Why I think all diabetics should have a CGM

[Spiker]

I agree that CGM is life changing. Using one halved my average BG with one third of the variability. But even though I own one, I can't afford to run it at the moment. They are very expensive. But in my personal opinion (anecdotal evidence only) they are far more cost effective than pumps in improving control. That may be different for other people (particularly people with complex basal demands).

The fairest thing in my opinion would be to give all diabetics, particularly [insulin dependent] diabetics, access to a CGM (as the OP suggested). If hospitals had a pool of CGMs they could give them out for say a month at a time to diabetics maybe around 6 - 12 months after diagnosis, and maybe at 1 to 2 year intervals after that. Most of the benefits are in discovering patterns that can then be locked in for a year or more. This would be 12 times cheaper and allow 12 times as many people to get say 80% of the benefit of CGM.

I think it would be smart if the CGM manufacturers paid for this themselves, because there is little doubt it would pave the way for widespread adoption of CGM. It would build popular demand, HCP acceptance, and a massive evidence base for NICE to use.

And apart from anything else, from a pure research viewpoint it would create a massive database of real time BG data that could be use to correlate things like SD to health outcomes, data which is sketchy at the moment, and also could be used to back validate HBa1c to average BG relationship in a way that is much stronger than the existing data.

 

[iHs]

I agree that CGM is life changing. Using one halved my average BG with one third of the variability. But even though I own one, I can't afford to run it at the moment. They are very expensive. But in my personal opinion (anecdotal evidence only) they are far more cost effective than pumps in improving control. That may be different for other people (particularly people with complex basal demands).

The fairest thing in my opinion would be to give all diabetics, particularly [insulin dependent] diabetics, access to a CGM (as the OP suggested). If hospitals had a pool of CGMs they could give them out for say a month at a time to diabetics maybe around 6 - 12 months after diagnosis, and maybe at 1 to 2 year intervals after that. Most of the benefits are in discovering patterns that can then be locked in for a year or more. This would be 12 times cheaper and allow 12 times as many people to get say 80% of the benefit of CGM.

I think it would be smart if the CGM manufacturers paid for this themselves, because there is little doubt it would pave the way for widespread adoption of CGM. It would build popular demand, HCP acceptance, and a massive evidence base for NICE to use.

And apart from anything else, from a pure research viewpoint it would create a massive database of real time BG data that could be use to correlate things like SD to health outcomes, data which is sketchy at the moment, and also could be used to back validate HBa1c to average BG relationship in a way that is much stronger than the existing data.

Well said @Spiker

I am grateful to have a pump but its ability to control my bg levels ok depends very much on bg testing to make sure the settings are ok and insulin to be delivered correctly. CGM will transform loads of diabetic's lives and the sooner more competition enters the field, the more the price will drop to make the technology affordable.

 

[noblehead]

Great posts @Spiker @iHs.

 

[tim2000s]

I think this is why the Libre has had such a huge demand. In spite of the idiosyncrasies, having all that data makes managing both levels and variability hugely easier.

It's a vast step forward for me and I only wish I could have had it years ago. It conclusively proved I had an issue with Lantus absorption (that I probably had for years), and it's great knowing how everything hangs together in a way it didn't before.

This is why the nhs trusts are really trialling this hard. Affordable cgm is far more useful than a pump, but also highlights to an MDI user where a pump would be hugely beneficial.

This is why, if you can afford to do it, I highly recommend doing so.

 

[Flowerpot]

Well said indeed @Spiker

CGM is a game changer and a life saver, I'm sure I wouldn't still be here without it.

The price of the sensors and transmitter haven't really changed in the 4 years I've been using it. It is cruel that such great technology is so prohibitively expensive yet it is a key to good, constant control. I have learned so much more from CGM than I'd ever managed in my previous decades and there is so much to constantly pick up on and try to improve on. It makes me want to do that,

It would be a great move to somehow enable insulin dependent diabetics to use a CGM for a longer period than the usual 7 days as that isn't really long enough to see established patterns and is often only offered when things aren't going well before being taken away again. From my experience HbA1c wise and general control wise I see it as indisputable evidence that CGM works.

