Why I think all diabetics should have a CGM

[gateian]

It might be stating the obvious, but having been lucky enough to have had a CGM for a brief time, it's obvious to me how amazing they are. Most notably when you are out and about and it's not easy to check BS levels. Of course, they are very expensive, but so were mobile phones once and over the years they have become very affordable pieces of kit so I'm very excited to see what technology advancements are brought out over the next 10 years.

Having said that, I really believe all diabetics should be allowed access to a CGM for at least a few weeks. I have learned alot about what my BS level does during the day and more importantly during the night which allowed me and my health professional to adjust insulin doses and eating habits and my HBA1C has come right down because of it (form 7% - 6.1%).

They might be expensive to the NHS, but how expensive is dealing with long term complications?

 

[emm2012]

Yep agree totally with that . With all the advances in technology they really should be more affordable then they are in this day and age.........

 

[iHs]

Its true to say that most insulin dependant diabetics would benefit greatly from cgm technology and competition from other companies should help to drive prices down. Good control of bg is not about achieving a low hba1c though, its about staying within healthy target ranges. There is nothing wrong with an a1c of 7%. I had an a1c of 6.9 to 7.2% for about 45yrs with hardly any problems that could not be fixed. 6.1% is too low for me and would involve a few bg levels of 4mmol and below every day which on the face of it, is not that good esp as I also drive a car, so would involve even more need for cgm or even more bg testing just to be ok.

 

[graj0]

The Freestyle Libre looks like a better deal, although about £50 a fortnight is still expensive, at least the monitor is only £50 and not the best part of a grand. It's operation may not be identical to the CGM, in that you have to "swipe" the monitor over the sensor, but I would hope you could get almost the same amount of information.

Hopefully manufacturing cost of the Libre sensor will come down as the device becomes available in the US, we shall have to wait and see.

Unfortunately, we all know that a good thing isn't going to be free on the NHS and I'm acutely aware that you can't spend money that you haven't got, nobody can, not even certain EU countries who seem to think voting in a new government will automatically mean an end to austerity.

 

[AcrossThePond]

I'm waiting for the Freestyle Libre to be released in the States as well. It has already received approval for sale in neighboring Canada which uses the mmol/L standard but we're still stuck with the mg/dL measurement. I am more than willing to pay for it out-of-pocket and plan to use it to determine how various foods and activities affect my BG levels. Although I am already well controlled (my avatar reflects my A1c in mg/dL which is equivalent to 5.2 mmol/L), my desire is to achieve better "flat lining" results over a 24-hour period. My biggest challenge to date has been to maintain less spiking blood levels when dining out since restaurant food often contains "mystery" ingredients used as thickening agents and flavor/taste enhancers in sauces and soups. The Libre could be invaluable in helping me to make better choices not just in the menu items ordered but perhaps in selecting the restaurant establishments themselves.

 

[novorapidboi26]

I agree they are amazing devices...........

you can still get the same information form normal testing though, although to get the same quantity and quality of readings would be a nuisance for everyone.........

I also think the Libre is very good, no personal experience though..........

For people who experience hypos with no awareness a CGM can be a life saver.........

For me though it would simply be a tool to see what happens to my bloos sugar when no carbs are on board...[basal tester...]

 

[June_C]

Sorry to be dense, but what's a CGM?

 

[CarbsRok]

Sorry to be dense, but what's a CGM?

CGM = continuous glucose monitor.
It a small sensor inserted under your skin and via a transmitter and receiver it reads you blood sugar every 5 mins.

 

[CarbsRok]

you can still get the same information form normal testing though, although to get the same quantity and quality of readings would be a nuisance for everyone.........

You can get better information from CGM because it shows how fast a drop or rise after food or exercise. It also shows exactly where your basal needs adjusting

 

[Spencer67]

I agree with @gateian and I'm quite interested in this technology but apart from the Freestyle Libre what others are on the market, is there a better one than the Freestyle, the censor looks massive and a few people have reported of pain on insertion and blood leaking.

There are others on this page http://www.diabetes.co.uk/cgm/continuous-glucose-monitoring.html what are their reps like?

 

[Jaylee]

I would love to go down the CGM route... I've always thought it would be great if the sensor transmitted to a smartphone via an app.. Vibrating alarm if low that sort of thing..? Can't be too hard to ask.. Lol

 

[June_C]

CGM = continuous glucose monitor.
It a small sensor inserted under your skin and via a transmitter and receiver it reads you blood sugar every 5 mins.

