I've had diabetes since I was 8, I'm 27 now, and I've been using multiple daily injections for the majority of my life. I don't have insurance at all, but my step-mother wants to pay for me to get a pump and a continuous glucose monitor. But I need some advice.
Preferably, I'd want a wifeless pump. I don't know if there's such a thing as a wireless CGM. Also, it's better if the components of the CGM are inexpensive. I don't even know what they use... no strips, I'm guessing. I can get the insulin for the pump for free from Lilly Cares. Honestly, the CGM is more important to me than the pump, because I currently test about 8-10 times a day, and I would practically KILL for the ability to have alarms when my blood sugar drops or rises. That actually sounds like a little slice of heaven to me. What can you guys recommend?
If you're looking for a tubeless pump, your only option is pretty much the OmniPod. It doesn't have an integrated CGM, although I think that's something they're working on.
As for an inexpensive CGM...you're not going to find one of those. The transmitters themselves are going to run around $750, then you'll need to replace a sensor every 3-7 days. The sensors run from about $35 to $60.
..., because I currently test about 8-10 times a day, and I would practically KILL for the ability to have alarms when my blood sugar drops or rises. That actually sounds like a little slice of heaven to me. What can you guys recommend?
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hi Melissa, I fingd the CGM is a good tool but it currently can not replace your blood sugar meter. All CGM reading tends to lag behind reality, All CGM on the market tests interstitial fluid and not blood glucose, all of them require regular calibraitons. Many are affected by OTC medicines, and for some people, try as they may they cannot get reliable feedback using a CGM.
That being said, if you are lucky, have a good calibration, and you are not eating or exercising (blood sugar not changing fast) the reading will tend to be accurate with respect to your blood sugar meter, which you will need anyway to back up a high CGM reading before you decide to correct with insulin.
I find it very useful for overnight trending, and general trending when I am tuning my pump. My total cost for testing goes up when I am using my CGM.
That being said, if you are lucky, have a good calibration, and you are not eating or exercising (blood sugar not changing fast) the reading will tend to be accurate with respect to your blood sugar meter, which you will need anyway to back up a high CGM reading before you decide to correct with insulin.
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I agree with the first two points, but not the third. In my experience, the Dexcom can be extremely accurate after meals, and during exercise. That's not to say it's always accurate - because it isn't; no CGM is at this point - but more often than not, the Dexcom reads within 20 or so mg/dL of what I test at.
You still have to test, and like Joe I tend to test more often when wearing the CGM, than when I am not. It seems to go hand-in-hand - the more information you have available, and the more you pay attention to what's happening to your body, the more information you want. Although I was taught in training to not use CGM data for immediate food/insulin decision, I sometimes do. If it's been reading accurately the past several hours, I tend to take it at it's word. That can be dangerous to do, though, so I wouldn't recommend it.
I just got on the new Revel Paradigm pump and CGM from Minimed. I believe the CGM has improved over what others have told me about the older one. I have only been on it for three weeks, but it seems pretty darned close to what my finger tests have been showing me.
It is a wonderful device and is making my control much more accurate. I used to drop below 50 without noticing it and now I am warned by the pump repeatedly that I am going low and to do something. I haven't dropped below 50 since the CGM!
The pump keeps track of everything and tells me how many times a day I do the finger tests. I am average over 8 per day with the CGM and I believe I was averaging 7 before I had it, on an older insulin pump. So, as others have said, the finger tests are not going away.
You probably can get a good price on the set if you tell the reps that you don't have insurance. I know the list is much higher than my insurance company and I paid. I think they would work with you.
Oh, and what medtronic doesn't want you to know is you probably can ware their sensor for 6 days, without a problem. The FDA approved it for only 3 days but I have been changing mine every 6 days and it even seems more accurate the last three days than the first. Dexcom is approved for 7 days, which is a benefit but I hear they charge more for their sensors. I think wearing them any longer doesn't work because the body reacts adversely with the foreign object sitting there that long and creates scar tissue.
I am testing far less now that I have the CGM. Not that that's what's recommended, but I'm just being honest here (sometimes only once per day... or less! Yikes). My A1C also dropped 1.2%, so I'm thrilled about that... I'm finally under 6%.
Seems like cost is going to be your largest barrier. Without being covered by insurance, the cost of supplies is going to be extreme.
Dan - I routinely wear my Dexcom sensors for at least 14 days. They do get a little itchy at the end of that period of time, but I haven't had any problems with lasting scars. I'm sure everyone's different in that respect, though.
Kim, maybe it's me, but mine gets pretty itchy after just 6 days. I am tempted to leave it in but I am changing every 6 days. I think I read that the dexcom wires are smaller than the medtronic wires That may be why. I really love having the info it gives me. It is a tremendous help!
I've heard some pump companies will slightly reduce costs for you if you're paying entirely out of pocket. So ask about that. I have no idea if CGM companies will do the same, but it's worth asking them. Just remember to factor in how long the sensor lasts when comparing prices. Do the division. :)
FYI including what my insurance company and I paid the cost of just the revel insulin pump was a little over 4600 dollars. That didn't include supplies. I know the insurance company gets a great price, but I thought I would share it as a tool for your negotiations! Including 3 months supplies the total cost was $5100 plus some change. I haven't got the info from the insurance company regarding the CGM yet. More shall be revealed!