Sunday 18 April 2010


About two months ago I wrote a post all about Continuous Glucose Monitoring (CGM), which is a way of monitoring your glucose levels 24/7 by wearing a small sensor in the skin which feeds information wirelessly to my pump. It then provides me with trend information about whether my sugars are stable, heading up or plummeting down. In theory, this should mean I can make better informed decisions about what action I need to take in order to avoid the highs and lows which can take you by surprise. Since embarking on life as a pump user, I have been increasingly interested in this, as for the first time in my life 'prefect' control is within reach. The reason I put the apostrophes around the word perfect, is that every diabetic knows there is no such thing, but there is something close enough which is achievable.

While the pump has become my new best friend, I have (and I have no idea why), had a very unstable couple of weeks. First, around two weeks ago, I rocketed into the twenties every day for about 3 days. I had to almost double my basal rates to see even the smallest improvement. I went from having predictable 4-7mmol sugars when I woke up, to mid teens one day, 3 the next and even a 17mmol - which was exactly the kind of number I thought I had put behind me when I joined the pump club! Then I started experiencing lows at strange times of day (no doubt because of the double basal rates - which I can see now were perhaps a little heavy handed!). In the last couple of days it has settled down somewhat, although I still hit 24.9mmol today after a carb counted lunch! I even had cheese and biscuits instead of sticky toffee pudding because the diabetes 'angel' who sits on one shoulder, managed to shout down the diabetes 'devil' who sits on the other!

The one thing which has come out of this episode, is that it would have been extremely helpful to see what was going on all the time, rather than the snapshots in time which the blood glucose monitor I currently use can offer. It is really hard to make decisions during the day when you have no idea what was going on overnight, or you have no idea whether the perfect 6mmol you just had, was sitting on an upward or downward trend. For example, if I had a low during the night, but didn't wake up, I will have a rebound during the day, so being wary of what I eat and how much I inject would be wise. But if I didn't wake up - how can I know this and therefore act on it? A frustrating situation I'm sure you will agree.

So, in the midst of my frustrations about my erratic and angry blood sugars, I contacted my rep from Medtronic who has agreed to offer me a trial on the Paradigm VEO Real Time CGM system. I have discussed this one in the past, as in my opinion, this one and the Dexcom 7+ are on a parr with one another in terms of the benefits they offer. As well as the benefits I previously raved about, Medtronic have managed to secure FDA approval for wearing the sensor for 6 days, making it even more tempting, seeing as the biggest benefit of the Dexcom 7+ was that the sensor could be worn for 7 days, while the Medtronic CGM only had FDA approval for 3 days.

One distinct benefit of the Medtronic CGM system is that it will feed information directly to my pump, rather than other systems, which require you to have a hand held receiver, to which the information from the sensor is fed. This means you can only be a matter of feet away from the receiver, otherwise the information feed will stop.

The only drawback I could see at the moment is that this is the CGM which reportedly 'flops' about on the surface as it is not fixed very well to the skin. This still freaks me out a bit as I'm not keen on the idea of catching it on things. That being said, I used to be freaked out by the idea of a pump - and now I would never look back. I plan on spending my forthcoming trial looking at ways and means of sticking the sensor to the skin a bit better, if I even need to. I may find that it seems perfectly fixed - we'll have to wait and see.

After looking at how much it benefits me, the one remaining decision will be about cost, while the Medtronic seems distinctly more affordable than others, it can still cost in the region of £180 per month for continuous use. By no means can I afford this, so unless I can get away with using the sensors for longer (which has been purported as extremely common by most users of the Medtronic system), it will have to be a now and then thing. For sure, having CGM as an option would have been a God-send during the last two weeks!

For the meantime, I will be very interested to see how well this benefits me and the benefits and drawbacks of the system, and will be keenly blogging about my experiences of using a CGM.

I will keep you posted and will include pictures, so that you can see what you make of it yourselves.

Over and out


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