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Continuous Glucose Monitoring Systems

Discussion in 'Blood Glucose Monitoring' started by sf352, Jan 15, 2013.

  1. VickiT11979

    VickiT11979 · Well-Known Member

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    I did, but as I have a pump it was more convenient for me to choose a CGM integrated system rather than carry another receiver around. I think the Abbott Navigator looked like the cheapest standalone system for self funders, but the sensors looked larger than the others as well, and it didn't sound as accurate from your posts.
     
  2. donnellysdogs

    donnellysdogs Type 1 · Master

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    No it hasnt been accurate!! I'm pump Roche user by way.

    Had new transmitter sent out yest.... This one even within first 24 hrs has been so much more closer to pump blood readings... Will update other postings if this can continue... They sent me two 104 batch numbers .. This number one of the two... Then back to old batch numbers 106/107. So havent actually got a clue why this transmitter / receiver working better with. This batch number.

    I actually like the ease of the Navigator... But am
    Soooooo hoping that this new equipment I have got is going to continue to be as accurate as it has in last 24 hours... Very different.. Normally first 24hr is the worst..

    Just wondered on reason.. Can fully understand why now...
     
  3. Bodybuilder type1

    Bodybuilder type1 · Well-Known Member

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    Is it worth the money ? Is anybody from Ireland on this form using it
     
  4. Engineer88

    Engineer88 Type 1 · Well-Known Member

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    Morning all,

    I know this post is a few months old now but ive found it massivly helpful.

    VickiT11979 Have you found the costs have worked out as you calculated?

    Im considering getting a lodger to pay for this, can anyone comment if it would be worthwhile enough?!
     
  5. donnellysdogs

    donnellysdogs Type 1 · Master

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    Well when we've had lodgers .... We had a 'madam' and ended up having a murder investigation. SOCI's wtc, we had one lodger 18 months later phoning from Ireland threatening to bomb our house...- he had keft us 3 months in arrear with rent. Another girl also left is 3 months in arrear... No bomb threats...
    We had to have police involved twice...

    To me.. Not worth it...
     
  6. Engineer88

    Engineer88 Type 1 · Well-Known Member

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    :crazy:

    I was hoping a placement student from my work would be a good option as they would be professional and vetted first!! (and i would be doing them a favour too)
     
  7. michaeldavid

    michaeldavid Type 1 · Well-Known Member

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    With the use of Betachek Visual testing strips (plus the usual kind of electronically read testing strips - sc. OneTouch Ultra), I have EFFECTIVELY continuous blood-glucose monitoring at a tiny fraction of the cost of the systems I see described above.

    Regarding convenience, I might point out that soon after I first became diabetic, I returned to work as a motorcycle messenger in London. And I was testing my blood-sugar in much the same way then as I do now. (However there was no electronic testing available at that time.) I was then using the visually read, BM strips. (I've no idea what 'BM' stands for.)

    May I ask why people bother with the highly expensive, invasive equipment when there is a far simpler and very much more effective option available?

     My HbA1c readings are always close to 5%. (Please see my other postings.)

     With or without the expensive equipment, can anyone beat that?
     
  8. Engineer88

    Engineer88 Type 1 · Well-Known Member

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    Because those strips are Highly inaccurate and still require a finger prick test. I wouldnt even consider it as an alternative and after reading a guy was jailed today as he had hit a pedestrain, I wonder how the courts would look on those outdated strips as a form of controlling diabeties.

    I would suggest your diabeties is highly stable which makes you very lucky. Not all of us are as lucky.
     
  9. michaeldavid

    michaeldavid Type 1 · Well-Known Member

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    One might say that a pencil and paper is old-fashioned alongside a printing machine, or a needle and thread is old-fashioned alongside a modern sewing machine. (But 'outdated'? Really?!) So, you're some kind of engineer. And what would YOU use to leave a note out for the milkman? ... or to sew a button on your dress or shirt?

    One might speak of 'reverse-Luddism': I've experienced precisely this form of unthinking prejudice expressed directly towards me by the leading professor at the diabetic centre I attend. And I've every reason to believe it's very common amongst medical professionals. (Otherwise, doctors would be prescribing the visually read strips more than they do - which, barring my own case, is not at all.) So it certainly doesn't surprise me that it infects the thinking of the diabetics they look after.

    Okay, so there's no decimal point in the result one gets from the visually read strips. That doesn't make them inaccurate. And just because the result from a meter-read stick may contain a decimal point, that doesn't make the reading accurate. (You're supposed to be an engineer, so you must know that to be the case.)

