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Old 08-29-2006, 01:30 PM   #1
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Continuous glucose monitor

Well I've now had it on for almost a week and I've decided that I don't like it. I'm going to try to send it back and get my money back. Maybe I'm just weird, but it makes me feel disabled. The pump didn't do that, but this thing does.

I may have a transmitter that doesn't work very well, but I'm not being taken seriously. I have to have the pump within a handspan of the transmitter or I get the message "weak signal" and it doesn't record the bg values. The first 24 hours with each new sensor are a write-off. It is very innaccurate during that time. I can get a week out of the sensor easily enough, but basically I don't really trust the thing.

The other thing I'm finding is that I'm not really using it. I am pretty stable so I don't really need to see the trends. I do get unexpected highs, and it does warn me about going up, but if I test regularly I can deal with that without having an extra almost pumpsized device stuck to my abdomen. Also, I already know how my body reacts to insulin and certain foods, so I don't need the graphs for that either.

Oh well, live and learn. I'd rather just keep testing 10 times per day than have this thing stuck to me.

No disrespect intended to others who like the thing.

Cora
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Old 08-29-2006, 11:14 PM   #2
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Re: Continuous glucose monitor

Quote:
Originally Posted by Coravh
.... Oh well, live and learn. I'd rather just keep testing 10 times per day than have this thing stuck to me .....
Good on you for trying out this new technology. Your comments echo my feelings on the subject. The way I see it is that these marvelously sophisticated devices undermine the discipline required to maintain stable blood sugar levels. Which sort of defeats the whole purpose of working towards good blood sugar control. But, having said that, I will get one when a non-invasive continous monitor that straps to the wrist,without expensive and unreliable contact pads, becomes available. But it must be able to tell the time too!

Mark
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Old 08-29-2006, 11:55 PM   #3
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Angry Re: Continuous glucose monitor

Quote:
Originally Posted by Mark1e
The way I see it is that these marvelously sophisticated devices undermine the discipline required to maintain stable blood sugar levels. Which sort of defeats the whole purpose of working towards good blood sugar control.
Mark, I will nicely assume that you have NO IDEA how difficult it is for some unstable cases which are NOT YOURS to handle THEIR problems. I had a lot of flame to throw at you about this, but I've edited it out. Your comment is DEEPLY insulting to attentive, hard-working, disciplined diabetics such as myself. It's kinda like non-D people telling you that you got type-1 "from eating too much sugar". Do you need a BIGGER clue-stick than this reply?

Last edited by rickst29; 08-30-2006 at 12:34 AM.

 
Old 08-30-2006, 12:12 AM   #4
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Re: Continuous glucose monitor

Back to Coravh:

Since you're pretty stable, you don't really need one. You gave the MM a fair shake, and it utterly failed to improve your life. Their tech "support" was obviously horrible, too.

Thanks for the report. I agree with your choice to dump it, your reasoning sounds excellent.

But I'd still like to re-iterate one part of my advice to people: if you're seriously considering one of these, always take a really long look at BOTH of the competitors-- even trying them both, and telling the two reps than AT LEAST one of them is 100% certain to be rejected after your Trial.

The fact that MM required me to stick on another GIANT transmitter-thingy, and Dexcom didn't, was the main reason I chose Dexcom, rejecting MM almost immediately. If you had tried it, you would also have found that Dexcom has an enormous range- in my house, it doesn't start missing readings unless I'm at least two rooms (and two WALLS) away. Without a wall, it's good for well over 15 feet, and my Transmitter is already well over halfway through its expected life.

These were two of your biggest complaints, and the OTHER device doesn't have these problems. On the other hand, Dexcom goes NUTS if it gets wet, and a lot of people get really bad readings when they sweat. The Overall accuracy of Dexcom (in trials) is just a little bit better than Minimed... in comparison with real blood-based meters, they both absolutely suck. I personally HAVE given up using my regular meter most of the time, Dexcom is nearly spot-on for me... but that's EXTREMELY unusual. Most users have to treat them as an extra add-on tool, not a replacement: something which should, if it's appropriate for you, give you at least a few CORRECT warnings about highs or lows which you didn't see coming in any other way.

