Why I don't want a CGM

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1

My pump manufacturer, Animas, announced recently that they are joining up with Dexcom to incorporate CGM technology into their 2020 pumps - Yahoo Finance - Stock Market Live, Quotes, Business & Finance News - and it got me thinking about how that’s not a road I’m too keen to walk down.

I've been doing this diabetes thing myself for about 1.5 years now. I've lived with my mom's own brittle T1 diabetes for the 22.5 years that preceeded my own diagnosis. I know all about fluctuating sugars and the benefits of knowing where you're at. Even so, there are a host of reasons that I'm not stressing my lack of CGM right now, nor am I too worried about jumping on the bandwagon in the near future.

1. I'm (generally) predictably in control - I'm getting pretty good at dancing the dance and being able to gauge the outcome. Maybe that's a factor of my age, my diet, my own continued insulin production, or luck. I don't know, but it's working well for me now, so I'm gonna go with it.

2. The variability of accuracy worries me - I hear stories. Sometimes they are spot on, sometimes they are 200 points off. I understand that they are going to have accuracy issues, just like conventional meters do, but those issues would aggravate me, and I see no reason to add such aggravation to my daily routine right now.

3. I'm not having babies anytime soon - I don't need to be in such religiously tight control for procreation purposes.

4. I don't want to deal with alarms, especially if they are potentially incorrect or about lost sensors.

5. I don't have any problems with hypo unawareness or not waking up when I'm low.

6. I don't want to give my diabetes any bigger a stake in my life right now - I think this is the main reason I don't want to sign up for a CGM. There's a certain danger for obsession that I think would come with my having access to my BG numbers every five minutes. That's just how I am. Though a CGM would certainly keep me more informed about what my BG is doing and maybe even why it's doing that, I do not want to give diabetes the invitation to dominate my thoughts right now. Control can go either way, and I'd like to remain the one in power.

I can't stress this enough, THIS IS AN ENTIRELY PERSONAL DECISION AND RATIONALIZATION BASED ON MY OWN EXPERIENCE. I'm sure I'll change my tune in a few years. I'm sure I'll eat my words eventually, but for right now, I'm happy to step to the back of the line and let Blue Cross pay for everyone who is ready for the technology.

2

Ooh, I have Blue Cross, does this mean they are gonna pay for my CGM? Lizzie, you don’t have to defend your decision. I’m sure, just like the pumps have, the CGM will make strides over the next several years and models. I have a 2020 too… don’t you just love it? I do struggle with hypo unawareness, so the CGMS is great for me. I do get frustrated when the accuracy gets off once in a while though, so I understand those concerns!! Glad your staying in control!! Cheers!

3

Lizzie,

If you have read any of my posts, you have seen my long fight for the CGM and I started using it two weeks ago and all you have stated above I am finding very true for me, not too happy about it, but you are so right on most of your comments.

4

Lizzie,

As Windy noted, CGM systems are still in first or second generation, and there are indeed a number of issues which need to be resolved before they are equivalent. However, just because a doctor recommends the latest technology doesn’t mean you should necessarily jump to get it … most claims of improved glycemic control are usually unsubstantiated in the larger patient population. A case in point is insulin pumps. Virtually ALL of the clinical literature published on pumps demonstrate that improvement is relative to your starting point. This means if you’re starting with horrific glycemic control, you are likely to see the greatest benefit of pumping, while those with already good control seldom see much improvement (if any at all). I found wearing a pump to be not worth the time, money and effort, and returned to MDI and have never regretted that decision. But there is a presumption that new, costly technology must somehow improve care and control even if the presumption is unsubstantiated. You should tell your endo the points you raised here, and see how he/she responds. In many cases, the offer follows an all-expense paid golf weekend sponsored by the manufacturer, but clearly until it is universally covered by insurance, if you don’t need it and don’t want it, it makes no sense to pursue getting it!