    There's a thread under this very section ('Blood Glucose Monitoring') entitled, 'Blood sugar testing machine': the thread concerns a machine called 'GlucoNexus'. There are pictures of the machine giving results one of which, very clearly, must be seriously inaccurate. (Indeed, both of the results pictured in the first posting may be inaccurate.) Moreover, unless you had some way to check the result that the machine delivers, you might never get to know that the result was inaccurate: it might already be too late - you might lose consciousness, or indeed you might even lose your life.

    For anything under 7mmol/l, the results that the Betachek Visual strips deliver are very accurate, and thoroughly dependable. (If I want accuracy for anything above 7mmol/l, then I use the meter-read sticks.) Moreover, if the pad on which one places the drop of blood is contaminated, then one tends to get a smudgy result; so then I KNOW that the result is inaccurate. You never get that feedback on a false result from ANY machine.

    My blood-sugar is stable because of what I eat (see my other postings, especially one I posted a few days ago under the thread entitled 'test strips' in the section 'Diabetes Soapbox - Have Your Say'), and also because I test my blood-sugar a lot.

    Indeed, I test my blood-sugar 15-20 times per day. And naturally, I use a meter too - if I need to. But testing with the visually read strips works out to around 1/20 of the cost of the meter-read sticks. To use the meter when you don't need to is simply a waste of money. And if the money comes from the NHS, then that's a waste of everybody's resources.
     
  10. Engineer88

    Engineer88 Type 1 · Well-Known Member

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    Right I never intended this to turn into a slanging match, but I would like to pick up on a few points you have made.
    and
    I am an automotive engineer without question. I have an engineering degree and have engineering awards. Yes I understand not all machines are 100% accurate, however as my blood sugars can swing between 3-20+ in an hour and you, yourself have said you can’t use them above 7, would you say that would be an accurate system for me to use? There are calibration solutions to check the accuracy and if used properly and not contaminated (yes, a possible issue) machines are very accurate.

    What would I use to put a note out for the milkman? I would go online and alter my order or email him. Probably to his blackberry or Iphone.

    Are you seriously telling me you eat exactly the same thing day in day out? Because that’s impressive, if you do. However I have done that as a kid and never had any better control from doing so. My diabetes is brittle. It very rarely responds to what I do as it should. Which is why I inquired to the latest technology in the chance it might help me out. That would reduce costs to the NHS, FYI, as I would be self-funding it.
     
  11. michaeldavid

    michaeldavid Type 1 · Well-Known Member

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    Hi Engineer88,

    I acknowledge I can be very aggressive in an argument. But I don't mean to be disparaging - only provocative, and intent on getting to the truth (about whatever). So thanks very much, just for responding.

    I really do aim to help. And if I can't help when I believe I might be able to, that makes me unhappy.
     
    I see that you've been diabetic, type 1, since you were a small child. I was not so unfortunate: I only became diabetic when I was around your present age - 30 years ago this month, as it happens

    My control certainly hasn't always been as good as it is now. In particular, it suddenly improved dramatically just a few years ago, when I moved home. I happen to move somewhere close to a good baker, and I happened to buy a loaf of rye bread, and I happened to eat the lot (slowly) over the course of the next few days.

    I live with my elderly mother, for whom I'm a carer. But naturally, she keeps her eyes open with regard to me. And she noticed, just as I did, that I was no longer having catastrophic hypos, and dropping to the floor (etc.).

    I eat rye bread (or rye anything) from early in the morning (starting off slowly) until mid-afternoon: this has a tremendously moderating effect on my blood-sugar. (I don't eat any rye after 4.00pm, or my blood-sugar will certainly tend to rise later that evening.)

    I don't eat exactly the same thing every day. But whatever else I eat (I'm just now eating a very nice bowl of muesli, with fruit juice rather than milk), I always eat rye bread in the way I've described. I get through just under half a loaf each day: that's a little over 200g, each day.

    As regards the visually read strips, I didn't say one can't use them when one's blood-sugar is higher than 7mmol/l. Rather, I said that the reading they give isn't very accurate over that level. But any great accuracy of readings over that level is redundant anyway. Even if one carefully measures everything one eats, one can NEVER accurately measure one's energy output. (I seem to use a lot of energy thinking - God knows how much.) However, I never need to weigh or measure anything I eat.

    I am very impressed with human engineering. However, I'm not impressed with people's degrees, by and large. (I'm being provocative again, but also truthful.) I too have a couple of degrees. But there are plenty of idiots with degrees. And there are even greater idiots who are in positions of authority in our universities. Perhaps there aren't so many idiots in the discipline of engineering, I'm not sure. But I certainly see plenty in scientific disciplines, just as well as artistic ones.

