I am on the Minimed Paradigm and I am considering getting a CGM. I think that it will help me keep in control. For the people that have one, what are the pros and cons of having a CGM?
Well their are many good things about the CGM, better control of A1c, detect highs and lows, alerts. That's just to start!
Now I'm going to focus on some bad things we will call the the not so good things. The biggest thing is that at first your pump is going to go off all night long. It happens too the best of us no matter what. Too Hhigh, too low, lost sensor, or any other reasons. It will keep going off until you fix it. Which isn't bad just very annoying at 1 in the morning.
Other thing that can be bad is the size of the needle on the senser is kinda of large compared too the insertion needle on the infusion sets. Also see a bit of blood with these.
Other than those they are great. You will love it!
Do you have to put the sensor in your stomach or is it like the infusion sites, where you can put them other places? Infusion sites don't work in my stomach, the needle won't go in all the way. Thanks for the answers! I go to the endo on Thursday so I was going to ask him if I could try it out.
The stomach has the best absorption as well as the back of the arm. Most doctors offices will let you try out a cgm if they have them available. That is probably the best way to see if you will like it or not. Be forewarned that there will be a lot of beeping in the middle of the night !!!
The sensors were approved by the FDA for the stomach. The reality is that you can put them anywhere on your body where there is sufficient interstitial fluid exchange (skin layer above the muscle or fat) and there is no pressure on the area.
Everyone has an ideal place. The testing on most CGMs by the manuf shows that the back of the arm give good performance.
One big negative on the CGM is that you MUST make a commitment to use it nearly all the time and test also to ensure calibration. If you want to only use the CGM part time, it is not worth is, and this is shown in numerous CGM studies over the last three years.
Biggest plus about using the CGM is being able to predict your BG trend and being able to act on them to mediate highs and lows before they are an issue.
Hey Danielle!
First of all, I want you to know that I think having a CGM is definitely a great thing, and I do not regret having one, at all.
That being said, there are a few annoyances that I have experienced while using mine..such as: the battery of the transmitter. I'm not sure if you're considering minimed (that's the kind of pump I have, so I got the minimed sensor & transmitter, obviously), but one thing I dislike about their transmitter is that its battery only lasts up to about 8 or 9 months. I've called Minimed to discuss this with them, and they said that that kind of battery life is average, and personally I think they are pretty expensive (and it's also a hassle) to buy a new one every year. Also, the transmitter's charger (or dock) is kind of temperamental (there are lots of different light "patterns" you must either follow in a diagram or memorize to understand what's malfunctioning with the transmitter, if you're having problems. The last thing that really bothers me about having a CGM is that it is kind of hard to deal with having two things stuck in your sides (I always keep my pump on my hips and stomach and lower back "fat") as a teenage girl. Not that it necessarily hurts (I think it feels the same as inserting a pump catheter), but it's just annoying to have a pump AND a sensor in you body at once. I just thought of some other things--sometimes if your site is where a vein is, then you have to take the sensor out and start all over. For me, that's almost not worth it, since they cost about $10 each. Also, the time it takes for the sensor to initially "calibrate" or get "registered" by your pump takes FOREVER (okay, it's about 2 hours). Since I usually insert them at night when I have a break from class, I just find it annoying since I usually am about to go to bed, but that's just poor timing on my part.
Okay, that may look like a lot of negative, but I really am grateful to be able to have a CGM. I think if you can afford one, you should DEFINITELY and WITHOUT A DOUBT get one! It can only do you good :) I usually wear mine every few months (since they're expensive), but when I do wear my sensor, I feel 100x better about my control. My a1c isn't that bad (it just went down from 7.0 to 6.7) but I find that wearing a sensor lets you stay in your range at least 75% more of the time, and your highs and lows are usually treated MUCH faster than if you had not been wearing a sensor. I love looking down at my pump and seeing TONS of perfect blood sugars. You can only get that with a sensor..and that feeling is definitely worth it to me. :)
I don't want you be turned off by my first paragraph, I just want to be realistic about what your expectations might be.
Good luck, Danielle! Let me know what you decide..
