General Info on CGMS

[karla0304]

Hi there all,

I have been diabetic since was 3 years old, 35 years this year and using a pump for the last 10 years. I can really say that it is a fantastic piece of equipment.

I stumbled across the CGMS side of the pump when I was renewing my Medtronic one last year. When online finding out about the Veo I saw that there was a CGMS addition available. My local health board fund my pump and consumables but I fund the CGMS part myself. Since purchasing it last May, I have been using it continuiously. It gives me a safety net when I am myself at home. It is worth its weight in gold for peace of mind overnight.

The sensor is preset with high and low levels and when your blood sugar reaches these amounts the pump will beep to tell you what is happening. My warnings are still good though if my blood sugars drop overnight then I don't get a warning. If you don't acknowledge that you have heard the warning then the machine will vibrate to let you know that something needs to be done. If this occurs at night when you are sleeping it is loud enough to wake you (which is great). The pump will stop delivering insulin if your blood sugar still drops. This is a great feature in my opinion.

When changing a sensor, you have to allow quite a lot of time. Not something that can be done quickly. After insertion the needle is removed (not scared of needles but it is quite painful) and you have to wait 2 minutes for the sensor to become used to your body. Then it is connected to the transmitter, which is about the size of your thumb, the sensor should then flash to confirm that it has connected with the transmitter. - I have lost a couple at this stage. After all of this has been done successfully then the sensor then has to connect (via the same radio link that blood test machines use) to the pump. The next step is a 2 hour callibration phase, finally a blood test and you are good to go.

The sensors come in boxes of 4 or 10 and each sensor gives 6 days of monitoring. The costs for this are high (box of 4 - £160 and 10 are £380), its a lot of money to find each month. I have asked my consultant if there would be any hope of the NHS funding this part of diabetes care but unfortunately its a no.

Hopefully this has helped with any questions, but feel free to ask.

 

[karla0304]

Hi there again,

Changed my sensor yesterday and had to change it again today. Not ideal as it coses £40 each time. The results I was getting bore no resemblance to what I was getting through my testing machine. It is worth the cost though. Gives me a peace of mind I can't get anywhere else. An amazing piece of equipment.

 

[Alzibiff]

As well as the sensors, there is another "consumable" which people need to be aware of when considering the cost of CGMS - the transmitter itself which has a guarantee period of just 6 months.

True, they can and do last longer than this but in the event of a transmitter failing, you have to purchase another one at around £400 if your old one is over 6 months old. The cost of the transmitter finally put an end to my self-funding of CGM - simply too expensive.

Alan

 

[donnellysdogs]

Oh gosh, I didn't realise everything regarding CGM's was so expensive etc....what I don't understand to be quite honest-what exactly is the benefit of knowing what your blood is every minute of the day (sort of)....

Is it not possible to just test yourself every 30 minutes or every hour, or every 2 hours during the night for a whilse to establish what is going on with somebodies diabetes.

I was offered CGM prior to going on to pump, but I knew when my levels dropped or went high, it's just that on MDI I couldn't have the minute control that a pump gives me to eliminate them.

Don't get me wrong I believe in doing everything to possibly bring diabetes under control and to give people a better quality of life, but I really don't understand how people can afford to self fund these instruments as such a high cost.

I realise that it alarms for highs and lows, and this can be beneficial during the night expecially if alone, and with hypo unawareness, but is a CGM really, really worth these huge amounts of money??

It isn't a criticism of anybody, just trying to gain a knowledge form people that have had them just what real benefit there is compared to to a comaparatively cheap additional box of test strips if they can't be gained from a gp...does the benefit real counteract the cost?

 

[karla0304]

Hi there,

CGM has really been a god send for me. My blood sugar does dip without warning at night (even though my BM is good before I go to sleep). When this happens I loose control of my arms, legs and can't string a sentence together. I am dependant on someone being with me continually and that person has to be able to cope with a hypo.

Apart from the alarms another benefit that I have found is that all of the results can be downloaded via CareLink onto the Medtronic website and can be viewed on the screen. This allows me to accurately map my results and tweek any basal rates which need work. These small adjustments would be difficult, if not impossible, to manage by testing blood conventionally.

I would imagine that CGM would be able to save the NHS a considerable amount of money each year. If this was available on the NHS then severe nocturnal hypos would not result in an ambulance call out, staff in A&E and consultant attendance, not to mention the long term savings if blood sugar control is kept monitored and kept tighter over a long period of time.

I do agree there is a serious financial cost for this equipment and that given the potential savings should be more favourably looked at by NICE.

 

[keycare]

I would have to say that CGMS shows the biggest benefit with children, when at school you can download their blood sugars and see how they were doing when you are not around. Also, as they are growing, their insulin requirements can change dramatically, with CGMS you can spot these trends really quickly.

WRT to having an apparent bad sensor, we have found that it is rarely the sensor at fault - more often its the transmitter battery, pump battery or just plain wireless interference that gives odd readings. The pump shows sensor errors when it can't get a reliable signal from the transmitter. Stick with the same sensor, keep re-starting it, it often corrects itself, re-charge the transmitter, change the pump battery and in extreme circumstances, go outdoors where there is less electrical interference. Once the initial callibration is done, the comms between the pump and transmitter seems to get more robust. Even if you get callibration errors and bad sensor errors, they can be recovered simply by re-starting the sensor.

Do you know how to check the ISIG value of the sensor? This will give a good indication of whether the transmitter is getting a good sample of fluid. If it is lower than 5 it generally means that it is not getting a good enough sample to be reliable.

Apologies if you've heard all this before ;-)

Regards,
Rich

 

[karla0304]

Hi there Rich

Many thanks for the pointers, some I knew but some I didn't. Will try the trick with the garden the next time I have a problem with calibration. You sound that you have been using CGMs, have you...? What did you think of it.

I keep singing the praises but it is a major financial drain. It is an amazing gadget and the download ability is second to none for pinpointing any small changes that can be done.

Best wishes

Karla