Which CGMS to choose?


#1

I am going to ask my endo to prescribe a CGMS. I have good control of my BG but I want great control. From what I have read a CGMS can help. What criteria should I use when deciding on a CGMS? What features to look for etc?

I guess I am moving one step close to becoming a borg.


#2

I have the impression that there’s a higher rate of “doesn’t work for me, I QUIT” incidents with Minimed. But they work pretty good on a lot of people, and Dexcom has frequent “this sucks, I QUIT” events too.

The only way to know which works better for YOU is to try both-- preferably, at the same time. Dexcom sells with a “money-back” guarantee, but Minimed doesn’t, so you’ll need your Endo to work a loaner/trial for you.

Minimed can use a 522/722 pump as the “monitor/receiver”, that’s very convenient if you already own (or are about to buy) a compatible pump. And the Minimed receivers (stand alone “Guardian” or pump) are quite waterproof if the seals are in good condition, while Dexcom’s receiver is not- splash it on the wrong place, even for a moment, and it’s dead. (Wrong places are the control buttons, and the data port on the side, and the hole to open it for servicing on the end, so there’s “wrong places” all over the durn thing.)

But other than that, and the much higher Sensor prices, Dexcom is nicer: the Transmitter doesn’t rub on your body, the Sensor taping pad holds up a lot better, and for many people (including me) it is way more accurate.

But YMMV! It’s very possible that NEITHER will work for you, so don’t put your money down unless you can get it back!


If you’ve got “good control” with no problems, I wouldn’t bother. Really! I have hypo unawareness and strangely flying bG levels (not related to food intake or insulin, probably something broken in my liver), so I need one. But they’re expensive and aggravating and not anywhere near 100% reliable; if you can get by WITHOUT, wait for much better future models. (NOT Navigator, it’s NOT really any better than the Dex.)


#3

Rick,
I just found out that I do have “good control”. The results of my last A1C had come in and my wife had forgotten to tell me. My A1C was 5.5!!! I feel silly saying it but… I am excited about this. All that finger pricking and controlling carbs has paid off.


#4

Hi Khürt,
The answer depends on a lot of factors you did not share. Are you Type I or 2? If 2, do you use insulin? Do you have many hypos? Are you worried about night time lows?

With an A1C of 5.5, the need for CGM seems slim unless you have lots of hypos.

Features that were important to us (my wife is Type I for over 50 years) include how long the sensors last, how they survive showers and cost. Ease of reading the receiver was important to her and the software appealed to the geek in me. Accuracy is important to both of us, but we have not found any convincing comparison.

Another important factor is the karma of communication with the factory rep. We chose DexCom based mainly on comparing their rep with the one from MiniMed.


#5

I just started on my Dexcom Seven today, so I don’t have much advice for you yet. Since my insurance covers nothing, cost was an issue for me. Also, my endo, who is diabetic, has worn each brand, and hooked me up with the Dexcom.


#6

I am Type 1. I am mostly worried about low since I have very tight control of my diabetes (A1C is 5.5). I have had a few scares (BG in the low 30s) and a CGMS would allow me to sleep more peacefully.


#7

Hi Khürt,

Thanks for sharing your status and your concern. Tomorrow my wife is to receive training on her brand new DexCom Seven. She was diagnosed with Type 1 50 years ago during the dark ages of diabetes. Her control is almost as good as yours, at about 5.6. She too worries about lows at night and we both look forward to better sleep. Too often when we suspect a down trend we set an alarm for 3 am to test and find out if a snack is needed. Now the alarm will go off only if it IS needed.


#8

Toni, that seems a bit “odd” – Dexcom is much cheaper to BUY, but the $60 per Sensor swamps the initial price difference pretty fast.

Now for something important: If ANYONE is gonna order a Dexcom in the next few days (before January 1), please advise a current user of the “Seven”. (Not me, I’m still using the old one for about 4-5 more months.) There’s a great offer for referrals–

“In the month of December, when you refer a friend who purchases a Seven CGM Starter kit and two Sensor 4-packs, you will received a free Seven System Sensor 4-pack”.

The Starter kit remains at the “promotional price” of $450, and the new user is gonna need Sensor packs anyway. So by buying two 4-packs right away (at the regular price of $240, which they never discount) you can pair up with a current user and let them “scalp” you and get a free $240 4-pack…

For which they should certainly be able to come up with suitable appreciation :wink:

Everyone needs to triple check, though, that all these spare unused Sensors can be returned for 100% credit, if it doesn’t work for you.


#9

Another slightly OT: when you are in possession of more than one box ofDexcom Sensors at a time, and they might last until very near (or even PAST) the expiration date-- you can extend their life by keeping them in a wine storage refrigerator (cool is good, but getting to close to freezing KILLS THEM). My 8-bottle-sized wine fridge is at 49F. Maybe 45F would be even better, but I’m afraid to go any lower. Your “normal” kitchen fridge is almost definitely a no-no for Dexcom, although Minimed stores in the fridge pretty well.

Cool and STABLE temps. I imagine that most of the possible lifespan gain is made in going from 70F down to 50F-- those degradation processes which are still occuring rapidly at 50F probably won’t get slowed down much by going down to 45 or 40. (They won’t last forever, no matter how you store them.)


#10

“to close to freezing” == “too close to freezing”.

Sorry, I can’t edit the typo while running a pre-release of Firefox 3.