If it only tells you stuff you ALREADY FIGURED OUT, then you don't need it, it's just wasting your money and time.

Last edited by rickst29; 08-30-2006 at 12:31 AM.

 
Old 08-30-2006, 01:25 AM   #5
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Re: Continuous glucose monitor

Quote:
Originally Posted by rickst29
Mark, I will nicely assume that you have NO IDEA how difficult it is for some unstable cases which are NOT YOURS to handle THEIR problems. .....
rickst29,

I really didn't mean to offend anyone. I feel deeply for all those T1s who are having a hard time with their control. I know what it is like to be hospitalised because a plunging blood sugar got away from me. But I don't believe that technology is the only answer.

My understanding of what it takes to control blood sugar levels could well be incomplete. But I get intensely frustrated when the medical fraternity gives counter productive advice to T1 diabetics and then offers products to enable them to sort out the resultant mess. And this is what motivated my comments.

I was, to some extent, reacting to a post in a different thread in which difficulty in controling blood sugar and a meal plan containing 200 grams of carb a day was reported. It goes almost without saying that relying on carbohydrate as the primary source of energy causes problems if you don't produce insulin. Most T1s get by on covering all that carb with insulin. But for many of us that doesn't work. And we have to deal with uncontrolable volatilty.

But, really, an "unstable diabetic" who consumes that much carb shouldn't be surprised about the unstable blood sugar levels. Failure of the medical profession to pick up on this mystifies me. And I really feel for all those T1s who suffer as a result of this.

While I know that some T1s seem to get away with a lot more than others, anyone who is eating more than 50 grams of carb a day simply isn't doing what it sometimes takes to remove blood sugar volatility and achieve stable control.

Cheers,

Mark
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Old 08-30-2006, 03:57 AM   #6
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Re: Continuous glucose monitor

I don't know that much about dexcom. Does it go with any pump? How does it work?

The other thing I found annoying was that you are not supposed to treat a high without doing an actual test with your meter. So I may as well test anyway!

In addition, I have checked my meter quite often against my labs (I get tested every month for my transplant) and at worst my meter is off by only 5 %. I have had several occasions where it is dead on! So my meter is much more accurate than the sensor.

Thanks for letting me vent.

Cora
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Old 08-30-2006, 05:05 AM   #7
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Re: Continuous glucose monitor

Yeah I have to go along with Mark, I also wait for the day where we can wear a wrist watch which constantely displays out blood readings, WITHOUT the expense of sensors, and an invasive needle!

That would be the next best thing to a cure in my eyes, I have had type 1 for 23 years, and have been a diabetic in denial for a lot of those years. It is only really since coming to thse boards, and reading about other peoples experiences that has made me wake up! for the first time in 23 years I am actually watching everything I eat, and read the backs of everything to make sure that there is no hidden unnecessary sugar added!

Rick, I sympathise with your frustration regarding people that say 'you can get diabetes by eating to much sugar', I got type 1 at 18, and my mum has always told everyone it was my fault, as I had a sweet tooth and overloaded my pancreas! ignourance I say.

On a more positive note, they are currently running trials on tear drops, apparently the tear drops we produce can work as well as blood for detecting how our sugars are doing. Don't know if anyone else has heard of this?

Last edited by brook65; 08-30-2006 at 05:05 AM.

 
Old 08-30-2006, 05:52 PM   #8
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Re: Continuous glucose monitor

Quote:
Originally Posted by Mark1e
rickst29,

I really didn't mean to offend anyone.....
Thanks Mark, it was really just the wording which "set me off". I know that you know which way is up

I agree with you re: less carb == easier to manage. In a new study on T2 pts. in the SouthEast (IIRC, it was Duke University), they divided a bunch of problem pts. into two similar groups, but then provided "intensive ADA diet" training and support for one group, while doing "intensive low-carb", support and training for the other.

The Low-Carb group's weight loss and blood test improvements, over the following months, TOTALLY BLEW AWAY the ADA Diet group's results. And in spite of the high-fat diet, even their triglycerides were significantly better! (Along with EVERYTHING else... A1c, LDL, HDL, and weight loss.)