 

[tim2000s]

From my experience HbA1c wise and general control wise I see it as indisputable evidence that CGM works.

I have to agree with this. Libre in combination with Lower Carb has seen my Hba1C drop from 7% to 6%. As the consultant put it, you are in the normal blood glucose range with that. So much harder without it.

 

[Iamcalledphilip]

Ive had a Cgm for 8 days! Overall I've always (8years) had pretty good control, but this (dexcom) is giving me much more understanding and I'm delighted to have it. Yesterday I shut down the transmitter and restarted it with the same sensor. This morning it's looking unreliable, with ??? and showing the sign for "no connection" periodically. This is obviously a cost issue. I'm hoping that it will recover.
Any suggestions about anything I can do to prolong the sensor's life?

 

[Spiker]

If you get ? ? ? or connection issues first of all just leave it half an hour with the sensor and receiver in close unobstructed line of sight. If that fails just restart again, but 75% of the time it will just resolve by itself.

 

[Iamcalledphilip]

Thanks. I'll try that.

 

[CarbsRok]

Ive had a Cgm for 8 days! Overall I've always (8years) had pretty good control, but this (dexcom) is giving me much more understanding and I'm delighted to have it. Yesterday I shut down the transmitter and restarted it with the same sensor. This morning it's looking unreliable, with ??? and showing the sign for "no connection" periodically. This is obviously a cost issue. I'm hoping that it will recover.
Any suggestions about anything I can do to prolong the sensor's life?

As @Spiker says, also how have you stuck the sensor down? It needs to be well anchored to work properly.

 

[smag3]

I have had my Freestyle libre for 3 day now and already could not live without it! It is accurate to .5mm on my finger stabber. I am slightly aware of the sensor on occasion but it certainly does not hurt. My blood sugars in just that time have improved enormously. It is totally liberating and I love it.

 

[RogerRam]

Hi, I didn't know what a CGM was until I read this thread. I am a great fan of Apple & use a the Withings app to monitor my blood-pressure. I thought this might be of interest http://www.macrumors.com/2015/02/09/apple-watch-dexcom-glucose-app/

I've been insulin-dependant for 50 years & use an Accu-Chek Mobile for testing-average BS's are within a normal range. However, adopting a low-carb diet has resulted in some hypos. I hope to try these small glucose bottles to correct this without the high BS 'bounce.

All the best,

Roger

PS I'm a doctor of psychotherapy practice NOT a medical doctor,

 

[Juicyj]

It's been really interesting to read these posts, I've been onto my team for over a year to try one and finally got my chance last week as we only have one machine in the county and my bg has been running high for a few months as was on levemir and it wasn't working for me, now switched to Degludec and getting brilliant results, so when they called me up I wasn't so sure whether I really needed to do this, but as I'd had a bad hypo whilst swimming a few weeks ago the nurse said it would still be worthwhile to try it for a week. I have a sensor fitted which I take back this week and they will download the results onto the computer along with my food/exercise diary and I get the results later on in April, I am keen to know as I believe knowledge is power although I would love to know as I go along what the readings are like based on food eaten etc and also to see how my body responds to exercise and hypos as had one yesterday. I think if it was affordable many insulin dependent diabetics should have it as it always walking a tightrope when taking insulin so it would be great if they were cheaper and I think if I had one I would get a much better HbA1c.

 

[Omnipod]

I could not live without my Freestyle Libre.
I had a really bad hypo once where I actually had a fit. I lost all my confidence and as soon as a hypo came on, that feeling of absolute fear and panic registered in my brain. I used to be so scared that i would drink an entire bottle or two of lucozade. I had no understanding of how fast insulin took to work, how fast or slow foods took to affect my blood sugar. As a result, I felt safer to run high.

