- advertisement -

Is it important to get CGMS?

Discussion in 'Parents of Children with Type 1' started by DadTheImpaler, Jul 9, 2008.

  1. DadTheImpaler

    DadTheImpaler Approved members

    Joined:
    May 12, 2008
    Messages:
    25
    We're looking at getting our 5-year-old on a pump, hopefully in the fall (next pump info session at CHEO isn't until September), and I'd like to hear some thoughts on the importance of getting CGMS to go along with the pump.
    We're leaning towards the Animas pump, so of course there wouldn't be any built-in CGMS, but I'm not too concerned about that.
    My wife was thinking that we'd be fine just continuing with the finger pokes, but I think that knowing what his level is at all times would be invaluable information.

    I'd appreciate hearing your thoughts on the importance of a monitor, especially if people have tried pumping before and after getting a monitor.
     
    Mama Belle likes this.
  2. Caydens_Mommy

    Caydens_Mommy Approved members

    Joined:
    Mar 24, 2008
    Messages:
    2,953
    We do not have either of these devices, but wanted to say that even if you get a CGMS, you are still required to do finger pokes.. The only reason I know this is because I thought the same thing for a long time myself.. And just remember, that they are both valuable, but it is what you think is best for your child.. You might want to go with the pump first and then incorporate the CGMS later if you want or vice versa.

    Also, good luck with the pump class, we go to a pump review class next month to decided whether we want to make the switch over..
     
  3. Mama2H

    Mama2H Approved members

    Joined:
    Oct 19, 2006
    Messages:
    4,236
    My daughter is in a panic without cgms. It is invaluable information! To always know where blood sugar is going is priceless! I would get a 2nd job and mortgage our house to keep the cgms for her.
     
  4. Jensmami

    Jensmami Approved members

    Joined:
    May 17, 2007
    Messages:
    2,082
    We have both too, and I don't like it at all when we are off the cgms because we have to replace the sensor.

    It is true you still have to do finger pricks, however you know if the cgms is accurate and lots of times we don't do the finger pricks, but just check the graph and move on from there. This is valuable in so many different situations, like dancing, playing with friends, enjoying a party and the most of all over night. I don't have to prick her again and again to see if her BG really rises, I just check her graph.

    I am with Nicole, I would give everything for her to have the cgms.:)
     
  5. tiffanie1717

    tiffanie1717 Approved members

    Joined:
    May 16, 2008
    Messages:
    2,415
    I think it is especially helpful for children that don't know when they are going low. My daughter doesn't know (but she hasn't gone below 64 yet). I am struggling with the same thing. She is so skinny and small. i really don't want to have to put 2 sites on her. I may go with the pump first and then incorporate the cgms later. But, on the other hand, it would be great to know what was going on all the time!

    I'm right there with you in all this confusion!:confused:
     
  6. DadTheImpaler

    DadTheImpaler Approved members

    Joined:
    May 12, 2008
    Messages:
    25
    I'm not too worried about continuing the fingerpokes - he really doesn't mind them. I just want that additional info that the CGM would provide. CHEO will actually be putting him on a CGM soon, in advance of the pump info, mostly to help us explain some of his unexplained highs. I believe it will be the Minimed version. We're a little worried about the gauge of the insertion needle, though - he's used to 31, and this is 23.
     
  7. Caydens_Mommy

    Caydens_Mommy Approved members

    Joined:
    Mar 24, 2008
    Messages:
    2,953
    We would love to be on a CGMS too, or I would love for him to be on one.. Though we are not all in agreement that it is the best thing for him.. The Dr really wants us to try the pump first and his Dad is not wanting to do any of it..
    If you think it is best for your son, then I say go for it.. I think it would be very much worth it for you.. Make sure your insurance covers it though, if not that can be a long road unless you can cover it without the help of insurance..
     
  8. jules12

    jules12 Approved members

    Joined:
    May 26, 2007
    Messages:
    2,333
    Having newly started the cgms, I can see real value. However, weighing the two right now, the pump is more important - it doses the small amounts I need, helps with corrections that I could never do with a syringe (0.1) and has the variable basal rates that I need for times of more activity. Not to mention the fact that it does the calculations especially when you are very very tired! We have been pumping for one year - it made a big difference for us.

    My son's a1c's have ranged from 6.3 to 6.9.

    CGMS is like icing on the cake - we can now safely start to close the gap and try and let him run a little lower because we have an extra safety net. I can also see where it will help me with trends. I think I will come to love it and think it is invaluable just like other cgms users - however, right now, as a newbie, if I had to choose, I would choose his pump. That could change in three months though ;)
     
  9. Mama Belle

    Mama Belle Approved members

    Joined:
    Jan 23, 2007
    Messages:
    4,540
    I don't think I can add anything to this thread that hasn't already been said, except for ... you have the coolest username I have ever seen! I have not laughed that hard in a loooooong time. Kudos my man! :D
     
  10. Twinklet

    Twinklet Approved members

    Joined:
    Jun 29, 2006
    Messages:
    2,123
    The CGMS your doctor's office uses is most likely the Minimed Gold 3-day sensor that they download. I don't think you can see the numbers when it's on.

    If you want the Animas pump, get it. They're going to integrate with the Dexcom soon. If immediate integration is important to you, the MM pump is currently the only game in town.

