Really interesting last few days. We finally generated enough courage to put Cadence on the Medtronic Minimed Continuous Glucose Monitor.
The CGMS system is designed to give "real-time" reading of Cadence's blood glucose readings. The problem is that it reads the glucose content of the interstitial fluid, the glucose meter that is used for finger poking measures actual blood glucose. The interstitial fluid is about 15-20 minutes behind. This may not seem like a bunch of time, but it does make a difference.
This little do-dad has a huge scary needle for insertion. In fact it took us 4 days to gather enough courage to do it. We finally decided that yesterday was the day. W
e numbed the insertion site with Emla cream, bent her over and using the "senserter" I jabbed the 23guage needle into her butt cheek....and it didn't go in...crap. Blood came out though and the crying ensued. A little panic by the parents and we decided to tray again. So, we grabbed the senserter again, reloaded and into the flesh we went again this time with success and actually no bleeding.The readings yesterday were all over the map, we had a significant low yester
day afternoon that the CGMS completely missed. It did show a large trend downward though, so we had an idea that it was happening and that seems to be the value in this device. You can't trust the number and you're happy if it's close but you can watch to see if a trend is developing instead of finding out what's happening late.We've only been hooked up to this thing for 24 hours now but I can already say that it's really a valuable tool in terms of seeing trends. The problem with point in time blood glucose monitoring (finger-pokes) is that you have an absolute value but no idea in which direction and how fast that value is changing. We did a poke with Cadence yesterday and she was 11.8, relatively high but the CGMS monitor showed a significant downward trend. Why is this important? Well, she was heading for a nap, if we had given a dose of insulin prior to that...the low would have been severe. Without a correction, she went down to 2.9. Now mind you, the CGMS missed the low but showed us it might be happening. We did a fingerpoke and caught it before it was too severe.
The big question is: Is it "WORTH" 6000 dollars a year....that's one that's hard to wrestle down.
I ordered the Dexcom 7 competitor unit last night as well to try it out. Many of the CGMS debates out there minimed vs. dexcom are based on an insurance coverage mindset of which we don't have. That puts us in a situation of being able to decide between the two based upon their merits.
Overall, very interesting experiment thus far.
b.
5 comments:
Brad,
I think both devices are a huge step forward.
Use the diabetes search engine and look for CGMS in blogs. You'll find a lot of commentary that maybe of help.
I've commented many times about my Dexcom and how much of a difference it's made in my diabetes management. And the needle is much smaller than the Minimed product (26 gauge), so it should be less painful.
I hope this technology helps your Cadence.
Hi Bernard,
your blog and comments have been some of our most important information resources for this experiment and I thank you for that.
We are very much looking forward to the Dexcom trial. After just 2 days of readings, we're hooked on this technology. We caught a massive high during her nap this afternoon that we would have otherwise missed.
all the best,
brad.
Brad
We don't have insurance coverage (yet) for the Dexcom. But it's definitely worth the out of pocket costs. I usually get about 10 days out of a sensor. So that's US$180 per month - $2200 per year plus the cost of the system itself.
Is this cheaper in Canada because the US dollar is so low?
Hi Bernard,
We are uninsured as well and actually Dexcom is not available in Canada (yet says the rep). I was able to buy one in the US however pretty easily. In terms of the dollar amount, we are paying US fees so it's about the same. In terms of minimed however...
Guardian system US - 1339.00
Guardian system CANADA - 2000.00
sensor costs are more expensive here as well. I questioned both the rep and sales people about the disparity in pricing and got made up answers both times (to be expected).
We are going to put in on Cadence today. The Minimed sensor only lasted 2.5 days which was disappointing. The one thing we loved about it though was the rate of change arrows, it's too bad the Dexcom (to my knowledge) does not have these.
brad.
I also live in canada, I was wondering how you were able to get a dexcom CGM? I am really interested in getting a CGM but I am on the animas pump so I can't get the medtronic one, also I like that the needle is smaller for dexcom. Thanks, Jen
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