The CGMS Struggle
Wednesday, November 18, 2009 at 8:30AM Yesterday I tweeted...
And afterwards I had some people asking me if CGM was a good idea. Here are my thoughts.
In case you do not know, CGM is a continuous glucose monitor. I use the Minimed CGM and it works with my Paradigm Insulin pump. Every 5 minutes is transmits a reading to my pump and I can see how my blood sugars are trending. Well, most of the time.
Sometimes the sensors just get out of whack. And when they do, I get frustrated. I understand that it is not a perfect technology but I am sticking another needle in me, wearing another device, all in the name of trying to manage this wild beast called Diabetes and for it to be useful now and then can be frustrating to say the least.
With that, I am going to keep using it. Have I started doing less finger tests? No way. I think I actually take more now just to see if the sensor is close to my actual blood sugar machine. When it seems to be spot on I can really take a look at what I am eating, how it affects my trends, and how I can use my insulin boluses in the most effective way.
If you have a different take on CGMS I would love to hear about it. Or if you have more questions feel free to ask.
Reader Comments (10)
Oh! I haven't talked to a single person that had many good things to say about Minimed CGM. Can you share anything you got with me? I have the paradigm and will start to use the CGM in January when we switch insurances that actually covers it. :)
I have been on Minimed sensors for awhile now, and for the most part, it's pretty accurate! I rarely get those kinds of disaparities.
The first day is a little wacky, but after that, usually fine. I calibrate 3 times a day:
- when I wake up or pre-breakfast
- mid-afternoon, usually 4pm, or 3-4 hours after lunch
- bedtime, which is usually 3-4 hours after dinner
I never calibrate at any other time (except by accident, but that doesn't happen *too* often).
For me, I can bolus off my numbers, and haven't had any problems. It's been great for overnight highs if I have a big dinner or dessert. I'm not wearing my sensor right now because I keep forgetting to put a new one in, but so far, I think it's great. Hopefully you can get yours to work well too. Let me know if you want to chat about it.
Cheers,
Allison
I have mixed feelings about mine too but like you, will continue to use it. My dexcom missed 2 lows for me yesterday & only alarmed me after I calibrated it with the low reading. Thanks for the heads up Dex! I think it does help a lot though .... I used to only use it for a week or so here and there. I have now been using it for about 3 months straight and my last a1c went down by 1 whole point. Obviously I cannot atttribute that to the cgm singlehandedly, but I honestly think it played a big part. I guess we just have to use what is available to us to the best of our ability and try not to get frustrated when it doesn't work completely. Easier said than done right? :)
Placement and depth of a CGMS sensor can make a large difference in accuracy and duration. I wear mine, usually in the abdomen area, but sometimes I try the thighs, and upper arm. I find also, my accuracy seems to get better in the middle of the second day through to the end of the 5th day.
My CGMS is a Minimed, and while they say it is good for 3 days, I 'Lie' to the sensor and usually get 6-9 days from one sensor. Normally, I go for 6 days if the accuracy is good. My current sensor is in my thigh, in front and not quite as 'sweet' as I'd like. CGMS is saying 177, but my meter BG is at 111 type of thing. So I may yank this and start a new one today in the afternoon if things don't improve. If my CGMS and meter start to 'Jibe' by noon, then I'll leave it.
You are correct however, that this is a relatively new technology. Considering this, I think the CGMS will only get better with each new release/upgrade of the systems.
Congrats on the new digs for your blog. Nice job!
My experience with the MM CGM is similar to yours. Some days are blissfully in synch, and others way off. Do I bolus off it? Yes, sometimes, if it's on a roll. My endoc asked me if I was testing less now that I have it. Nope, about the same. What few tests it saves me, I have to pay back in order to calibrate, which is mostly at times that I ordinarily wouldn't test. But I do like it for spotting trends before and during a workout or other activity, the courage it gives me to make basal changes without a test fest, and it has caught a few lows and more than a few nightime highs. In fact, I'm in from doing yardwork right now because it alerted me to a low that I didn't feel due to my leaf mulching an bagging euphoria....wheeee!!
Thanks for the review! There seems to be a trend in the opinions I've heard regarding CGM's. Basically everyone I've talked to thinks they can be a royal PITA, but they are great for picking up on trends and putting the kabosh on crazy ups and downs. Of all the people I've heard from, there seems to be a 50/50 split of folks who think it's worth it and folks who don't.
I've never used a CGM but based on your review and everything else I've heard, I don't think it would be all that useful for me. I already check my blood-sugar a million times a day and it doesn't bother me. Plus there really isn't anything going on with my blood-sugars right now that is throwing me for a loop. Of course you could always say that maybe there is a trend hidden between testing or during sleep hours but my A1C is good and I'm pretty happy with my sugars so . . . I think I'm going to have to say that for now I'm going to forego the CGM. But it's nice to know that it's out there if I change my mind.
~Layne
George-
I'm sorry I can offer any advice. I'm sure someone else would be able to help:) hugs
I got the Navigator first and it was pretty accurate. It did allow me to have fewer finger checks. The only thing that I didn't like was that I didn't have enough room for the bulky sensor/transmitter on my arm. There was also a 10 hour calibration wait time. Then I did use the Minimed cgms and the paradigm insulin pump. It was so frustrating for me because the numbers were way off. It would be about 50-70 points of a difference. So I got off of all of my Minimed stuff and I am back on the Navigator and insulin pens. My blood sugars have improved and less pain. I am in the process of ordering the Dexcom. I wonder how this is going to work for me this time.
I really like my Minimed CGM and wear it all the time. It's usually very accurate. Yes, it does go floopy sometimes - but I find the majority of the time it's less than 15 points off from a finger-stick.
I've learned when I can trust my Navigator and when I can't. I think it does help quite a bit, and if it can help prevent even one or two surprise highs, then it's probably worthwhile for me.