Tuesday, March 29, 2011

Bye Bye CGM

Larry The Loaner CGM and I have finally parted ways.

We've had a love-hate relationship for nearly three months, but our time together has come to a close.

You may remember that in early January I started a trial run with the Minimed 523 Paradigm Revel, a loaner from my local pump rep who offered to help out in making a decision about whether I truly wanted to purchase this most up-to-date Continuous Glucose Monitor (CGM). I've got a 722 Paradigm pump, but it only sports the real-time CGM without any predictive alerts or what the x23 styles offer. So I brought on this 523 (which has a smaller reservoir than the 7-series but is same in all other respects). Affectionately, I named this loaner CGM/pump Larry The Loaner.

We rode the glucoaster and recognized the Highs and Lows for a decent amount of time, with a few sensor breaks every once in a while to mix things up. We had our fun. And quite the opposite of fun. Overall, it wa an educational and eye-opening run together.

But after getting three "Motor Error" alerts in the past month, several mentioned that the alarm is essentially a sign the pump is dying. Luckily, I made it through the Washington D.C. trip unscathed, even though I did endure another one of those alarms there. So, that's helped motivate me to put Larry aside. Then there's the fact that I'm out of the little 180-unit reservoirs that this pump required... Smaller versions of the 300-unit reservoirs that my insurance company has so generously paid for and I have a full supply of. Without these smaller versions, it's time to go back to my own pump that holds more insulin.

So now, I've put aside Larry The Loaner and gone back to my trusted Bacon Gibbs (honoring not only the wonder that is Bacon, but the NCIS character we know and love as Leroy Jethro Gibbs.)

Just the other night, I uploaded the Carelink data one last time and took out the battery before putting Larry aside - until he can be returned to the local rep here in Indy.

I've written about my Minimed CGM feelings before on why I'm not leaning toward buying my own MM CGM, and honestly nothing has changed to make me rethink that view.

Philosophically, I've pondered the line between whether a CGM is beneficial or not. You have an influx of information that allows you to constantly monitor your health and always be in tune with what you're body is doing as far as diabetes (at least, as much as is possible with all of the existing "accuracy issues" of these devices). You can react quickly and be in more "tight control." But that all comes with a price, one that has the potential to likely flood you with just too much information. To the point of burn out.

You couple in the inaccuracies and flakiness of current CGMs, and that brings me to my final verdict: The MM CGM isn't for me right now, simply because I've experienced it lacking in the two most important aspects - accuracy and consistency. Having the CGM and pump merged into one device is appealing, but that's not the most important factor. When I can't trust the device, it defeats the purpose of having it. Not to mention the sensor needle is huge and intimidating, and the ever-slow FDA approval process on the next generation has no end in sight.

So there it is. I may at some point reconsider. Maybe when the next MM sensor comes out. Or maybe if Dexcom allows me to trial-test the Dex again, for more than a single sensor life. We'll see.

But I don't see it as a necessary expense at this point in my life, when I'm more than able to test 10 times a day and get the same desired results. The CGM makes me more in tune with what my BGs are doing, but only because I'm constantly checking and wanting to make sure I am doing my best to get to No Hitter range. That's a mind game, and one that I'm more than able to achieve without a CGM (assuming I can be disciplined enough to test, carb count accurately, and do what's necessary).

So, we go on our way as a pumper but not a CGMer. At least for the time being. And I'm cool with that.

10 comments:

Amy Lederer said...

"No Hitter range" - Love it!

Sarah said...
This comment has been removed by the author.
Valerie said...

Good to get your insight. I am still new to my medtronic CGM and I actually took about a week or two off and re-connected a couple days ago. I'm still not sure how I feel about it yet and I am leaning towards what you're saying here. Have you tried the dex? Seems like that one is the more popular choice in the DOC.

Reyna said...

Yep...I can totally see going without it. I use it as an adjunct to common sense, activity, and bgs. The trending is the most useful...AND...I DO NOT look at it all the time AT ALL...just peeks here and there depending on what Joe is up to next.

AND...one more thing...NIGHT TIME care it is a HUGE help for us parental-unit-type-3's.

Sarah said...

sorry I had to edit my comment...but wasn't sure how. What I really wanted to say is that I think technology sometimes can be more of a burden than others. For me it can lead to times of anxiety with unnecessary alarms that draw attention at times that make my son uncomfortable. However, it has helped tremendously for me in that I now am able to do basal testing and can see where we need to do tweaking rather than just guessing at what is happening. It has also helped me have many nights of much much better rest than I have had in years as a parent of a CWD.

Hallie said...

It's not for everyone... I know nothing about the MM. We have a Animas/Dex combo and I am in love with that! Of course, I wish they'd hurry up and integrate but... For me, the cgm is a necessity because Sweets does not feel her lows. Ever. And I like to get a little sleep at night! BUT... she's tiny thing so we don't need a pump that holds a lot of insulin. Her TDD is about 7 units! Good luck on your cgm-less journey!

Sysy said...

Thanks for this. I've been considering going to bat for this again with my doctor (who says, I don't need it) and the insurance company (who says, we won't help you pay for it) and I think I'll rest for a little while because my life is pretty stable at the moment, meaning I stay home all day with kids and I can test all day and night if I want to (well not really but you get what I'm saying)

I appreciate your take on this.

Lorraine of "This is Caleb..." said...

I'm glad you had the opportunity to assess and decide.

Natalie said...

I don't think a CGM is necessary (except for OCD types) as long as you're willing to test frequently, and have good hypo-awareness. But I think it can be a life-saver for the hypo-unaware. And for parents, particularly when the child protests frequent testing, or is unreliable at identifying lows. I also think that CGMs will improve greatly in the future, just like meters did, so you might end up reconsidering in a couple of years!

Sandy said...

Like Hallie said, the CGM is required when you don't feel your lows. My hubby doesn't feel his lows so it is very necessary to have it. Also like this other doc I like my sleep, and before CGM times I didn't get much of it :) CGM's aren't for everyone but if you decide its not for you now, just keep it in mind in case you find more of a need in the future. It can be a real gift in the right situation.