How useful is a cgm?

Lakeman · #1 01-11-2011, 07:51 PM

Just got back from the 3 month clinic visit and our daughters a1c was 7.1! My wife cried tears of joy. Anyway that is not the purpose of this post - I too just had to share our joy.

I asked about getting a cgm while we were there. I thought I might have to fight to get am authorization for it. But the nurse said, instead, that they are just not that great. That they do help but are not very accurate and do not replace checking with a meter for giving doses. But I trust you all much more. So my question is how valuable are they as part of a treatment plan? What are the pros and cons?

Also she said that only about ten percent of their patients use a pump. the impression I get here is that a much higher percentage of people use a pump. So what do you think?

Lovemyboys · #2 01-11-2011, 08:05 PM

I think a cgm is very beneficial! That said, I'm not sure it decreases the number of finger sticks, but it does give useful information. I can track what causes spikes, what doesn't, how long I need to prebolus, when I need to up the basal after eating a high fat meal, etc. Which I couldn't do with just fingersticks. For example, I don't feel I have to treat a 90 (sometimes I will, sometimes I won't depending on the trend that it's showing).

chbarnes · #3 01-11-2011, 08:08 PM

My 14 y/o recently said he couldn't imagine life without his Dexcom. Most of the time it is very accurate. With experience we have learned to recognize when it isn't. Even without any number the tracing alone is worth the cost of the product (and we pay OOP). the tracing let's you know what's about to happen. You can't get that from a meter. You can watch what happens to your child while they sleep, without poking them or waking them. Sports and exercise are way easier than with a meter alone. We actually do bolus from the Dexcom when it is accurate. Typically, Chris does about 2 fingersticks a day (this won't work for e everyone, but it does for us).

timkris724 · #4 01-11-2011, 08:17 PM

Whaaaaaat?? I love our CGM. It is not accurate 100% of the time but it is always accurate about how Will is trending. For instance he might not be quite as low as it says he is but he is heading that way and it lets me know. I would say during the 1st 7 days of a sensor we are within 10-15 points 85% of the time. That is assuming the blood meter is correct and the CGM is not.

As long as it was not causing a financial hardship, like not covered by insurance and we could not afford it, I would never go without it. It is the future of diabetes management in my opinion.

BrendaK · #5 01-11-2011, 08:26 PM

CGMS brought A1C down an entire percentage point. But more importantly than that, it has given my SON peace of mind and independence he hasn't had before. And oh yes, we sleep at night now....

The nurse sounds like she was educated only with the first generation CGMS that weren't super accurate. The ones on the market now are very accurate! Our endo said diabetes is like a road trip, you can either drive with your eyes open (with CGMS) or shut (without CGMS). You may get to your destination with your eyes shut, but not nearly as safe and together as with them open!

Flutterby · #6 01-11-2011, 08:28 PM

Honestly, if someone tried to take Kaylee's cgms, they'd have to pry it from my kung fu grip.. I wouldn't give it up for anything.. they aren't perfect but they are extremely useful, help prevent lows, we treat highs faster, and it gives us a more peace of mind at night.

lakevictoria · #7 01-11-2011, 09:12 PM

Your endo needs to support you with these valuable tools. If your team is not up to date with all of this technology, then attempt to find another team. We've already switched as our first team put us in a diabetes box and we had to dance at their pace. You have NO idea what's happening between BG checks. A 120 is actually two different numbers. It's a 120 going up, or a 120 going down. You can't know that with just a finger prick. Go for it!

P.S. Romans 8:28 has been my rock these past couple months!

Lisa P. · #8 01-11-2011, 09:54 PM

Our endo told us, when we asked about the cgms, that for our small child:
1. It would use valuable "real estate" that might be used for pump sites.
2. I would never be able to entirely rely upon it so that if I ever took any actions or had any worries I'd be sticking her anyway.
3. The accuracy just isn't there yet for little ones, when you calibrate their bg is moving so fast it's hard for the machine to figure it all out.
4. We'd still be testing her a lot and we'd have no certainty from the cgms about any numbers.

We got the dexcom anyway, he was happy to help us get it (I love our endo, he doesn't always have to "have his way"). He was absolutely right about everything on the list. I wouldn't live without it anyway. I'd give up the pump first.

We have weeks where it is a frustration, I can never entire rely upon it because it is often quite wrong and occasionally extremely (300 points) wrong. But as one tool in the box, you put it together with the other stuff you know, and it can really make a huge difference. For example, if I think she's likely to go low because of questions about carb counts and the sensor has been pretty reliable, I can watch the arrows to see if she's moving down instead of sticking her four times in an hour waiting for the drop. It also catches lows sometimes when I don't see it coming, that in itself is invaluable.

The CGMS is a very imperfect tool, just like manufactured insulins are very imperfect tools. Both are much better than nothing, though. Just don't expect it to do what it can't yet do and you should be fine.

(Oh, for the record, we still test her probably 7 to 10 times a day, with an occasional day of 4 and too frequently a day with 15. But we used to test between 12 and 17 times every day. In itself, that's enough reason for our family).

khannen · #9 01-11-2011, 10:07 PM

Quote:

Originally Posted by Flutterby

Honestly, if someone tried to take Kaylee's cgms, they'd have to pry it from my kung fu grip.. I wouldn't give it up for anything.. they aren't perfect but they are extremely useful, help prevent lows, we treat highs faster, and it gives us a more peace of mind at night.

I was about to same something very similar. You would have to pry it from my fingers!! Lol It has totally changed the way we care for Shealyn. A1c dropped 1.2 in the first year we were using it. We've gone from the average of 10 fingersticks a day down to probably 4. She says she fees safer and 'better' on it and got upset when I once asked if she wanted to take a break from it. I can catch the lows before they are too low and correct the highs earlier and more aggressively. Therefore, she physically feels better.

It also gives me peace of mind overnight knowing it will alarm if there is a problem and when she is away from me (at school, at a neighbor's house, etc) . love love love cgms!

Melissata · #10 01-12-2011, 06:45 AM

I agree that CGM's are going to be the norm in a few years. I would certainly question a ped's endo that only had 10% of patients on pumps. Sounds to me like they are behind the times. Just telling their patients that would make them think twice. Even though we may be looking at paying out of pocket for sensors with our new insurance, we will make it happen somehow. That is how important it is to us, because Melissa does not feel her lows, and never wakes up to them at night without the CGM. Last week she made the mistake of putting her Dexcom receiver in her backpack and didn't hear it in the store. After we got home she heard it and tested. She was 30 and had been that low for a couple of hours! No symptoms at all. Most people don't have that problem, but there are many more reasons to use a CGM. Advanced warning of highs is also priceless. Instead of finding out hours later, you can start fighting to get it down.