Hayley
Hi Danielle! I am currently doing a trial with the dexcom CGM...I got it on Friday and have to give it back on Thursday =(. It has really been great!! I absolutely love being able to see the trends, it is such amazing information that you can't get with your regular bg checks. I was pretty scared of the insertion because the needle is quite large, but it only stung for like 5 seconds and then was fine. The only downside for me, that I have experienced so far, is having to carrying around the receiver. If I put it in my front pocket, it kinda looks like I'm packing some male parts hahah, so I have just been wearing it clipped to my pants in its little case. I definitely think it will be a big help for control, so you should try one if you can!!
Pros: I have amazing control when I have the CGM, because it urges me to be more obsessive about my blood sugars (who wants to see their blood sugar going up on a graph, right?) The amount of information that my CDE has been able to gain from the CGM data is incredible. I wore the CGM for two weeks and tracked all of the food I ate, and we were able to go through all of the data and see where I made mistakes in carb counting so that I could learn from them. It was the best session with a CDE I ever had.
Cons: For me, the insertion is very painful, and sometimes so much blood comes out that the adhesive patch that holds the sensor on gets completely saturated and I have to throw the sensor away, and even when that doesn't happen, the adhesive patch sometimes comes loose, making it hard to keep the sensor in. I usually have to change the clear sticker that you place over the sensor at least once during use because water from the shower gets under it, which is no good.
Overall, despite the cons I listed, I definitely do recommend the sensor. I don't use it all the time, but I like to use it before I see my CDE so that she can review all the data. The more you use it, the better you will be at inserting the sensor and keeping the sensor in for the time you'd like it in. As far as control goes, there's really nothing like it. You will achieve a new level of BG obsession and control that you never thought possible. ;) It also gives me a huge sense of security when driving, exercising, sleeping, or in other situations where my blood sugar might fluctuate but I can't test.
Molly
Thanks again everyone for the insight. I will definitely be asking my endo about getting on a CGM when I see him. I think that it is the next step for me to get better control of my bs. I am so excited. It is the needle that scares me more than anything else. :) thanks again.
I've been using the Revel cgm for about two months now, and I am amazed at how much better my control is. I agree with PPs that you do have to be committed to using it all the time and to finger sticking often enough to calibrate. There is also a lot to learn about when to calibrate and when not to, and how to understand the patterns in your readings, etc., but overall, it is definitely worth the learning period.
Negatives do exist, but again, I feel that the benefits greatly outweigh the disadvantages. As others have said, it WILL go off all night. I have been diabetic for 17.5 years and I have never not woken up from a low (or not felt a low in general - my adrenaline is very good to me!), so I have shut off the alarms (and changed the high and low thresholds to a very wide range for the ones I can't shut off) for the middle of the night because I was tired of not sleeping. Also, as previously mentioned, the insertion needle for the cgm is considerably bigger than a cannula, and it is also more painful to insert. However, once it's in, it's fine after a few minutes. I have been using my cgm in my upper hip/butt area, and I have had very few calibration issues.
It's important to keep in mind, if you have site issues as it is, that the cgm site and the cannula must be at least 3 inches away from one another, so you'll have to be comfortable thinking outside the box in terms of sites, but as long as you are okay with that, you shouldn't have any problems.
Overall, I definitely recommend asking your endo about it. It was one of the best decisions I've ever made. Good luck.
My daughter has a CGM. We actually put it on her bum and we've had great luck with it. You can set for when you want it to alarm, say 100 to catch a low, or 240 to catch a high. At least in our case that's what we've found works well. We usually get 6 days from our CGM. Occasionally we get a bad sensor and it doesn't last as long, but rare for us. We love that it will alarm even if it hasn't been 2 hrs since her last mealtime so we can catch those lows. She's quite the roller coaster and we've had scary lows, so for us it's just one more way to help us manage her diabetes.
I LOVE MY CGM!!! It is the best thing EVER in my opinion!!! I cant say enough good things about it!
Hi guys! I went to the dr last week and he said that he doesn't see the benefit to doing a cgm right now. He said maybe down the road that we could look into it a little more. I was really hoping that he would say that it was a great thing to do, but he seems to think otherwise. :(
[quote user="Danielle"]
Hi guys! I went to the dr last week and he said that he doesn't see the benefit to doing a cgm right now. He said maybe down the road that we could look into it a little more. I was really hoping that he would say that it was a great thing to do, but he seems to think otherwise. :(
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Unless your sugars are ALWAYS awesome or you check 25 times a day, if you're willing to put in the work/money a CGM requires why the heck would he tell you no? Doesn't see the benefit? Are you kidding? Can't think of any negatives if the patient is smart and compliant.
