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Questions about CGM

Discussion in 'Parents of Children with Type 1' started by truck2ff, May 30, 2011.

  1. truck2ff

    truck2ff Approved members

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    We're going on 2 years since dx with our 9yo DS and about a year since he started pumping with his MM Revel and we're been thinking about looking into CGM for it. Our CDE is supportive (she's been T1 for 30yrs) and would push for it if we asked , but I wonder about a few things and thought maybe someone who's been using CGM with the Revel could offer some insight.

    1. Our son is pretty lean and was even before dx, so we have been somewhat reluctant to have something else "stuck" in him that requires another site location. Maybe it's no big deal, we rotate sites between arms, bottom, and belly with not one infection issue since he started pumping and sites last 3 days 99.9% of the time. How does the CGM insertion compare with the MIO set insertion?

    2. His A1C went from off the charts at dx in Aug 2009 to 8 shortly after and has been in the low 7's since (1yr) pumping with a 7.0 at his last endo appt. and his endo prefers that he not run much lower than middle to high 6's.
    His endo likes his growth and weight #'s and seemed very happy with his A1c at his last appt.
    We've not had a severe hypo that required anything other than juice or a few glucose tabs and only had an issue with Keotones once when he had pneumonia. We test about 6-7 times a day, depending on school PE schedule, dance and tumbling etc.. one test is at 10:00pm or so when we go to bed and then at 2-3am. Would the CGM improve his care that much or would it be more of a convienence and help in cutting back on the number of times we test....just wondering?:)
     
  2. mph

    mph Approved members

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    I'd say the #1 benefit from the CGMS for Nick is "knowing" what his bg is or is not (and the directional trend). It is a "quality" of life benefit for ALL of us.:)

    It also makes "other" people feel more confident caring for him, and "I" feel better leaving him in the care of others.:)

    As for insertions (we use the arms), he says he has gotten used to them, like site changes and bg checks. Just part and parcel of life with D.;)
     
  3. hawkeyegirl

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    Honestly, I think everyone can benefit from a CGM. Your son is nearing the age where he will be going more places by himself, and I can't tell you the peace of mind that CGM brings.

    You'll be amazed at the things you were missing before the CGM. Not only at night, but during the day too. It's hard to describe, but the CGM is really life-changing.

    My son has been using the CGM since he was 4. We use upper bottom exclusively for CGM. Most kids have enough "pudge" there for a sensor. We rotate from cheek to cheek, and that has worked for us for 3+ years now.
     
  4. truck2ff

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    Sensor changes every 2-3 days just like the infusuion sets? I have to admit the trending would be nice as well as not having to wake him so much to test. We've gotten used to the middle of the night checks, but I think it really drags him down by the end of the school week.
     
    Last edited: May 30, 2011
  5. hawkeyegirl

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    We change the sensor once a week.
     
  6. selketine

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    We use the Navigator (not currently for sale in the USA) and usually get 10 days if we do one restart. Some Dex users restart and get 14 days I think. The whole restart thing is very YDMV. I think in general that most cgms users "can" in theory get about the same length of wear out of their sensors doing restarts.

    I think both Dex and MM have an angled insertion (Nav has 90 degrees). The new MM Enlite sensor has a 90 degree insertion and is available overseas in some places but no one knows when it might come to the USA.

    I'm guessing with a Revel you are looking at the MM cgms so you might search up the Enlite if you are interested - that sensor looks way better than their current model so I'm hoping it is approved here sooner than later.

    The cgms also has a bit of a learning curve. Not that it won't work right away but learning how to get good calibrations and make it the most accurate for you can take weeks/months of trial and error on that but it is well worth the effort.
     
  7. rutgers1

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    I am considering pushing for one for my son. How many times per day do people with a CGM still check blood glucose with the traditional finger prick? Do you still have to prick the finger for meals?

    On a day like today when Matt ran a 5K, it would give us INCREDIBLE peace of mind if he had a GCM. INCREDIBLE.

    I tried to pitch him the idea as we drove home from the 5K, but as usual, he didn't respond. He doesn't like the idea of a CGM or a pump.
     
  8. emm142

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    Using the CGM I tend to do 4-6 fingersticks per day (compared with 10-20 without CGM). Rather than doing fingersticks before meals particularly, I just do checks when the CGM says I'm high or low (or if I think it's not reading correctly). If it hasn't said I'm high or low for a while, I do fingersticks before meals to check it's on track.
     
  9. rutgers1

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    Doesn't it give you the latest reading? I ask because you said that you check if it hasn't read high or low for a while. However, if it said 100, wouldn't you just go with it? Or are you saying that a red flag is waved by virtue of it staying within range too long?
     
  10. emm142

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    It's not so much that if it's says I've been flat for a while it's probably wrong. It's more just the fact that if it was wrongly saying I was in range, I wouldn't know, whereas if it was wrongly saying I was out of range I would check BG and find out. So I like to check at least every 4-5 hours, even if it is telling me everything's fine. Just my suspicious nature, I suppose. :p
     
  11. hawkeyegirl

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    When I know a sensor is working well, I would probably never check if the sensor is reading 100.

    We do fewer BG checks a day with the CGM, but the real advantage is that the checks we do are SMARTER than without it. We don't check when everything is humming along fine (even before meals), and we DO check when we're alerted that BG is going out of range. So we get rid of virtually all unnecessary checks (i.e., checks that don't require action) and only check when some action is likely to be needed.
     
  12. truck2ff

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    Well, if we didn't have to change the sensor as often as his infusion sets and given all of the other advantages you mentioned, I think we might want to look into it the next time he goes to see his endo. I know we're missing highs and lows, even though we test more now than when they started us on MDI at dx. It would be nice to see what the heck is going on, especially when we get wonky days that don't make sense.
     

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