The big-fear CGM sensor insertion went just fine. My DE deftly and expertly got the thing inserted and it only stung for a second. It bled a bit, but the DE thought it would be ok. So after making sure everything was set up properly, off they trundled (the DE and another DE who was observing) and I was left to enjoy my afternoon and the next 6 days attached to a Medtronic Guardian Continuous Glucose Monitor.

When the first “lost sensor” happened, I was impressed that I found how to fix that immediately and thought the unit was just being temperamental.

When then 20th one had occurred by 3 hours later, along with Cal Error, Sensor Error and just about every error in the book happening several times, my expectation of the wonderful data that would ensue from wearing this CGM went plummeting with every passing moment. By early evening and after a gazillion text messages back and forth to my DE, she decided I should take off the sensor. That turned out to be the best decision.

Little did anyone know how much I’d bled under the skin with the insertion. The little wire which sat under the skin was fully coated and dripping with blood when I pulled it out, I bled some more, and my skin was beginning to look rather nasty – bright purple and resplendent red, measuring about 5cm at its widest point.

There was no way all that blood was ever going to resemble interstitial fluid, which the CGM relies on for taking continuous measurements. No wonder it couldn’t calibrate anything and it went crazy with alarms!

Today that purple and red has turned into an unmistakeable black and blue with tinges of dull purple and redish-yellow. Doesn’t hurt at all, but when I had the sensor in, it was a tad uncomfortable but nothing I thought would bother me, and I have a very low threshold for pain. So now I know why it was uncomfortable.

While I’m disappointed, I fully understand that these things do happen. I’ve had plenty of bruises from using insulin pump infusion sets, and I still have a now-small remnant from injecting Levemir for a few years on the right side of my belly, even though it’s nearly 2 years since I stopped. The new bruise will heal and the only thing I have to do is to remember where not to put a sensor next time!

As far as the Medtronic Guardian goes, firstly, there’s a 30 minute lag, so having alarms on for highs and lows can be a bit pointless unless you’re looking for patterns and not warnings.

The readability of the screen is horrid, particularly because I’m used to the nice, bright screen on the Animas 2020 Insulin Pump. I had to constantly turn the screen light on and have my glasses on to see where all the button pressing was taking me. I can read the Animas screen (only just) without glasses – a big plus for me!

The alarms are way too quiet for me. I missed a few of the “Lost Sensor” alarms and I couldn’t see a way to turn up the volume. With a normal volume TV on, I couldn’t hear the alarms even when I was expecting them. I went shopping in the afternoon and in a crowded place and there was no hope for me hearing it at the mall. My husband, on the other hand, who has eyes and ears like a hawk, did hear it one time there, even though it alarmed about every 5-10 minutes.

I can’t tell you how the Guardian did on measuring my blood sugar. It didn’t do a single measurement in 6 hours, such was the frequency of the sensor errors! I have no doubt it would be useful for its intended purpose.

Again, my choice would be for a Dexcom 7+ which is more instant than 30 minutes, so I’ll be waiting for that to hit Australia.

From this study: Regular CGM Use Increases Diabetes Control For All Age Groups: JDRF-Funded Studies

The latest data from groundbreaking human clinical trials of the effectiveness of continuous glucose monitors (CGM) show that the primary determinant of improvements in achieving better diabetes control is regular use of monitors – six days per week or more – rather than the age of patients, and that benefits continue well past the time when people with type 1 diabetes begin using the devices – including experiencing fewer low blood sugar emergencies.

This is the result of two studies funded by JDRF. It’s not only these two studies, it’s tons of anecdotal evidence from CGM users. Why then won’t most insurance companies subsidise them? A few will in the USA, but none will at this stage in Australia.

I guess insurance companies prefer to be paying for emergencies with hypoglycaemia and hyperglycaemia, and later on, to be subsidising the complications that are often a part of life for people with diabetes.

How does that make economic sense, let alone be serving the health of people who have to deal with this dreaded disease on an hourly basis? Sorry, but it makes no sense to me.

CGM is the future of diabetes, at least the forseeable future. I would do anything to get one. From all I’ve read about the CGMs available in the USA, and possibly coming to Austalia in the near future (Medtronic already markets one here), the  DexCom SEVEN^® PLUS is my current choice.

I work hard to keep my BGLs in range – in the lower range of my target if possible.  If I test before I go to bed, and I’ve tested 2 hours before, I often can’t tell if I’m headed up or down. Unfortunatlely I have to have that extra mmol/L of safety before I go to bed. Night hypos (nypos) while you’re sleeping are horrid and I’ll do anything to avoid one. A CGM would be ideal in this and many other situations.

If I could know if I’m headed upwards with my BGLs, I can take action. Without a CGM, you’re just going to test 2 or 3 hours later, and find out that you’re exactly where you don’t want to be! You’ve already got the spike and then you have to work to get it down.

CGMs don’t really replace testing blood sugar on a conventonal meter – you still have to test a couple of times a day to calibrate the CGM (I’m sure this will change in the furture). Their primary role is to alert you to trends. Going up? Going down? With a CGM you know and can take action.

Insurance companies need to understand that for those who want it, it’s mostly out of their financial reach. But… at around $1000 for a CGM, how many medical dollars will that save in the long run?

Figure just one incident – transport by ambulance to a hospital, doctors and nurses time, drugs, a hospital bed and a whole lot more. How much would that cost? I dare say a whole lot more than the cost of a CGM, and a subsidy on the $70 per week for consumables, or less if you don’t wear it all the time. If you’re getting to hospital for some reason around twice a year, figure the cost!

It not only makes more economic sense for insurance companies to subsidise CGMs, both short and long term, they need to be encouraging anyone on insulin to be wearing one!

Are insurance companies in the business of helping people to stay healthy or are they saying no for some other reason?

Closer and closer – 17 days to be almost exact. I’m not counting that hard, but every time I start a blog entry, I need to add the days.

I’m still learning in preparation for my insulin pump start but also lamenting the fact that Continuous Glucose Monitoring Systems (CGMS) are so lacking in Australia. I had high hopes for the Freestyle Navigator and the Dexcom 7+, but they’re nowhere to be seen and don’t look like they’ll land here anytime soon. Pity.

CGMS, like insulin pumps, really do help in diabetes management. What you can’t see, even if you test 10 times a day, is accurate trends. Is your blood glucose going up or down? What’s it doing when you’re asleep? At what point after food do you spike? Answers make for even tighter control.

I’m insanely jealous of those forum posters who write about their experiences with CGMS. The only CGMS available in Australia at this time, is from Medtronic. They’re expensive, the sensor only lasts a 3 days (unlike those mentioned above) and the cost is beyond my current budget.