    I'm racking my brains. Yes, I've just remembered. I can't remember his name, but it's the bloke who was in charge (I think) of designing and building the fantastic footbridge over the Thames, which had teething problems when people started walking over it. I read an article he wrote in The Guardian newspaper. He said engineering is an art that's supported by science. (He may not have used the word 'supported', but the word he used was in that vein.) But I think that's wrong. Science doesn't support anything. Rather, I would say engineering is an art that's INFORMED by science

    My tongue is in my cheek here (but only slightly): I count myself as a kind of idiot. And I'd say it's no coincidence that the word 'autism' derives from a Greek root that corresponds to the Latin root of 'idiot'.

    Incidentally, what does 'FYI' stand for?

    Sorry, my final edit (perhaps): that must mean 'for your information'.
     
  12. Engineer88

    Engineer88 Type 1 · Well-Known Member

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    Hi michaeldavid,

    Ok you may have caught me on a bad morning also, bloods of 22. I wanted to punch things/people.

    Before we get to trying to 'fix' me let me tell you a bit more about me:

    I’m coeliac and hypo thyroid. Basically my auto immune is about shot. I’ve also recently realised I can’t handle much dairy, including a standard yogurt, so I'm lactose free as well. As great as rye bread sounds I defiantly can’t eat it but thanks for putting it in :)

    I’m lucky in that I don’t have the catastrophic hypos anymore (touch wood!) since my gut has healed being gluten free.

    The reason I'm looking at a CGM system is to reduce finger pricks even if only slightly. I do between 6-15 maybe a day. The problem I'm having is my fingers aren't healing fast enough and my hands are stupidly small (think child’s hands). So when I go to pick up that cylinder head at work I find the holes are opening up and I’m bleeding at inappropriate moments. I hope to combine this with a pump eventually as it might reduce overnight hypos which is where mine mainly are.

    I agree there are idiots everywhere, I just hope I'm not one of them! You kind pushed a major button for me there with the engineering thing don’t know if you noticed :thumbup:

    What do you reckon then? other than putting me out of my misery!! :p
     
  13. michaeldavid

    michaeldavid Type 1 · Well-Known Member

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    I'm pretty ignorant about gluten. Of course, there's plenty about "gluten-free rye" on the internet. But as you will know, it's not really rye bread at all, just 'rye' bread: ie. something that's kind of bready in texture, I suppose, and perhaps vaguely rye-like in taste, but with no rye in it whatsoever.

    However, my knowledge of my ignorance itself serves to leave a big question in my mind: I don't know what it is about rye that makes it have such a moderating effect on my blood-sugar.

    When I've mentioned this effect to doctors or diabetic experts, they're simply uninterested: they don't take what I'm telling them seriously. Neither do they seem remotely interested in the control I demonstrably manage to achieve. Without fail, I now get HbA1c results of around 5; and I hardly ever get a serious hypo. (Obviously, I can be distracted, or simply be careless, or unwittingly make a mistake.) But the only remark I've ever got from a diabetologist is of this character: "Ooh! That's a bit low." (That's just one of the remarks that sticks in my mind.)

    Doubtless they get loads of patients asking them all kinds of questions, and naturally they don't have a lot of time to talk about these things, and doubtless many patient's questions are daft anyway. And moreover, very possibly the specialists themselves are ignorant about some of the issues they're asked about. So they just try to humour the patient and change the subject.

    I know it can't just be gluten itself that produces the very marked effect that I've noticed. (As I've mentioned, my nonagenarian mother also noticed it.) I know that because other bread, such as white (or even wholemeal) wheat bread, certainly does not produce anything like the same effect. (Spelt bread seems to have a similar effect to rye, but not quite so marked.) Do you have any idea about what it might be? Or do you know of any medical or dietary expert you could ask? Because possibly, there may be some kind of gluten-free flour which might help you. Or have you tried them all anyway? 

    Regarding getting the blood-sample, I hope you don't use those blasted spring-loaded gadgets. They're completely unnecessary. I just jab myself, very gently, with the bare lancet. And unless I'm careless or in a hurry, I barely even feel it. (The lancets are exquisitely sharp, of course.) But surely now, by telling you that, I'm trying to teach my grandmother to suck eggs.

