. A couple months, maybe 6 weeks, ago I started on the Dexcom and have not regretted it for a moment. It is great in comparison to MM’s version. The first 24 hours are iffy but after that I find it is so close to finger sticks that I am in awe each time I check.

Good luck! I hope you’re able to swap the Guardian out. If not, when the warranty runs out in 6 months you can always go with the DEX.

Yes pockets are good - I keep my animas in my pant pockets and the CGM in my shirt pocket. I think that the CGM is allowed annually, the Pump every 4 years

The Dexcom Gen 4 sensor reportedly has a 25 foot range. You are right though that the current Dexcom sensor means you have to be fairly close to the receiver (e.g have it on you when moving).



I will echo Dick’s comments as far as Dexcom having the best sensor (for me anyways). I believe that MM’s sensor is a viable option and if my insurance ONLY covered MM it would be worth using. However, all other things being equal (namely $$), even not being integrated with a pump, Dexcom has a superior product. The next generation of sensors from both companies may change this but until then…

I, too, have had difficulty with inserting and wearing a CGM. I do one thing that seems to help a bit with the insertion pain and bleeding. Before you insert, apply an ice pack of some sort–to the area you plan to stick–so that area will be chilled well (like a glass of white wine!) and then apply your disinfectant and stick in the lance. Hold the inserted area for about 5 minutes and then take a look to see if there is less blood. Hopefully, YES. Use a good non-latex tape like Smith & Nephew, too, after you insert everything. You will notice variation in your numbers (between the CGM and your meter), but it is still helpful to look at the overall patterns. It also helps me with avoiding extreme lows by warning me when I get to a certain level. You will also learn how different foods affect you and how to avoid the extreme highs. It TAKES TIME to master the CGM, but you get better at it. But, sometimes the above interventions (for insertion) just don’t work and you have to start over, which is a bummer. Do you have someone you can call when you need help or encouragement. I have found the Medtronic folks not to be very helpful. They just say the same things each time. Good luck, Sarah.