But back to my issue: Low carb doesn't do much of anything for a 400-point "Dawn Effect", which I is just one of the things I have to deal with. We're all unlucky, but some of us are even MORE unlucky than others. We all gotta simply handle the cards which we were dealt, as best we can. And for me, things are going a lot better with my "little new friend" replacing my old 15-20 finger-***** tests-- even 20 wasn't really enough. For me, continuous FLAKY readings makes my life go better. Thanks for the friendly reply!

 
Old 08-30-2006, 06:32 PM   #9
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Re: Continuous glucose monitor

Quote:
Originally Posted by rickst29
... Low carb doesn't do much of anything for a 400-point "Dawn Effect", which I is just one of the things I have to deal with. .....
rickst29,

That is quite some DP! I have spent many hours trying to sort that one out (My morning BG was often in the 180-240 range). Something I found worked for me was taking Metformin in the evening (sometimes we have to think outside the box with this!). One of the actions of Metformin is to inhibit hepatic glucose production. Which is where that DP surge comes from. It is worth a try if you haven't tried it already.

Cheers,

Mark
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Old 08-30-2006, 06:38 PM   #10
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Re: Continuous glucose monitor

Part of the reason I decided not to keep the monitor was because of my stability. My DP is next to non-existant. I my basal rate during the day is 0.6 units per hour and from midnight to 6 am it's 0.7.

I'm lucky too in that the only carbs that don't act normally for me are licorice and pasta. I can eat the equivalent of 20g of carb of licorice and my glucose will shoot up as though I ate 80. And pasta I just plain eat too much.lol

The other thing with the meter was that you were supposed to calibrate it 3 - 4 times per day and then test if you needed to correct either a high or a low. So what's the difference between testing 5 or 6 times a day to 8 or 10 times a day. The only difference was the tape burn and the crater from the insertion. I think I'll hang out for the non-invasive one too. Whenever it arrives.

Cora
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Old 08-31-2006, 12:58 AM   #11
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Talking How does Dexcom work? (LONG, BADLY WRITTEN)

Coravh,

Here's the main differences: As you figured out, the Dexcom is completely independent of your pump. (I use the old DTron+, although I'd probably be inclined to buy the Animas 1250 if I was shopping today.)The Sensor which you punch into your skin is about the same as Minimed's, maybe a tiny bit thinner. It is definitely less reactive in the body, that's why (on average) Dexcom users get a few more days than Minimed users.

With Minimed, you must connect the Radio Transmitter by wire to the Inserted Sensor, and the Transmitter is really big. Nearly everybody tapes it on their body, with all the nastiness that taping stuff implies. And the wire connector isn't very long- you can't have the Sensor on your belly and hide the Transmitter on your back. The Dexcom Transmitter, in contrast, clips right on top of the Sensor-- it's tiny, only about 4mm tall, and the top has beveled edges to keep it from getting caught on clothes.

Unfortunately, the Dexcom system doesn't use ANY replaceable batteries. You can extend the life of the rechargeable receiver by plugging in the charger every day, keeping it near 100% charge all the time (you can't overcharge it). But eventually it will wear out, and cost you $550 to replace. The Transmitter isn't rechargeable, so it just wears down over time (even when you're NOT using it, if you don't run 24x7). They cost $250. Dexcom estimates 12 months life for the Receiver, but only 6 months life for each Transmitter, so the total replacement costs are expected to be over $1000 per year. For me, this is significantly more expensive than the Sensors! But my total cost of $1800/year is a pretty good buy for the assistance I get.

I hope to get at least a couple extra months from the Receiver via my aggressive recharging schedule, each month is worth about $50 of cost. There's nothing I can do about the lifetime of the Transmitter, when it dies, I'm stuck. But I've had this one for about 4 months and it still works from over 20 feet, so I'm hoping that there's still quite a bit of life left in it.