    Overnight hypos were a major problem for me in the past. But in time, I duly realised that one could so engineer the timing for taking insulin that the effects run out at bedtime. For me, they run out at 12.00pm. So at 11.00pm, so long as I haven't eaten anything during the mid- to late-evening that's slowly digested, then I know that my blood-sugar will fall by a further 2mmol/l precisely. (Naturally, I need to take a little long-acting insulin to ensure that it doesn't rise too much overnight; but with care, that's perfectly safe.) If my blood-sugar is 4mmol/l at 11.00pm, then I eat one half-slice of the co-op's wholemeal bread - it's carbohydrate value is always exactly the same: it raises my blood-sugar by 2mmol/l. (Blimey, it's so much easier to say this stuff rather than write it!)

    What staggers me is that I had to work that out for myself. It's just so obvious to me now that one doesn't want any significant amount of alien insulin in one's system when one is asleep. Why don't the blasted experts recognise that and ensure that it's standard advice for all diabetics?

    Having said all that, I recognise that continuous blood-sugar monitoring might be ideal for you, if the technology is up to it yet. (However, I suspect that may be a pretty big 'if' as yet.) Previously, I simply failed to realise that not all type 1 diabetics are simply type 1 diabetics without other problems thrown in. I'm sorry I didn't think about the mere possibility of that kind of complication before.

    I know I'm arrogant, and I normally don't have too much of a problem with it. I once heard an army man talking about arrogance: sometimes you have to be not just arrogant, but BLOODY arrogant, or you will not defeat the enemy. (You're not the enemy, I hasten to add.) But hubris is another matter.
     
  14. Engineer88

    Engineer88 Type 1 · Well-Known Member

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    Im glad we were able to sort that out and it sounds like you might have opened your eyes a bit wider to some of the other (comman) problems amoung T1's. After all I was trying to educate myself about the CGM system to start with the thread its what we are all on here for.

    My very ammature guess at rye would be the complexity of the molecular structure is very high meaning it takes a long time to break down alongside some of the natural additives giving a sustained boost. Like I said a guess at best. I will try and ask my diatition when I see/speak to her next.

    Gluten free flour. Wow. Its...Special. normally made from things like rice and potato or blends of stuff. I tend to find rice flour is best for everyday cooking but is shocking for bread so I leave it to the Genius team now.

    Ill let you know how CGM goes if it happens.
     
  15. EPicLURcher

    EPicLURcher · Newbie

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    Chas c, how did you get a'trial' dexcom g4?
     
  16. Chas C

    Chas C Type 1 · Well-Known Member

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    You have to pay a fee up front of £1107.50 for which you get the full kit plus two sensors. If after two weeks you do not like it and return it then they refund £912.50. They need to cover the cost of two sensors and a retest fee of £62 I think.

    If you contact Advance Theraputics they will send you all the details.

    BR

    Chas
     
  17. nmb264

    nmb264 · Well-Known Member

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    Am I right in saying a sensor only lasts up to a week so you will constantly be paying for new sensors?

    I was able to use one for a week from my DSN and it was amazing to see what went on.


    Sent from the Diabetes Forum App
     
  18. Chas C

    Chas C Type 1 · Well-Known Member

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    Depends upon the manufacturer and the user - I have the the Dexcom G4 GCM, for me each sensor lasts over 21 days, 3 wks. However I have a friend who can only get 8-10 days from each one.
     
  19. karla0304

    karla0304 Type 1 · Active Member

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    Hi there. I use the enlite system from Medtronic. It's amazing. The sensors continually transmit toy pump and should my blood glucose rise or fall too much the pump will alarm. If my blood sugar is dropping and I don't acknowledge that there is a change in my levels then the pump will suspend all insulin delivery.

    I was self funding my sensor system, which cost approx £180 per month (old system though) which is a lug of money. Since January I have been able to get these funded by my health authority. My control is so difficult to manage and I have now lost all hypo warnings. I'm on the waiting list for a beta cell transplant. The whole thing is scary but I want my life back. At present I can't be left alone in case my blood sugar drops quickly. Sensors are great and I would recommend them to anyone.



    Sent from the Diabetes Forum App
     
  20. VickiT11979

    VickiT11979 · Well-Known Member

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    Hi Engineer88, I'm sorry this reply is pretty late, I don't come on here that often & was also trying to let the dust settle wrt the alternative view that CGM is a waste of money.
    Anyway, I got my Vibe pump at the end of April then ordered the CGM starter kit for £500. I put my first sensor in on May 7th and it's still working & is accurate, that's 37days now. I wouldn't recommend doing this to anyone else, but I've not had any irritation or discomfort from it. The adhesive dressing that attaches it only lasted 2 weeks & then I covered it with Opsite flexifix which has kept it attached since then.
    If (and it's a big if) this continues I'll only need 1 sensor a month & annual cost will be more like £900
     
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