I have many questions, but I’ll start with one. Should I consider a CGM?
I usually do not have have a problem with night time low. Only happened once in the past 7 years. If anything, I wake up with a 110-140.
A few times I got caught with a low during the day…once I hit a 20 with out realizing it and was envolved in a minor accident. I can usually tell when I am going low, but this one time it did catch me off guard. A typical low for me is 70.
I am currently on the ominipod, which I love. I hate the idea of sticking another device on me. What do you guys think? Any advice. I am tired of sticking myself 6-8 times a day, but I am not sure if that it is better than going to another patch on the body.
Thanks for any advice.
Hi Jon.
I was in a similar quandary and shared many of the same sentiments.
I am now on week 3 of my new Dexcom. (it JUST noted that I am at 63 while typing this!).
I changed my thinking and realized that for me, whatever can keep my BG in range and thus lower my AIC is well worth it!
If your insurance will cover it, I would say GO FOR IT!
My endo gave me a week long trial run on a sample Dexcom that helped make up my mind.
I am just now starting to not watch the graph line constantly!
Good luck with your decision!
How’s your A1C?
Mine was decent, but with the CGM I realized that it was really an average of undetected lows during the night (in the 50’s) and higher peaks during the day.
I understand your reluctance to wear another device. I do not use a pump in addition to my CGM. But my endo and I agree that when the Dexcom/pump combo debuts (this Spring, allegedly), I really won’t have a good excuse not to use a pump too.
The CGM is another device on your body and (even more annoying to me) another device to walk around with. Omnipod has promised to fix the second problem (if you go with Dexcom) sometime this year but it’ll still be something extra stuck to your body and another thing to stick yourself with every 7 (or if you wear it like me every 12-16) days. With that said, my A1C was decent, about 6.4 - 6.8 most times before I went on my Dex. I knew I had wide sugar swings but they weren’t really bothering me. What made my decision was just the need for knowledge. I wanted to know where I was at all times. I can now say that because of the Dex and the Omnipod about 80% of my sugars fall between 80 and 120. It’s been wonderful being able to see it and use it. I get frustrated for the two hours it takes to start the sensor and if I have a bad sensor it almost drives me crazy. I think, even more than my Omnipod, the Dex has really allowed me to take control of my diabetes and know what I’m doing. It is the most useful device I have. Make your decision based on what you feel you can live with but most of the people I’ve talked with agree that the Dex allows for amazing control. I feel like a person again, not a diabetic.
I am very happy with my CGM (Dexcom) because I am extremely hypoglycemic unaware. I don’t feel anything until I am down in the 40s. I am still adjusting to CGM and sometimes it is significantly off. It does help me see what foods can do to me. I just figured out that rice takes a while to kick in and then it keeps going and going and going and sends me hyperglycemic even though I bolus for the correct number of carbs.
My Dexcom sensor is much smaller than my pod. I tend to forget it is on, and the one time I placed it below my waist, I ripped it out when I was undressing. It wasn’t painful, just annoying that I ripped it out on day two and wasted five days. If your main concern is yet something else stuck to you and you are considering the Dexcom, maybe you should wait until the Dexcom/Omnipod integration takes place later this year (hopefully).
Brad
This is the first I have heard about Omnipod/Dexcom intergration…I heard about Animas and dexcom. Any other info?
About a month ago there was a stockholders report posted on the Omnipod website saying that the Omnipod PDM was being submitted for approval as a Dexcom receiver in the first quarter of this year. They also had some pictures of screens with the Dexcom readouts, search the posts, it’s in TuDiabetes somewhere. This report disappeared from their website within days but we’re still hoping that it’s true. 
I think tha the most important question hasn’t been asked, so here it is: How often do you find yourself (per month) below 60 mg/dL in the daytime?
You don’t need to reach 20 mg/dL, or even 40 mg/dL, to become “under the influence” for driving or operating power equipment. And in fact, with an accident already in your driving record, the licensing people are likely to revoke your privileges if you ever have another accident with sub-normal bG levels. “DUI” from prescription drugs is getting a lot more attention that it used to, and many States are becoming much quicker to revoke driving privileges.
To say nothing of how YOU’LL feel afterward, if you cause an injury to someone while Hypo.
But if your only reason is to avoid pokes, and you’re not below 60 more than a couple of times per month, then I don’t think you’d like it. IMO all of the alarm buzzing, the Sensor shoot-in, and the carrying of the Receiver is a far bigger hassle than a mere half-dozen finger pokes. Add on the recharging, the “where did I just leave the durn thing”, and vastly greater uncertainty of the readings, it’s a lot of trouble (and maybe money) for something of little benefit.
Nearly everyone I know who likes CGMS knew that they NEEDED one of these things. And wanted to get one from the moment they learned of the devices. (That includes me, of course; I bought my first Dexcom just a few weeks after it was approved.) If you don’t feel a need for more “safety” and “confidence” and “control” in your bG management, then I’ll guess that it’s not something you’ll like to use.
Just a guess though. Doesn’t your Endo have a “loaner” to try?
I have been using the Dexcom for a few months and felt pretty much like you did before I started. I have been pretty successful using it and have experienced the typical search for an acceptable spot for the sensor/transmitter (the hip/buttock area works well for me) and similar to you the last thing I wanted to consider was a second device to wear in addition to my pump (Animas Ping). Now I would not give up my Dexcom and feel like I am missing something for the few hours when I’m without accurate readout while swtiching from one sensor to another. Bottom line is if you are so hypoglycemic unaware that you did not sense a BG of 20 there were probably a lot of other times when you were low and did not know it. I don’t have many downsides except it is yet one more thing to do. Good luck and let us know how you make out. -Allen
I agree with what the other members have said. I had good control with my pump, but I did have too many highs and lows. The Dexcom CGM has enabled me to see oncoming highs and lows very early so I can do something to keep them from getting worse.
