Continous Glucose Monitoring?

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Continous Glucose Monitoring?


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Old 02-01-2012, 13:55   #1
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Default Continous Glucose Monitoring?

This is probably more for the T1's in the room, but looking for thoughts.

I work a fast paced, very physically and emotionally demanding job. There's times when I just can't get a finger prick in.

I've been doing some research on continuous glucose monitors - in particular the DexCom Seven promoted by Animas. I understand that it's not a substitute for the finger stick, but more so basically a bs alarm clock.

Anyone have one? Thoughts on them?

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Old 02-01-2012, 17:38   #2
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I started on a continuous glucose monitor last fall. I'm using the Medtronic system. I'm using it to try to get my A1c better and it took me awhile, but I've grown to appreciate it.

My reaction to the CGM was very much like my reaction to first being diagnosed with diabetes: Acceptance, honeymoon, resentment, denial, acceptance. Except instead of years and years of denial and ignoring the issue, it only lasted a month or two .

I'm totally convinced now that CGM offers me more benefits than shortcomings. CGM is NOT a perfect system. When I was reading up, I thought it would be the answer to everything. I soon discovered, however, that all the things I wanted it would do for me had "buts" on them, i.e. "It can do this, but..." or "It can do that, but...."

Because of my stubbornness, I had to stop using it and come back to it before I could accept its limitations and understand how much it really does help me and find a way to use it effectively in my life. I know it that I need this to help me keep better control of my BGs.

I can't imagine not using it at all now. The CGM lets me see trends and what my BGs are doing 24 hours a day. The BG meter at each meal gives me verification periodically to calibrate my progress. I feel now that if I didn't have the CGM I would be flying blind, like a pilot without radar, only using landmarks on the ground to get where he needs to get.

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Old 02-02-2012, 01:52   #3
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[QUOTE=Stargazer;75679]I started on a continuous glucose monitor last fall. I'm using the Medtronic system. I'm using it to try to get my A1c better and it took me awhile, but I've grown to appreciate it. [QUOTE]

Very useful posting, thanks!

I have a couple of question for you now that you've 'seen both sides' straight on:

1. What about initial and running costs? (I'm going to be going through 10 strips a day until I establish some things, then maybe down to only 3-4-5 depending on what I learn - hopefully - but that's $300 per month before insurance initially)

2. Do you see Continuous "as the future" so to say, over time, for maybe 50% of folks with Type II "within a few years". (Or however you want to say it.)

3. I would very much like to see the "curve" of my Glucose after meal 'A' compared to meal 'B' but pricking my finger every 5 minutes would not only be cost prohibitive but a terrible distraction from anything. OK, well, so this is something you can see on your CGM by way of its ability to chart? ( If that is so I would be Very impressed and not a little jealous.)

Thanks again,

george

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Old 02-02-2012, 08:19   #4
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Quote:
Originally Posted by gkoller View Post
1. What about initial and running costs? (I'm going to be going through 10 strips a day until I establish some things, then maybe down to only 3-4-5 depending on what I learn - hopefully - but that's $300 per month before insurance initially)
I'm not sure how the prices in Canada compare to the rest of the world, but after the initial cost of equipment, the CGM sensors cost about $50 each and they need to be replaced approximately every 6 days.

Luckily, my wife extended health covers 80% of that cost for us.

Having the CGM doesn't eliminate the need for finger testing. In fact, the CGM must be calibrated between 2-4 times every 24 hours. When I first started on the CGM, I ended up testing maybe 6 - 8 times a day because the CGM was telling me my BGs were swinging high or low and I didn't trust its readings. It was a big disappointment because I definitely wasn't expecting to test MORE with the CGM .

Now that I'm more comfortable with understanding what the CGM is telling me, I'm testing about 4 times a day, and only do more if I don't feel well.

The nurses and trainers I talked to say that some people only use the sensors for a month or two at a time, just so that they can figure out what their body is doing. Once they've established a pattern, the choose not be on the CGM all the time.

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2. Do you see Continuous "as the future" so to say, over time, for maybe 50% of folks with Type II "within a few years". (Or however you want to say it.)
I definitely see some kind of "closed loop" system as the future--but I'm not so sure for Type 2s unless they were taking insulin as well. I think that right now, the cost is the biggest hurdle for the foreseeable future. My first endocrinologist actually recommended against me using them a year or two after they first came out because of the cost. And that cost hasn't changed from what I'm paying now many years later. My insurance company actually didn't approve my use of the CGM. I wasn't an "extreme" case (i.e. active person with no sense of having a low BG). If my wife's insurance hadn't approved, I don't think I would have gone on the system.

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Originally Posted by gkoller View Post
3. I would very much like to see the "curve" of my Glucose after meal 'A' compared to meal 'B' but pricking my finger every 5 minutes would not only be cost prohibitive but a terrible distraction from anything. OK, well, so this is something you can see on your CGM by way of its ability to chart? ( If that is so I would be Very impressed and not a little jealous.)
Yikes! My fingers are sore from just thinking about pricking them every 5 minutes .

Thankfully, the CGM does take its own readings every 5 minutes and the pump has the ability to show you graphical charts of the results. There are 3 hr, 6 hr, 12 hr, and 24 hr charts so that you can see the trends and you can also scroll backwards to see each individual reading.

On top of that, all the data can be uploaded to your computer to Medtronic's Carelink site where you can get additional charts and graphs of everything in pdf format and print them out if you like. Every 2 weeks I send my doctor an email and she looks over the data on the computer and replies with adjustments if needed. When I visit her office, the nurse uploads the data from my pump to their computers and they look over and discuss the results with me.

