Hello Everyone,
What would be the upside or downside to having a cgm but only wearing it on certain days? For instance when my "normal routine" is interupted (vacation, yard work, exercise etc). On a daily basis my numbers basically stay the same, but I get so obsessed w/ those abnormal days because I don't want to go too low. I've bee thinking about getting a cgm but I would only wear it on those atypical days.
What are your thoughts?
Jason in Orlando
I've worn a CGM periodically to test basal rates or as extra insurance at high stress times. Haven't actually bought one, my doctor just prescribed it for me a couple of times when I had concerns and the diabetes educator give me CGM supplies.
CGMs are cool but wearing one all the time is a drag and makes me feel like something out of the Matrix. I'm sure my diabetes would be a little better controlled with it, but I also am glad not to have the extra burden every day.
My old endo told me that some people will wear one for one week a month to "tweak" their basals, get trend info, etc, esp if their insurance doesn't cover it and they don't want to pay for 4 sensors a month. (Although, I know off label, the dexcom sensor often works for more than 7 days for some people.)
But, on the other hand, jdrf's recent cgm position paper said that a user must use the cgm full-time in order to see a benefit in a1c's. Obviously, their goal is to get insurance coverage, but I'm assuming that was also based on some research data...
For me personally, once I got used to having it, I always wanted to wear it. You might see what feels most comfortable for your needs and how your control is?
P.S. After rereading your post -- it might be a pain to put in and calibrate a sensor for only one day. It might make more sense (esp considering the cost of each sensor) to use one for at least a few days in a row, even if you take a break in between.
It's not the perfect solution..but Medtronic has a CGM called "iPro" which is worn 3days at a time. The catch is that it's not a product an individual can buy, it's made for doctor's offices and D clinics. If your local clinic has some, you can arrange to go in, get it put on and then wear it for 3days, return it and then go over the results.
The "iPro" is different, in that you only wear it for about 3days and it doesn't give real-time results. There are no beeps, no screen to show you a graph of what your levels are doing..all of that is downloaded onto the clinic's computer once you return it.
It was recommended to me by my endo, because he didn't think I'd enjoy the CGM 24/7 and we're just looking for a pattern, which is exactly what the "iPro" is made for; to find a 3day pattern of what your levels are doing, so you can adjust insulin.
If your clinic has one, maybe that's something to look into..though it wouldn't give you the real-time warnings it sounds like you're looking for =/
I've been waiting since August for my local D Clinic to call and say they FINALLY have them in. Apparently it's been over a year since they started trying to get them in their office, I donno if it's associated to cost or the fact that Medtronic Canada is a pain to deal with (well at least in my experience of trying to get the Guardian CGM & sales rep info from them since August!) but I'm still waiting!
Batts,
I think I did the IPRO thing about a year ago. In order to get the data, you had to do a follow up visit with the CDE. I actually cancelled the follow up, just because there were some high and low readings that she would have freaked out over when maybe I could explain them pretty easily with exercise or ice cream. Good info though.
Thanks
Thank for your input. I'm just wanting to catch the lows before there is a serious issue. I just wonder how much work would be involved to put the sensor on, and calibrate it for one or two days of use. Or should I just stay with the ramped up amount of testing on those days?
Jason
[quote user="Jason"]
Thank for your input. I'm just wanting to catch the lows before there is a serious issue. I just wonder how much work would be involved to put the sensor on, and calibrate it for one or two days of use. Or should I just stay with the ramped up amount of testing on those days?
Jason
[/quote]
For the dexcom (I can't speak to the others), it takes about 5 min to put in the sensor (10 min the first 1-2 times) and two hours to calibrate. But, with a new sensor, it usually takes about 12-24 hours (usually more towards 12 for me) until the readings are very accurate.
[quote user="Sarah"]
[quote user="Jason"]
Thank for your input. I'm just wanting to catch the lows before there is a serious issue. I just wonder how much work would be involved to put the sensor on, and calibrate it for one or two days of use. Or should I just stay with the ramped up amount of testing on those days?
Jason
[/quote]
For the dexcom (I can't speak to the others), it takes about 5 min to put in the sensor (10 min the first 1-2 times) and two hours to calibrate. But, with a new sensor, it usually takes about 12-24 hours (usually more towards 12 for me) until the readings are very accurate.
[/quote]
I must be super-fast... it only takes me two minutes to put a new one on. :P
It also takes my sensors 12 - 24 hours to become reliable.
I am a part time CGM wearer because I cannot get the sensors into my body. I have a lean body type and I can only get it into two spots on my body, also the same two spots where my silhouette (Minimed) is. Therefore, I wear them when my schedule is different or if I'm sick. I also will try to wear it the week before I see my endo so my diabetes educator has some data to look at. The days I don't wear it, I usually check my bs every couple of hours and take corrections if needed. My A1Cs for the past few years have all been under 6.5.
I've been told that the Dexcom is easier to insert and more comfortable than the Minimed CGM.
I wear a MM cgm on my arms and I have to say I don't notice it until someone asks me what happened as if I was in an accident. Its very comfortable and my A1C have never looked better. I guess as far as management goes I cant see being without it. My endo did mention wearing it one week and then taking a week off but when I do that I am out of balance. The only time I find it a hassle is when we are on a beach vacation and I want to be able to swim without worrying about it. That is when I take it off.
I hope this helps.
I use a CGM almost all the time. I do take breaks but never more than a day. Really, I like having it. It is great constantly knowing what your blood sugar is. I would suggest (because of the time it takes to start it up and the cost) that you at least be willing to wear it for a few days. Maybe a week out of the month. You might find, like me, you don't want to go without it!
Jason,
A lot of people wear the CGM on and off. Me included. I usually will wear it one week on, two weeks off. If I know I am having problems I will wear it more often. The best time to wear it is when your normal routine is off like you stated, that is exactly what it is used for! Like others have stated wearing it for one day is not really worth it because the sensors are very expensive and you wont really get that much data from one day. A few days of wearing it is more beneficial.
About Sarah's comment, the JDRF study include several medical sites and the facts from that study and several others since the JDRF sponsored study was published has shown that the key to getting a benefit is directly correlated with how much you where your CGM and your commitment to learning how to calibrate the CGM.
The study was done determine who gets the most benefit from the CGM. Many insurance companies determined that the only T1Ds that should have CGMs are those that are having hypos that cause medical intervention. Now that perception has been proven to be incorrect in terms of who should use a CGM.
I have used the navigator, the minimed paradigm and the minimed revel. I have not been able to test the Dexicom. If you wait till all three manuf hope to release a new upgraded sensor and improved accuracy. I can't wait. The MM revel has very different software in the pump to support the CGM.
Thanks EVERYONE for the words of advice. I will see if my endo has a loaner, as well as go through the precert process w/ my insurance and see how that comes out.
Jason
I have a difficult time inserting the CGM. Using two sensors per time is way too expensive when I am paying out of pocket. I do have trouble with the pump and sensor communicating. They can't be over 2 feet from each other and if I near other wireless devices they won't communicate at all.