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VERY HELPFUL call with Abbott re: Navigator

Discussion in 'Continuous Glucose Sensing' started by Nancy in VA, Apr 9, 2009.

  1. Nancy in VA

    Nancy in VA Approved members

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    I asked last night for someone to call me back after my Navigator fingerstick and Navigator CGMS were reading 90 points off.

    I learned two very interesting things - 1 fact and 1 "major speculation" on our part. I spoke with one of their CDEs, and she said she has worn it before.

    1) If your fingerstick on the Freestyle is 20-49.9% off of the CGMS reading, that is a good time to FORCE a calibration. The documentation says only to do it if the helpdesk people tell you, but she said that definitely, if its that far off, then to do it. She said it tells you that it will "wipe all" data. This is important to know because she says that the last 2 days are supposed to be the MOST accurate because the algorithm takes all of the calibrations and readings over the previous 3 days to do the "readings". Forcing the calibrations loses that data, but forcing the calibration should get it back on track within 20 minutes.

    2) And this is purely speculation on my AND Her part, and I asked her if she would research it more. I "appears" if you do a fingerstick using the built-in meter, than the CGMS factors that in to determining the readings. Last night, Emma had stayed flat at 116 for 90 minutes, and the minute I did a fingerstick with the built-in, her readings started going UP. The CDE said that the engineers said it didn't, BUT, she said she personally has observed the same thing AND that the only people that seem to call with major discrepancies are ones who AREN'T using the built in meter. So, those that are using the built-in meter seem to have more accurate readings, meaning that it HAS to be factoring in those regular BG readings into the formula.

    I asked her if she could look into that further because that's very interesting to me, and that I wouldn't be using the meter full-time as ours is a meter/remote, but I will use it more if I'm seeing numbers that are "off' and don't want to force a calibration.

    I wish I had been told it was ok to force a calibration last night.
     
  2. Melissata

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    That IS very interesting, and I was starting to think along those lines as far as using the Navigator for finger sticks. I can tell you that my son has far more accuracy than my daughter does by day 3. He uses the Navigator for all finger sticks. He has used it a lot longer and has done fewer forced calibrations that we do. I have started doing them anytime I know that it is over 20 points off and has not self corrected within a few hours. I am really tempted to have her use the Navigator rather than the Cozmonitor and compare how accurate it stays, but I don't like to have her always entering the bg into the pump. I'm getting more trusting of her doing this on her own, so if that is the case and it will keep the Navigator on track all of the time, I will really think about it. Thanks so much for posting that info.
     
  3. BrendaK

    BrendaK Neonatal Diabetes Registry

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    And OFF with that bulky cozmonitor for us!!!


    Thank you so much Nancy -- that is so helpful!!!
     
  4. selketine

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    That is interesting. Our insurance doesn't usually cover the freestyle strips (only One Touch - we're in an HMO) - so we are still trying to get them to cover the one bottle or so per month we need for calibrations.

    I doubt I could talk them into covering more than that if Abbott doesn't make a point of saying that non-calibrations finger sticks on the Nav help the accuracy.:(
     
  5. Nancy in VA

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    Carol: We're an HMO but they don't specify strips. They don't like covering both and we're still fighting that but if I get to the point I want to do more figersticks on the Freestyle, I'll probably reduce the number on the OneTouch and increase the # on the Freestyle - or strike a deal with someone here to trade strips! :)
     
  6. Diana

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    Well, that is interesting. We use the Nav for all BG checks (home and school) and I would say that we generally have very good accuracy.

    I have never had a rep suggest a manual calibration. The reps I have spoken to have made it seem like it is a REALLY BIG DEAL and you shouldn't ever do it except in DIRE SITUATIONS. It's dumb. They usually suggest I pull the sensor instead.

    I figure that if the sensor is that far off, you may as well try to fix it before you yank it. What do you have to lose?
     
  7. buggle

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    The one person I've spoken with at Abbott who truly seemed knowledgeable (John) said that the forced calibration does not toss previous calibrations. He said it incorporates it. I know that Carol was told the same thing as you, though, Nancy. So, I really don't know what the case it.

    But John did say that if the child is stable and the BG is off substantially from the CGM, to not be afraid to use it. They don't want people manually calibrating every minute, but it is there for a reason.

    ETA: We rarely use the built-in meter other than for calibrations, but when we have, it does seem like it corrects a bit. I wonder if it does...
     
  8. Diana

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    I have asked 3 different people about the manual calibrations and they all said it tossed the prior info. The knowledge level of these people, however, is up for debate.:rolleyes:
     
  9. ecs1516

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    I agree. :rolleyes:

    I have also noticed that it seemed to bump the number when doing calibrations. I guess if you do that make sure they are steady at the time. I check sometimes when they are not steady and I don't know if I would want to use Navigator at that point.
     