I say you tell him "I respect your opinion, but I've actually decided to get on one now, so can your office help me get the paperwork done?" Unless there's something else going on I can't wrap my head around him saying "no, later..."...it's not an insulin pump, or a new medicine.
I don't use a CGM b/c I wanna wait till they get smaller, but if I wanted to I wouldn't let my doc tell me no. :)
[quote user="Ideen"]
[quote user="Danielle"]
Hi guys! I went to the dr last week and he said that he doesn't see the benefit to doing a cgm right now. He said maybe down the road that we could look into it a little more. I was really hoping that he would say that it was a great thing to do, but he seems to think otherwise. :(
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Unless your sugars are ALWAYS awesome or you check 25 times a day, if you're willing to put in the work/money a CGM requires why the heck would he tell you no? Doesn't see the benefit? Are you kidding? Can't think of any negatives if the patient is smart and compliant.
I say you tell him "I respect your opinion, but I've actually decided to get on one now, so can your office help me get the paperwork done?" Unless there's something else going on I can't wrap my head around him saying "no, later..."...it's not an insulin pump, or a new medicine.
I don't use a CGM b/c I wanna wait till they get smaller, but if I wanted to I wouldn't let my doc tell me no. :)
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Agreed. I would be very uncomfortable with my doctor not wanting to advance my care. :/ If the cgm is something you want, you should absolutely be able to get it. I don't understand what would make him say it's a bad idea.
The only thing that is going on is that I forget to bolus after lunch. I talked to him about that and he sent me to a refresher on carb counting, since it had been about 5 years since the last one. He said that we needed to work out the kinks of my BG's and that he didn't see where the CGM would benefit me that way. This is only my second time seeing this endo. He seems to be good, I really don't know what his deal is with the CGM's.
Do you have to be on a pump to have a CGM? My daughter just turned 2 and I would LOVE to have one, but she currently isn't on the pump yet. Her sugars are SO CRAZY! She'll go from 350 to 40 and we are doing everything correctly! She is using lantus and humalog pens. (1/2 unit increments)
You definitely don't need to have a pump to have a CGM. Some of the CGM's work with the pump, but not all. My daughter does have a pump (Animas Ping), and also wears a Dexcom Seven CGM. It's an incredibly valuable tool. That said, having a pump and CGM is even better, in my opinion, because I can give very small corrections using the pump to keep her more in range. Also, the pumps track "insulin on board" which prevents you from stacking insulin. Maybe consider looking into a pump and CGM for your daughter? I friend of mine has a daughter the same age as yours and she wears both.
Hi there. Can I ask how old your daughter is? My son is 7 and was diagnosed at 5. We have been on the pump about 18 months. Besides one good month of an A1c of 6.8 we are kind of still all over the place even with the pump. He had a seizure about 6 months ago due to a low during the night. During the days most recently we are kind of all over the place. I know my carb counting is probably not perfect, but I also know it can't be off this much to make him bounce up and down all day. We are currently making some adjustments with his basal and sensitivity, but I was wondering if a CGM would also be of use? It just breaks my heart when he gets a terrible low and he is crying and feeling awful. I would love to avoid those if at all possible! I just don't know if he would go for the extra insertion site. Lots of people are commenting on how painful it is. How does your daughter react?
norwaymama, it's really common to be all over the place. I've had a1c's down to 6%, and every day is a challenge and there are always outliers and highs and lows. I've had it over 30 years, and it's epic if I have a single day without a high or a low, and a certifiable miracle if I could go 3 days in a row and be in target. pumping helps, but corrections and my favorite juice are part of my life.
I think at age 7, with growth and high levels of physical activity comes high levels of monitoring and doing the best you can. an a1c under 7 in a 7 year old is excellent work. in my opinion - don't strive for perfection, shoot for manageable. Still, a low causing a seizure is terrifying. I hope you and his CDE have a good plan for a higher overnight blood sugar target and some long acting carbs so it doens't happen anymore.
I think a cgm is a good tool, but I stopped using mine a while back. it was great for tweaking basal rates, but for me, not so good for tracking bs during exercise. with time they will get smaller, faster and more accurate.
cheers