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Looking for some CGM advice

Discussion in 'Parents of Children with Type 1' started by cgbphp, Jan 8, 2012.

  1. cgbphp

    cgbphp Approved members

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    My son Hayden just turned three and was diagnosed last June. He is on pump therapy with a Revel MM. I thought for the first time since our pump start his numbers were good last week but they are all over the place again. Ranging from 46 to HI and everything in between on a daily basis. So I thought a CGM would be good for him. I had asked about it when he got his pump and the Endo said he was to young and he didn't have enough body space for a pump site and a CGM site. Is this true? Does anyone have a toddler with both a pump and CGM? He has a Endo appt. coming up and I would really like him to have the CGM so I am just trying to get my ducks and info in a row so I can know what I am talking about when I speak with the Endo. Also does each pump only have one CGM option or can different CGMs go to different brands of pumps? As my Endo PUSHES medtronic she is part of their research and development team and really pushed us in that direction when deciding on a pump. I was leaning towards a pod and again she said he was to young for a omnipod. Any CGM info would be helpful thanks
     
  2. CAGrandma

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    A couple of random facts that you might be able to use: our endo said that Medtronics should be making an improved CGM available this spring and it would be worth waiting for. Also, even if your son doesn't use the CGM all the time it could be worthwhile (and worth finding a spot on his little body) if he wore it periodically to give you more information so you can spot trends and tweak his basal rate, etc.
     
  3. PixieStix

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    Yes, it does use up real estate on the body to have both an infusion set & CGM sensor rotating around. So you have to be willing to use belly, butt, legs, etc as there is not much room to solely use one little specific place. CGM can work on a little one and provide invaluable data, though you might have to pay OOP for it. Since you now have the MM pump, would make most sense to use MM CGM for now, can reassess again when pump goes out of warranty. I would recommend you fully educate yourself on what a CGM does/doesn't do, and go to the appt with a clear rationale what you believe the CGM will allow you to achieve that is not happening w/o it.

    If this were me, I'd go to the endo appt determined to secure a script for the CGM. I would listen to the doc's rationale of just why they wouldn't support getting a CGM at this time, and consider those points too. Based on our experience of DS wearing the CGM continuously for the past 5+ years...I can't imagine ever going w/o CGM again, not even for a day. So in the end I would find another doc who supported my care goals for my child if the endo still refused.
     
  4. VikkiMum

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    Hi
    My daughter is 6 and she was 5 when she first started using the Dexcom CGM. She's quite slim so we don't have the full choice of sites (tummy doesn't work for the CGM & thighs don't work for the pump). Yes, you need to keep the pump site & the CGM sensor apart but it is possible. We mainly use her bottom & hip areas for her pump and then rotate her CGM from arm to arm. It's a case of trial and error but I'm sure you can make it work for your little one. The CGM is fantastic for us! Not perfect, but close and we couldn't live without it. We always seem to have a pattern of about 3/4 weeks of good levels and then suddenly everything goes haywire & changes yet again (I guess this is because she is so young and growing all the time). Without the CGM it would then be an extremely frustrating few weeks trying to get it back on track. I find that now with the help of the CGM it is so much quicker to get things back on track. She is aware of about 50% of hypos and completely unaware of highs so the CGM alarms are invaluable. I personally sleep much better at night now she has a CGM which means I am less of a zombie and a much better mum to her & her siblings and better able to cope with her diabetes. We live in Scotland so the system here is very different to your system. We were given the DANA pump by the hospital and then chose to fund the Dexcom ourselves privately. I am guessing that having the same make of CGM would mean that your child only has one machine to carry around - ?
    Lots of luck
    Vikki
    x
     
  5. Lovemyboys

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    At 16 months my son had both a pump and a cgm. If one of them had to go, it'd be the pump! We usually alternate arms for the cgm site and put the pump site on his upper thighs, buttocks.
     
  6. cdninct

    cdninct Approved members

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    My son started pumping with the Revel last May at 3 years, and he started using the Minimed CGM last month at 3.5 years. We use the tush for the CGM and for the pump for 3 days, then we move the pump site to an arm or leg for the other 3 days. So far, so good! I was concerned, especially since he is small and skinny and we use the Sure-Ts with the needle, but they seem to work everywhere. When we get more comfortable with the CGM, we might try it on the back of his arm, too.

    We were told at dx that he was a great candidate for the pump but was really too young to be using a CGM. Even after we started pumping, we were told that kids his age generally did not do well on CGMs. At our last appointment, though, I went in determined to get the prescription, and when I said we were really interested and we understood the benefits and limitations of the technology, the CDE became, more than just willing to proceed, actually enthusiastic about the idea, and we were up and going in a few weeks.