The Libre has truly changed my life. I feel like I am in control now and I have learned more about my own body and diabetes. I was one of the lucky few - first people to start using the Libre and in the last 6 months, i learned more about my diabetes than in the past 14 years since becoming a type 1.

My HBA1c was always above 11%. Now Im in the mid 7%. I will slowly get to my target of 6.5%. I have not been to see a dr. in 6 months because my sugars are near normal. When i was at 11%, I constantly had dr.s appointments as i got eye infections, flu, neuropathy pain.... to name but a few.

Without CGM, it is virtually impossible to learn all this. I really hope that all diabetics are able to get this treatment. At the moment, its only for those who have the money to pay for it which i find really unfair.

An average pot of sticks costs the NHS about £10 - £15 depending on what meter a person uses. 200 - 250 sticks costs an average of £50 - £75 per month and this only give about 8 tests per day.
If the NHS only pay up to say £50 / £70 per month, I cant see why they dont subsidise the Libre. Why cant they allow us to 'top up' on the price? It would make so much more sense. This would make sense financially to many families and reduce costs to the NHS with few dr appointments, complications etc.

Being able to buy the sensors from a local pharmacy would also be so much better. Abbott do need competition fast!!

Just the fact of them not being able to keep up with the demand says it all!!!

 

[Ian Stonelake]

As someone who has over the years become hypo unaware a CGM would be extremely useful to me in providing warnings when I'm going hypo. Getting funding for it is still problematic though, my primary care provider won't so unless I stump up the cash myself I'm at a dead end. I'm sure this technology could have saved money in not having to be rescued by paramedics on a number of occasions, but all too often the politics of NHS costs are driven by short term considerations.

Ian

 

[jeannie3009]

Hi everyone I do not understand the readings for HB1AC my reading has come down from 83 to 68 in the last few weeks. How does this relate to a percentage?

 

[CarbsRok]

Hi everyone I do not understand the readings for HB1AC my reading has come down from 83 to 68 in the last few weeks. How does this relate to a percentage?

68 is equal to 8.4% and 83 is equal to 9.7% so that a drop in the right direction.

 

[VsUK]

I honestly would hate having a device attached to my body. I'm type 1 & the thought of having a device that slowly pumps insulin or glucose into my body whenever I get low or high is just a way to get lazy. I'm on top of my Diabetes & I take 2 injections a day, 1 before breakfast & 1 before tea.

I already feel uneasy about injecting myself in public never mind having some expensive device half in & half out of my body!

 

[misswhiplash]

I honestly would hate having a device attached to my body. I'm type 1 & the thought of having a device that slowly pumps insulin or glucose into my body whenever I get low or high is just a way to get lazy. I'm on top of my Diabetes & I take 2 injections a day, 1 before breakfast & 1 before tea.

I already feel uneasy about injecting myself in public never mind having some expensive device half in & half out of my body!

I really thought I would feel the same about continuously wearing something, and I think I probably would about something obtrusive like a tubed pump, but I honestly LOVE both my (new) Omnipod and my freestyle libre - they have pretty much revolutionised my life

 

[Jeannie87]

I honestly would hate having a device attached to my body. I'm type 1 & the thought of having a device that slowly pumps insulin or glucose into my body whenever I get low or high is just a way to get lazy. I'm on top of my Diabetes & I take 2 injections a day, 1 before breakfast & 1 before tea.

I already feel uneasy about injecting myself in public never mind having some expensive device half in & half out of my body!

Oh my so glad to read someone has same issues as me. I have had the offer of pump therapy, and I have been soooo un decided, but I have fairly reason at control, my HBA1c was ok last time and I have few hypos. Like you the thought of permanent attachment to anything let alone two things, just doesn't feel right for me. I use Levemir long acting twice per day, and NovoRapid when I eat, and always do it after I eat as I can relate carbs to insulin with my Insulinx freestyle meter. I've used my pens whilst out socially, the needles are 4mm so basically it's stick and go, no problem. Being attached would make me feel like "a patient" and not a Normal healthy person - I don't wish diabetes type 1 to define me in any way.