What a fantastic idea, but sounds expensive though. Whilst waiting for your reply, I checked out the Freestyle Libre as I sort of guessed what a CGM was and to my horror found that the sensor would cost about £28 per week. Can't eek that sort of expense out of a pension

 

[kitty55]

I can only speak about the Libre from experience as I've never worn a CGM so far (mostly due to the costs). The Libre is not cheap I have to admit but well worth every penny for me. I don't think I would've been able to sort my BS as well as I have in the last few months. To be fair I have never had bad control but I have sorted my basal and ratios as accurately as possible which resulted in a HbA1c of 6 end of January and I expect the next one to be slightly lower. It's a fantastic little machine and yes, I do second what others have said and every diabetic should be able to have access to a CGM/FGM at least for a period of time as it's so useful info you get from all the graphs

 

[CarbsRok]

What a fantastic idea, but sounds expensive though. Whilst waiting for your reply, I checked out the Freestyle Libre as I sort of guessed what a CGM was and to my horror found that the sensor would cost about £28 per week. Can't eek that sort of expense out of a pension

Hi June, I have what is known as the Dexcom CGM These sensors are meant to last 7 days and cost £46, like many others who use the Dexcom CGM I can make the sensors last 4 weeks on average now, with the longest time being 47 days for me. Others have managed longer.
I have an Animas Vibe insulin pump so the receiver is built into this pump at no cost to me. I do have to pay for the transmitter though which is just over £300. The transmitter lasts for about 12 months on average so I have been told.

 

[Nicola M]

I had a CGM for 1 week from my hospital and without it I wouldn't have known that throughout the night I was dropping low and staying low for hours. From seeing my night time sugars my diabetes team was able to altar my night time insulin to stop me from waking up at a low level. It would defiantly be useful to be able to have one all the time but the cost is too high.

 

[novorapidboi26]

You can get better information from CGM because it shows how fast a drop or rise after food or exercise. It also shows exactly where your basal needs adjusting

the basal side of things is brilliant, that's where I would make most use of it.........

with regards the the speed at which I am rising and falling, not so much, as this all depends on my carb count, the dose timing etc......which can be completely different for every bolus...........

good for those who suffer from hypo unawareness........

 

[tim2000s]

I've always said that the trend information is the most useful piece of one of these systems. And I love it, except when the sensor is being somewhat naughty, like mine is at the moment.

 

[CarbsRok]

the basal side of things is brilliant, that's where I would make most use of it.........

with regards the the speed at which I am rising and falling, not so much, as this all depends on my carb count, the dose timing etc......which can be completely different for every bolus...........

good for those who suffer from hypo unawareness........

The most startling bit of info I have found is from the lows I was getting at 4.30 pm. I never from testing found the drop and it was a massive drop that started at 12.30 pm. No more hypos at that time of day now.

 

[Bebo321]

It might be stating the obvious, but having been lucky enough to have had a CGM for a brief time, it's obvious to me how amazing they are. Most notably when you are out and about and it's not easy to check BS levels. Of course, they are very expensive, but so were mobile phones once and over the years they have become very affordable pieces of kit so I'm very excited to see what technology advancements are brought out over the next 10 years.

Having said that, I really believe all diabetics should be allowed access to a CGM for at least a few weeks. I have learned alot about what my BS level does during the day and more importantly during the night which allowed me and my health professional to adjust insulin doses and eating habits and my HBA1C has come right down because of it (form 7% - 6.1%).

They might be expensive to the NHS, but how expensive is dealing with long term complications?

I'm absolutely in favour of that @gateian
Personally I think CGM should be made available free or at least subsidised for anyone with T1, T2 using insulin or gestational diabetes. I also I think it should be utilised at part of an education program for anyone diagnosed with pre-diabetes or T2 diabetes for a period just after diagnosis.

I think it will happen eventually - it will be necessary to make the financial case that the long-term savings far outweigh the initial upfront costs.

 

[tim2000s]

I think the "killer app" in CGM is the smartphone app. Once you can remove the £900 receiver and stick it in the app, then the price of the transmitter and consumables is a whole lot better, and focus can be placed on selling more and bringing the cost down.