Keep in mind, the CGM does not correspond 100% with the meter reading. That's what surprised me at first and made me wary about trusting what it told me. I've learned however, that most of the time it's accurate in showing me trends and letting me know when my BGs are rising or falling at any time of the day so that I can act before it gets too extreme. It makes it easier to avoid the mountains and valleys and keep my BGs smooth and gradual.

I'm not all the way there yet. I still need to change a lot of bad habits, but I'm trying. After being on the CGM for several months, my A1c was better than it ever was since I was first diagnosed. Then I stopped using it over the holidays. I thought that if I still kept testing regularly (this is from someone who never tested for years) I could keep good control. Boy, was I wrong ! Without the CGM, I found myself wondering if my BGs were rising or falling, or how I was doing after a meal, what it was through the night. I kind of missed it. Gradually I tested less and less and my last A1c reflected it.

But I'm back using the CGM now. It's good for me because it forces me to test when I otherwise would not. And know better how it works I'm truly appreciative of what it can tell me. I'm also looking forward to my next A1c .

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Last edited by Stargazer; 02-02-2012 at 08:22.
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Old 02-02-2012, 15:41   #5
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I've used the Dexcom for just over 3 years. It does not give 'at the moment' blood glucose readings compared to a finger stick. It does give trends - whether you are heading up or down or staying stable.

My CGM is self funded because Medicare does not recognize it as being medically necessary. Currently I believe the price (from Dexcom Company) is about $349 for a box of 4 sensors. The FDA recommends the sensor for 7 days, however myself and many other people who use the system wear the sensors much longer. I've gone up to 31 days on one sensor. I also know people who wear the Medtronic sensor going much longer than 3 to 6 days.

Dexcom guarantees the receiver and transmitter for one year. I am told that either of these items can 'live' much longer than one year. I hope so, because my current Dexie is now 18 months and still quite accurate.

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Old 02-02-2012, 17:15   #6
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I also know people who wear the Medtronic sensor going much longer than 3 to 6 days.
Yes, my nurse and trainer both mentioned "tricks" that some people do to get more life out of the sensor. I'm sure to get 6 days, but it must be my body rejecting it because the most I've been able to stretch it has been 7 or 8 days. After that, the transmitter itself still has power, but the sensor is dead and no longer communicates any data.

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Old 05-03-2012, 20:19   #7
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Quote:
Originally Posted by Stargazer View Post
Keep in mind, the CGM does not correspond 100% with the meter reading. That's what surprised me at first and made me wary about trusting what it told me. I've learned however, that most of the time it's accurate in showing me trends and letting me know when my BGs are rising or falling at any time of the day so that I can act before it gets too extreme. It makes it easier to avoid the mountains and valleys and keep my BGs smooth and gradual.
This is definitely what I need! I workout very often, most of the time intensely, and my BG numbers vary greatly. Just because I test once and it reads 120, it almost never means that it's going to stay there. most of the time it's in the middle of declining or inclining and sometimes it's hard to tell which way it's going. This would definitely be something that could change that (I hope).

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Old 08-26-2012, 02:46   #8
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Quote:
Originally Posted by Strawberry View Post
I've used the Dexcom for just over 3 years. It does not give 'at the moment' blood glucose readings compared to a finger stick. It does give trends - whether you are heading up or down or staying stable.

My CGM is self funded because Medicare does not recognize it as being medically necessary. Currently I believe the price (from Dexcom Company) is about $349 for a box of 4 sensors. The FDA recommends the sensor for 7 days, however myself and many other people who use the system wear the sensors much longer. I've gone up to 31 days on one sensor. I also know people who wear the Medtronic sensor going much longer than 3 to 6 days.

Dexcom guarantees the receiver and transmitter for one year. I am told that either of these items can 'live' much longer than one year. I hope so, because my current Dexie is now 18 months and still quite accurate.
I've just recently received the dexcon 7+. So far I like it except for not being able to look back at previous readings. I deffinetly see this as the future. I wish Apple would make an app to replace the receiver it would be a lot more convenient if you could just carry one device instead of your phone your receiver and one touch with insulin.
Any advice for a newbie dexcon user.

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Old 08-26-2012, 04:19   #9
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I've been using a Dexcom 7 for about 4 months. I would advise reading the book "Beyond Finger Sticks" for anyone contmplating getting one. The biggest annoyance I have is having to install a new sensor (every 10 days or so for me) and it usually takes 24 hours for me to get a new one working acceptedly. Now that I am on the LCHF diet my lines are usually pretty flat, but it helps a lot when I am doing manual labor or exercising.

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Old 08-26-2012, 14:32   #10
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Originally Posted by frankly
I've been using a Dexcom 7 for about 4 months. I would advise reading the book "Beyond Finger Sticks" for anyone contmplating getting one. The biggest annoyance I have is having to install a new sensor (every 10 days or so for me) and it usually takes 24 hours for me to get a new one working acceptedly. Now that I am on the LCHF diet my lines are usually pretty flat, but it helps a lot when I am doing manual labor or exercising.
So far I'm liking it alot. The only draw backs I'm having is the distance some times is a issue and I too I'm a physical person with a job to match I'm sometimes scared I might break the monitor. The only other thing I'm having a small issue with is not being able to go back and look at times and numbers, it's all a guess between the lines or estimate, probably safe to say most diabetics get anal about specifics.

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