The most frustrating thing when you start with a CGM is that iths numbers may not agree very well with your fingerstick results (meter). I had very little agreement for my first two weeks. Then I joined the Dexcom users group and the members helped me very much. People like Rick (see his post in this discussion) gave me hints you will not find in the manual. Now my Dexcom and my meter agree very well 80-90% of the time. There is only an average of 6-8 points difference the great majority of the time. I still use my meter whenever I bolus and before I drive my car. I also am having occasional gaps of approximately 20 points between Dexcom and meter results. Therefore, I cannot completely trust the CGM and I have not reduced my number of fingersticks by more than 30%. My A1c was 5.8 before I started using Dexcom, and it was 5.6 one week ago when I saw my doctor for the lab results. I give Dexcom the credit for that improvement. That is definitely incentive for continued use of my Dexcom.
Nope, they can only give you the official “target date” for submission to the FDA. (Corporate policies against pre-releasing non-public information which could affect stock prices are very firm, lawsuits could result.) AFAIK, Insulet hasn’t offered a new “target date”, so they’re later than they had originally hoped for. The FDA list of recent PMAs (through the end of January) doesn’t show it having been submitted yet.
Animas has a target date of “3rd or 4th quarter”, which I take to mean 4th quarter at best, probably not available until next year. Many of us remember Abbott promising that the Abbott announced “plans” to have the Navigator CGMS available for sale at all kinds of dates in 2006 and early 2007; the real date missed by almost a year and a half.
RITA, YOU OWE ME A NEW KEYBOARD.
(LOL, I’ve got to stop drinking coffee while I read these forums-- sometimes it goes everywhere.)
I got my Dexcom because I was having scary nighttime lows and my daughter put her foot down! It has really helped catch those and wake me up in time to fix the low before it gets bad. It’s also great to have the trend data available during the day so you can see which way you’re headed and intervene with glucose or exercise. One thing I didn’t expect was that having the Dex allows me to test the effects of various foods. I’m a patient of Dr. Bernstein’s and I follow his diet pretty rigorously, but it’s very restrictive, and I’ve been wondering if it needs to be quite so much that way (no milk, no fruit, no grains, etc.) It occurred to me that I could use the Dex to test that. So I ate some strawberries (my first fruit in over a year – I can’t tell you how good they tasted!), and then watched my trend graph. To my amazement, it stayed level, so strawberries are back on the menu for me.
I love my Dex and already cannot imagine life without it (and I’ve only had it for a week and a half) – but Jon, be aware that you will still be sticking yourself 6-8 times a day even with a CGM. The BG values themselves are not always that accurate.
I guess I really don’t understand Ann. If I am still pricking myself all the time, why bother with a CGM? I am not prone to nighttime lows, (usually that will catch me off guard during the day). I currently use the omnipod, which I really love…worship…etc. Maybe if they integrate the two, I would be more responsive. I just hate the thought of having two things stuck on me, and carrying two different PDM’s. What are your thoughts? I want to have more control of my diabetes but I do not want to make it my life. You probably understand that. Only a diabetic would.
The integration between pump and CGM will only be at the data level. You will have to wear an additional sensor that is injected into your skin.
With 6 tests per day we have only assumptions about the BG between the tests. Mostly the BG will behave as expected but I am sure that most new CGM users will learn something new they did not know or expect about their quality of control. Thus even a short period with a CGM can be helpful. You can get an impression of the dynamics of the BG here (Dexcom data).
I have definitely learned a lot in just a week about what my BG is doing between tests and I love having that knowledge. I’ve already done some fine-tuning to my nighttime Levemir dose. I had initially resisted the idea of a CGM because I didn’t want something stuck to me, but it really hasn’t been bad. Of course, I don’t have a pump, so it’s only one thing. I can see that two would seem like a lot. I think if you have ANY lows that catch you off guard, a CGM would be a big help.
To clarify:
No matter what, the kind of “Dexcom integration” which is being worked on by both J&J and Animas will still require that a Dexcom Sensor be shot in separately from your Pod and it’s infuser. But, your “upgraded” Omnipod PDM will replace the Dexcom Receiver/Controller module.
So right now, you would have two PDMs. But in the future, you’d need only the OnmiPod controller, it would manage both the Pod and the CGMS (displaying graphs, ordering the Dexcom Transmitter to send CGMS readings, and etc. – just like the Dexcom Receiver unit does now.) If you really, REALLY find just 6 pokes a day to be adequate for “good control”… then you don’t need the hassles and expense, even though the Dexcom Sensor (once started up) is so trouble-free that I frequently forget which side I’ve got currently got it shot into.
And unlike a Pod, my Sensors can typically last for 14-17 days each. So the hassle of choosing the next site, washing up carefully, preparing the site, and doing the replacement occurs 1/5 as often. But if, OTOH, you really, REALLY want better control than you’ve got now, this is probably the best way to get it.
Personally, I was a lot more fixated about “hope this works, hope I haven’t made a mistake, hope something doesn’t bite me in the butt unexpectedly” BEFORE I got CGMS. Even though I’ve got another gadget online 24x7, I feel much more “free” of diabetes management now.
Rick,
I totally agree. With the Dexcom, I’m much more calm, because I know what’s going on all the time. With the finger sticks, there was always that element of (unpleasant) surprise – “Yikes, how did my BG get that high? or that low?” Now that the information is always available, I don’t have to obsess about it, and that is very freeing.
Great to read this discussion, I am filling in BG logs for Dexcom this weekend, done this once before but my son endo wanted us to wait for the Omnipod intergration. Great to hear possibly this spring for roll out. Will call Omnipod today for an update.