  10. Melissata

    Melissata Approved members

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    I did the same thing yesterday. The pump is lighter and the buttons easier to push without it. Had a conversation with my son about whether or not the bg's are being taken into account and he doesn't believe that they are. It would be nice to know. Maybe Abbott didn't want to tell people which meter to use, but I do believe that One Touch's read low and that is going to make it look like there is a discrepancy when there isn't. My son has always used an One Touch until he got the Navigator. His A1 c went down below 6 for the first time in his almost 15 years of diabetes. He has hypo unawareness so we didn't really expect to see a huge change in the A1c. Of course he is correcting more now, but I think that the change in meters has something to do with it also. He is on MDI's, so didn't do as many tiny corrections as most people on pumps do.
     
  11. Nancy in VA

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    Melissa: The One Touch and the built-in are reading about 20-30 points different for me. But I account for that in setting my alarms. My problem the other night was that the built-in and the CGMS were reading 100 points off with no trend line to indicate it would catch up during the lag.
     
  12. ecs1516

    ecs1516 Approved members

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    Yes, we took ours off for the same reasons. I liked the BG going into the pump but made it thicker and and harder to hold too. Also, carrying the Navigator in the pouch this was just adding even more weight.
     
  13. Nancy in VA

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    ecs1516 - check your PM!
     
  14. ecs1516

    ecs1516 Approved members

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    I don't see the PM yet.
     
  15. Melissata

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    Hi Nancy, Melissa is my daughter, my name is Mary. I recalibrate at anything more than 20 points off. We are at that point right now, but she will be due for her 72 hour soon, so I am holding off. If you get 100 point difference from the built in and the CGM, then you have a big problem. We only had that happen once, and that was before we discovered the alignment pin was broken. I'm sure it is trickier to deal with younger kids, so waiting to be sure is probably better than to keep forcing calibrations that may not be accurate.
     
  16. Melissata

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    I made her a case out of a meter case and put a clear front on it so that she can see the Navigator easily. When she had it in an enclosed case, she wasn't paying attention to it unless it alarmed. I am going to try making a leather case for both her and my son. He drops his from the clip pretty often as well. Sometimes he does it just getting his car keys out of his pocket. It is pretty durable, but that won't last forever!
     
  17. ecs1516

    ecs1516 Approved members

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    What do you put your case on?
    My kids can't use the plastic belt clips they seem to just jump off their pants. We have been using double pump pouches from pumpwearinc.com. It has a totally clear front on the front pouch for the CGM. They wear it 24/7 so it is about had it. I bought a second set for backup. I just ordered new spibelt couble paks. My younger son loved the regular spi belt because they don't bounce when jogging. I wish the pouch on the spibelt had a clear front.
    We also put pda protection screens on the front of the Navigator because it scratches easy.
     
  18. Melissata

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    She usually wears a belt and the case has a strip of fabric with velcro on it. I had made some pump packs and used caribeener clips on them so that she could just clip it to her beltloop, but she was forever scratching up my kitchen cabinets with them, so I got rid of those. I like the spibelt too but it scares me a little because it is so stretchy and she doesn't watch what she is doing when she takes it out, so it could easily jump out of there and onto the floor. It is hard to explain, but she is almost like a blind person with never looking at what she is doing, lol. She also will put the case on the spibelt, but it would be pretty difficult to put a clear front on something so stretchy. She wears one Spibelt for swimming, but Pumpwear is really overpriced and the one case that I got from them didn't last at all. I actually just ordered it to copy it. I am thinking of trying to make a leather case with a clear front, but don't know if my machine can handle it. I think that my son would even wear that one. That is a good explanation of how the clips seem to just jump off! I just looked at the clip and wonder if gluing some of that rubbery shelf liner type stuff to the inside would help? I can easily see why it comes off.
     
  19. Nancy in VA

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    I'm definitely convinced that the finger sticks affect the CGMS readings

    We got a low alarm - 69 with an arrow straight down last night.
    My OneTouch read 115
    My built-in Freestyle read 99

    Within short order, it readjusted itself, gave me an angled up arrow, and settled in on about 113. It went up slightly to around 140 last night but stayed in range all night and she woke up at 150.

    Quite happy with that - would have been happier to have a night like that while my husband was out of town and I could have used the sleep
     
  20. BrendaK

    BrendaK Neonatal Diabetes Registry

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    I'm with you on that. When we were using another meter for fingersticks the Nav would be 20-30 points or more off. I've been using only the Nav for fingersticks now since you posted a few days ago and it's between 1-10 points off max. And we're on day 13 of the sensor!!
     

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