Cool Gizmo Machine AKA CGM

"Meet Mr. CGM Man!"

I am really wanting to initiate some serious CGM (Continuous Glucose Sensor) sensing in da house full of Diabetics.  My drawbacks were financial, basically couldn't afford the 200 for 4 sensor equation. But we now have a "Flex Account" meaning, I could, if I wanted to, get them covered. Hence my new dilemma.

The new barrier is not the cost, but the size of the Medtronic Sensors.  They could be used to hang up the cork board in my kitchen. Seriously, that BIG!  So I did some research to try to sway me into making a decision. Just Skim it. Thought since I read it I might as well share it!

My Take: 

Battelino and crew took 120 people with type 1 DM. (Randomly - which makes the study better) split them in half, one control group, one treatment group. They followed the groups for six months and concluded the following:

“In conclusion, the results of the current study demonstrated significantly shorter time spent in hypoglycemia in children and adults with type 1 diabetes who used continuous glucose monitoring compared with standard SMBG, with a concomitant significant decrease of HbA1c.”

In a nutshell:

CGM is a good way to stay out of the hypo zone.   It also has an effect on over all control shown by a lower A1C.

 Here is very informative article discussing some “don’ts” with RT-CGM(Real Time CGM) use and insulin pumping, written by Howard A. Wolpret, MD.

Here is the Link to the Article Titled; The Nuts and Bolt of Achieving End Points with Real Time Continuous Glucose Monitoring.  Here is the Article Link  Lots of cool graphs, talks about things like not shutting the basal off to treat lows, and not pre-maturely bolusing for highs. Good stuff!

Another Study published by the Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group.  The authors randomly assigned 272 PWD to use CGM over a period of six months.  This is what they found:

“After 6 months, near-daily CGM use is more frequent in intensively treated adults with type 1 diabetes than in children and adolescents, although in all age-groups near daily CGM use is associated with a similar reduction in A1C."

Once again the results show that there is a benefit from frequent use of CGM for PWD of all ages.

"MedTronic"

I think there’s a trend here.  Well on a personal note;  in our house full of diabetics  we are the proud owners of  two insulin Pumps with CGM capabilities.  We own one sensor (2800 bucks) and we don’t currently use it. For the aforementioned reasons.

"The Dex"

Unfortunately the Dexcom CGM isn’t available in Canada(I hear from the DOC that it's mucho better) and I have yet to hear anything back from my numerous emails writtem to the company.  I love my Medtronic Pump, and the built in Sensor thingy, but the needle is ginormous! Like Hammer and Nail large.  I can barely stomach it let alone my wee one.

If anyone reads this and knows anything about the Dex and when it is going to immigrate to Canada, please keep my clan posted. 

Trev

Sources: 

Another Study published by the Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group.  Factors Predicative of Use and of Benefit from Continuous Blood Glucose Monitoring in Type 1 Diabetes. Diabetes Care 32:1947–1953, 2009.

http://care.diabetesjournals.org/content/32/11/1947.full.pdf+html?sid=4c7cc395-3b1b-48c1-b381-6a43aa732cd5

Tadez Battelino, MD, PHD, Moshe Phillip, MD, Natasa Bratina, MD, PHD, Revital Nimiri MD, Per Oskarsson, MD, PHD, Jan  Bolinder, MD, PHD. The Effect of Continuous Blood Glucose Monitoring on Hypoglycemia in Type 1 Diabetes.
Diabetes Care 34:795–800, 2011

Howard A. Wolfert MD.  The Nuts and Bolt of Achieving End Points with Real Time Continuous Glucose Monitoring.  http://care.diabetesjournals.org/content/31/Supplement_2/S146.full.pdf+html?sid=21e0bbe2-9439-45b6-825b-69b69aca3cc3