Wednesday, April 19, 2006

To CGM or Not To CGM

Continuous Glucose Monitoring (CGM) Gadgets

It's hard to believe that just over a month ago, I was despaired at ever having peace of mind when Jack's alone with the kids. And now, I feel as if I've hit the jackpot (not quite gold, but at least silver).

Just over this short period of time, not one, but two CGM gadgets have received FDA approval. After comparing available options, it's clear they each have their benefits and shortcomings. But I'm excited about Dexcom. These are the characteristics that I care about*:
- The FreestyleNavigator seems to have the most potential, but it's still awaiting FDA approval after three years. Listen to the informative presentation from the 2004 Diabetes Symposium.
- The MiniMed Paradigm REAL-Time System is a step closer to the artificial pancreas, but come on folks, it costs $1000 plus $35 (or $40?) per 3-day sensor.
- The Dexcom transmitter has the smallest footprint, and at $500, a lot more affordable. The 3-day sensors each cost $35, but rumors say it's possible to wear them up to 7 days (Abbott is currently seeking FDA approval for the longer use). Matt Vogel's blog about using it

Jack's (Mental) Challenges

Anyway, I've been subtly making all of this information available to Jack, trying not to cram it down his throat. His reaction? (1) He doesn't see the benefit of getting glucose readings every 10 minutes instead of every 2-3 hours. (2) The gadgets are too expensive.

Well, I think, I'm quite sure I didn't marry a stupid man. Someone actually awarded him a PhD once, and he sounds reasonably intelligent in normal conversations. Although, my boss has a theory that PhD's are so focused on the esoteric that the logic of pedestrian life passes them by. Hmmm. Anyway, my crack rebuttals go like this:
(1) It'll be easier to catch highs and lows before they happen.
(2) CGM will help to keep his BG within normal range. Yes, his HB1Ac is always around 5.3, but that only measures his average BG, not how widely they diverge from the norm.
(3) He's ok spending thousands (and I mean thousands, although I steadfastly refuse to know exactly how many thousands) of dollars on two speakers for his beloved/treasured/idolized stereo system, but he complains that a few hundred bucks is too much for the improvement of his health? Hah! Got you there!

More discussions after I get home tonight. We'll see how that goes...

* I guess I should do the disclaimer blah blah: I'm not compensated in any way by Dexcom, nor am I making any recommendations for treatment or gadgets!

4 Comments:

At 20/4/06, Anonymous David said...

Anna, I argue with my girlfriend about this all the time. :) I think she's finally come around to see the light, so don't despair. We significant others can persist until we get our point across. It's a great benefit of being stubborn.

I can see why Elizabeth is so resistant, though. She had a hard time adjusting to the pump so adding another attached medical device is not high on her to do list.

You may want to read LifeAfterDx and print out some relevant portions:

http://lifeafterdx.blogspot.com/

It's a blog by William, a man who got one of the first GuardianRTs. It pretty much revolutionized the way he treats his blood sugar. And the graphs of his numbers are amazing!

I think in 10 years we'll look back at CGMS as the biggest step forward since the pump... and perhaps even bigger. I bet more people will obtain sub-6 hba1cs than ever before.

So keep at it. :)

 
At 21/4/06, Blogger AnnaQ said...

David,
Thanks for the encouraging words. Yeah, we've got to be at least as stubborn as they are! Will definitely send relevant portions of William's blog to Jack, since he most likely will never read the whole thing. Jack seems amazingly dispassionate about the CGM's. But then, he's the one sticking himself... Keep us informed if Elizabeth goes on a CGM and how she fares.
Good luck!

 
At 5/7/06, Anonymous Anonymous said...

For many, the cgm is wonderful. though not all that acurate, certaionly acturate to avoid having to test before, say, jumping in the car. Not accurate enough however to make any insulin related decisions. I gave the dexcom a try, and loved it, when it worked.
As is always the case with new things such as this, they just dont work on 100% of the people, and unfortunately, I was in that small minority. I simply was unable to have it run reliably.

It is a bit steep ($500+ up front, and $37.00 / 3 days), but, if you can afford it, it is, IMNSHO, worth a try...

Dont be fooled by words like "integrated".
This is a nice bit of advertising, that means some pumps can be used as READOUTS, not as anything even closely resempling an articical pancreas.

 
At 31/1/07, Anonymous Anonymous said...

my experiences with the dexcom CGM.....
the excitement far overshadowed the actual experience....
www.lenlutz.com/mydiabetes.html

 

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