Friday, May 22, 2009
Type 1 CGMing
We've got 1 week in with Adele's new pump and Continuous Glucose Monitor (CGM). We are very fortunate to have an insurance plan that enables us to use this new Type 1 game technology as it is very, very expensive. The new pump with the CGM transmitter and 4 CGM sensors cost over $7000. It's sad, but success while playing the Type 1 game is very dependant on the size of your wallet (or your insurance plan). Not all players can afford the same level of care. Very sad for the genetically disadvantaged but true...
After a full week using the new system, here are my impressions:
The good - you can set low and high blood sugar alarms, it saves Adele's fingers from most of the finger pricks that she gets when not on the CGM, it is very practical while we're out and about - you don't need to stop and test, you simply quickly glance at the pump and can see her blood sugar at that moment as well as a graph showing the trend in the last 3 hours (or 24 hours). The pic above was upon waking this morning. CGM said 6.9 and fairly steady for the last 3 hours which means basals are good. The blood glucose meter (finger prick) said 6.1 - pretty close.
The not so good - the sensor needs to be changed every 3 to 5 days (at $50 a sensor), the transmittor needs to be recharged (took about 15-20 minutes after 5 days of use), once the new sensor is inserted there is an initialization period of about 2 hours after which you need to calibrate (test blood sugar using the meter and a finger prick then enter the value in the pump) and then recalibrate within another 6 hours - you need a good 4 - 5 hour period following a sensor change to be good to go which means immediately after supper during the week or on the weekend, recalibration is also necessary every 12 hours or less after initial calibration, if sensor is not inserted properly - many errors and pump alarms, sensor readings are not as precise as blood glucose readings using the meter and a finger prick (can be up to 20 % off - or more in my experience if the blood sugar is changing rapidly), Adele is terrified (and cried lots) when inserting the sensor (even with the Emla cream that supposedly numbs the skin).
So, even if my "not so good list" is longer than my "good" list, we're going to continue using the system. We may go off it from time to time in cases when we just don't have the 4 - 5 hours to change and calibrate the sensor or if we're getting recurrent error alarms during the day. After playing the Type 1 game for over 6 years now, it is an amazing, unexplainable feeling to simply be able to look at Adele's pump to see where her sugar is at and where it's going. It gives us an added sense of security. Already, she's had less lows this past week since on the CGM system. Another drawback is having 2 insertion sites on her body - 1 catheter for insulin delivery and the sensor to read glucose values (no they're not integrated together - the catheter needs to be changed every 3 days, the sensor can stay longer - up to 5 days).
How does Adele feel about the system? Like I mentioned before, she is terrified on the sensor insertion. It's done using a spring loaded pen-like device and the needle is thicker than the infusion site catheter that she is used to. Hopefully this will get better. She says it hurts more than the other infusion site (it needs to go deeper), but still understands that it saves her finger pricks in the long run. She's quite the trooper and my hero... I'm not sure I could handle all those needles and pokes as well as she does. She's an amazing Type 1 player !
TEAM ADELE will again be walking in the Telus Walk to Cure Type 1 Diabetes on June 7th. You can pledge our team here (100% tax deductible):