The Dexcom Sensor is very sensitive to getting wet, it reports crazy "High" readings for several hours after it's been soaked (under the Transmitter). The Transmitter clip ISN'T waterproof, but putting one of their "shower pads" or some IV-3000 over the entire Sensor, including the clip, will prevent it from getting wet unless you're doing a lot of muscular twisting (i.e., swimming or water skiing). Snorkel or SCUBA? Forget it. Might as well rip the Sensor out and throw it away before you even go in.

Quite a few people who sweat a lot also get crazy "High" readings frequently, which doesn't surprise me at all. What DOES surprise me are a few people who sweat really hard but still get accurate and consistent results-- One guy says he uses it when he drives his race car, and it's a genuine semi-pro race car: Over 100 degrees in the cockpit, no A/C, no Windows, everything being shaken like crazy, PLUS he's dressed in really heavy fire resistant clothing and helmet. He posted that his Dexcom was with about 15 points of finger-stick before and after the race (IMMEDIATELY after, before there was any time for the equipment to recover form the heat conditions) on both of the events' two days. His time on the track was multiple continuous hours each day, and he used the Dexcom to guide his slugging of Gatorade. In the past, he has always had to stop the car to test, and take part in only short-duration events.

And I am really delighted with my results: Although the FDA and their own lawyers MAKE THEM say "Don't treat until you've confirmed with a genuine bG meter test", my results have been reliable enough to ignore that advice: Once in a REAL LONG while, I'll wonder how far off the Dexcom is, and I'll usually find that it was quite close... except for the time delay.

So my procedure is: Treat immediately, because it's almost certain that the Dexcom buzzer or graph curve IS indicating correctly. (Prompt treatment is more important in Lows, of course.) Only after treatment, if I question its reading (i.e., I FEEL different than I normally do at the indicated bG), do I bother with a finger-stick test. More than 90% of the time when I've done that, the Dexcom WAS RIGHT, and my "not feeling like I should at that sort of reading" WAS WRONG.

I try to pay really close attention to how I feel, but how I feel isn't a remotely reliable indicator. After all, that's why we have meters!
- - - - -
Hardly anyone on either brand of CGM gets results as good as mine. A couple of posts above, I was whining at Mark about how "unlucky" I am in the difficulty of managing my case, but I'm obviously EXTREMELY LUCKY to get such good reliability from this device. Nobody should go into a CGM trial expecting that they will be able to "dump" their bG testing, but that's basically what has happened for me.

Twice a day, I plug in the OneTouch to recalibrate the Dexcom, and most of the time it's off by 15 or 20 points. But fairly often, I carry the two meters over to my wife, smile, and show her the OneTouch screen with a number like "108" and the hasn't-been-calibrated-for-12-hours Dexcom screen showing a number like "109", and crack yet another sarcastic joke about "yep, can't trust these dang things, they're totally unreliable and you always gotta punch your finger to get a real number. wink, wink."

But again, among CGM customers, that's EXTREMELY unusual. For once, I get to count myself among the lucky ones.

Per above, even though it sounds like you chose the wrong one to try, given that you HATED wearing that giant Transmitter, you probably made the right choice at the end:
"I don't need EITHER ONE of these CGMs... I'll revisit when they're MUCH cheaper, MUCH less hassle, and MUCH more reliable."
If you're doing fine without a CGM, there's better things to do with your life and money than putter around with these gadgets and their idiosyncrasies. It's REALLY HARD to find Sensor sites which work well.

I'm privileged to get all the RELIABILITY I want, but it's still an huge hassle (due to the "gotta keep it absolutely dry" characteristic), and it's still a HUGE expense. I used to enjoy swimming for up to a mile or so, but I simply can't go anymore. If Abbott ever releases their WATERPROOF product, and it has similar accuracy than Dexcom does (for me), I'll switch vendors in a second. But they were saying it would go on sale in August, and August is done and gone. All they've done so far is a bunch of "demos" at conventions, plus a nasty law suit against a competitor who DID create something which WE CAN BUY. I'm not happy with them. Minimed and Dexcom have shown for them EXACTLY what it takes to get FDA approval-- IIRC, Dexcom's 3 weeks from application to approval set a new record as the fastest device approval EVER. So, what on earth is Abbott's problem?

Last edited by rickst29; 08-31-2006 at 12:59 AM.

 
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