    I should also mention that the day we went in to start on the CGM, we met another family in for their first appointment with their newly-diagnosed 18 month old, and it was suggested to them that they start on a CGM right away. This little guy was chubby, so they wouldn't have too much trouble finding a site, but I was still surprised the clinic was pushing CGM use on toddlers after our experience. Perhaps attitudes are changing?
     
  7. lisamustac

    lisamustac Approved members

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    My son was also pumping and gcm when he was 2. It is another site but we stick to pump on arms and gcm on his behind. I think the Cgm is so great for little ones because they can't tell us how they are feeling. We have caught many lows before they have become dangerous. While they are not perfect I'm not sure it's something we can be without. Its like a security blanket for me.
     
  8. joy orz

    joy orz Approved members

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    Ditto what the others said. Ava was on the pump at two and the CGM at three. LOVE our Dexcom.

    You don't have to go for the minimed cgm, just because you have the minimed pump. Try them both. We found the minimed cgm sites to be really rough on Ava, but the Dex is a better match. I also like having them not be attached. I usually carry her dex on me and at school her teacher keeps it with her. That way all the adults know what is going on with her blood sugar without having to fish under her clothes to look at her pump.

    Minimed has come out with a parent unit, but if I am understanding correctly, it needs to be plugged into a wall outlet? This gives it much less flexibility.

    But again, try them both. We were able to do a trial with no problem. In fact, when we did the Dex trial, we caught some serious lows so it helped us get insurance coverage for it.
     
  9. cdninct

    cdninct Approved members

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    DS has a Revel, but I still got the Guardian unit for him. It is great because he has the Revel on him so he never loses the signal (or the unit!), but I have the Guardian so I can keep it with me and check the number without fishing out his pump, and I can keep it on his bedside table so I don't have to worry about him rolling on his pump and muffling the alarm. We had no problem whatsoever getting insurance to approve it, so I would say if you want to go with Minimed, you should give it a try!
     
  10. Lisa P.

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    I believe CGM is harder on small children because the bg moves so rapidly in a little body, the CGM has a hard time keeping up. We can get very wrong numbers on the CGM.

    That said, I consider it an invaluable tool. We have found it a far, far more useful tool than a pump. I'm not sure why endos who encourage pumping discourage CGM -- seems to me if it's got to be one or the other, CGM is the way to go.

    Real estate is an issue, but remember that while a pump has a cannula infusing constantly for days, a CGM only has a small wire, so the scarring and invasion of tissue usually isn't as "bad". They both take up space, but while you have to rotate a lot with the pump site you're not looking at as much trouble with the CGM and rotation. What we did was rotate the pump site all over the toosh and thighs but just switch back and forth on the back of the arms for the sensor.

    Talk to some CGM reps, they can give you good info.
     
  11. lisac

    lisac Approved members

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    I guess we were lucky that our endo suggested the CGM for my daughter. She was having crazy numbers just like yours is. High, low, high, low. It was a nightmare! Hadlee just turned 4 and has the Ping and Dexcom and we don't really have any "real estate" problems. We alternate her CGM on her arms and both sides of her belly and her pump sites arms, belly, butt (wherever the CGM is not.) Her last A1c (before Dexcom) was around 10. (I'm a bad D mom and I can't recall her A1cs like some moms can) but I know it wasn't good which is what made her endo push for CGM. We go back this Thurs for her check-up, so I guess we'll find out then how much it's helped out there, but we LOVE it!! I can't imagine being without it now! Part of our high A1c problem is that (T1) dad is too paranoid and won't let her BG get below 150 at night, which results in lots of mid 200 to 300 bgs from about midnight until around 9 am.

    Btw, the week leading up to our insurance approval, Hadlee had her worst week ever!! We had like 3 nights in a row of bgs in the 40's, so our insurance covered it at, I think, 90% So, make sure you have lots of bg logs and your ins. may at least cover some of the cost
     
  12. Darryl

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    We started using the CGM at age 8 so I can't speak for age 3, although many people here have used the MM CGM at age 3 or below. What I can tell you is that by seeing the BG at all times, you can steer it back into range whenever it starts to venture out of range. This makes a BIG difference in overall BG control vs. waiting for the results of BG checks every couple of hours. IMO, the younger a child, the more beneficial because they are so sensitive to insulin, and they have so many years to live with D that you can give them many years of better control by starting off with a CGM at the youngest possible age.

    Don't get diverted by possible talk of an "improved" CGM. The "improved" CGM has been just weeks away since at least 2007, and the current CGM is plenty good enough to help attain very good BG control.
     

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