    I like the CGMS a lot, but in our situation the pump is more important. The extended boluses and variable basal rates are a Godsend. But I admit I am a bit lost without the CGMS when it's off!!
     
  11. Nancy in VA

    Nancy in VA Approved members

    Joined:
    Jul 16, 2007
    Messages:
    7,308
    You are going to get varying opinions. There were a couple of threads maybe a month ago around the lines of "if you had to choose between your pump and CGMS"

    We did a week-long trial of the CGMS. I know that wasn't long but it was enough for me to know that I don't think I'd want it full time. I'd like it for trending during troublesome times, and basal testing, but I don't think we'd want it 24/7

    I do think it has the possibility to make someone who is already obsessive / OCD (like me) even more so. There is a balance between disease management and lifestyle management and I am trying really hard not to let this disease take over every waking minute of our life, so for us right now - no CGMS
     
    Rick likes this.
  12. jendean

    jendean Approved members

    Joined:
    Aug 28, 2007
    Messages:
    1,427
    Well, it is and it isnt.
    It is good to know, but you will still be doing BG checks, as this measures the glucose level in the interstitial fluid, which can be off by quite a bit at times.
    I would not use it as a diagnostic tool, (meaning, if we are really high, we dont bolus until we have done a fingerstick, because they are often a lot different)
    I think that it is good to have. It is a really useful tool, and very helpful.
    I will say that I do appreciate that we are not reliant on it... If it goes bad, or comes off... Life goes on, we dont stop for it. We put one in later when it is convenient.
    My son does not want to drop everything and do "D stuff" all the time.
    Now, I do like the animas, and they will be doing cgms soon too, as will lots of companies.

    But for the time being, make sure your insurance company would even pay for it... you have to call in the hcpc codes for what you want.
    :)
    Good luck.
     
  13. Darryl

    Darryl Approved members

    Joined:
    May 8, 2008
    Messages:
    4,313
    The easiest way I can explain the CGMS is in relation to the value of actual blood tests.

    You will read many posts where people make a BG measurement, make a correction, and then are surprised by the next reading being being much higher or lower than they would have expected. For example, a 180 is corrected only to end up being a 50 an hour later. Then the 50 is corrected only to result in a 250 an hour after that.

    Finger prick BG tests alone have limited usefulness. For example, if you test 130, what does that mean? It could mean that you are 130 going high very fast, or it could mean that you are 130 going low very fast. So what do you do? Do you give insulin, or do you give food? Based on BG tests alone, it's impossible to know. So you make your best guess, which is sometimes wrong, and send BG exactly in the opposite direction of what you expect. That is why correcting for BG tests alone can result in large "oscillations" in BG throughout the day rather than a relatively well corrected and stable BG.

    The CGM shows you not only the current BG number (with typical +/- 15% accuracy), but more importantly the trend. So, the CGM might mistake a 100 for a 120, but there is no mistaking a 120 going up from a 120 going down. So, with the CGM's data, your corrections are at least in the right direction, which makes all the difference in the world in achieving stable BG.

    It is true that 2 to 3 blood tests are required each day to keep the CGM calibrated in a normal range, but it is good to also do BG checks to confirm when the CGM reports a very low or high BG before correcting. In a typical week, we'll do a 4th test on a couple of days.

    The CGM also changes the whole picture of diabetes with regard to the possibility of severe low and highs. The traditional concerns about DKA, seizures, unconciousness, etc., become remote possibilities when using the CGM as long as you pay attention to the readings and set the alarms appropriately.

    The downsides are the cost, the 2nd site, etc. But in most respects the CGM provides a much more care-free lifestyle, avoidance of serious situations, and much better overall BG control vs. blood checks alone.
     
    Mama2H likes this.
  14. Mama2H

    Mama2H Approved members

    Joined:
    Oct 19, 2006
    Messages:
    4,236
    Bravo Darryl! Thank you for saying what I am not articulate enough to put down!!!!!
     
  15. DadTheImpaler

    DadTheImpaler Approved members

    Joined:
    May 12, 2008
    Messages:
    25
    Awesome input, people, thanks a bunch.
    Fortunately, we don't have to make a choice between a pump and a CGM - living in Ontario, our provincial healthcare recently (within the last 2 years) started covering the cost of insulin pumps for kids. We'll have to see if our benefits will cover the CGM, but if we feel it's important enough, I guess we'll shell out for it. Dexcom isn't available in Canada yet, I believe, but if that's the one we choose, it may be a matter of some cross-border shopping, who knows.
     
  16. thebestnest5

    thebestnest5 Approved members

    Joined:
    Aug 16, 2006
    Messages:
    3,001
    Great job, Darryl. :D

    We love, love, love CGM and have been using it since June '07. It has actually made me less obsessive about numbers--since I can see the trends and don't have to "guess" what happened as much as before. For us, CGM has made mananging diabetes easier, with some less stress. My DD really likes having CGM and it helps her be more spontaneous in life--more about just enjoying being a kid and less about thinking about D management when she's out with friends or just playing in the yard.

    I look forward to the advancements in CGM and tell DD that she is one of the pioneers in using CGM technology--just like I remember her uncle using the old autoclix lancet and one of the very first BG meters widely available in the 1980's---compare that to the new BG meters on the market--and it's amazing!!
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice