CGMs, How do I get one?


(plaidjack) #1

I have tons of questions about CGMs.  I'd love to have one.  How much do they cost?  Where do you get them?  How effective are they?

Thanks!


(cmolivier) #2

I just acquired a CGM to go with the paradigm pump- it was a long haul and lots of paperwork to get the insurance to approve it. The cost for the pump plus the CGM and starter supplies was about $8,000+ total w/ insurance coverage for part of it. I have BC/BS of MN. Medtronics, to date, has been good to work with- great reps and they go to bat with the insurance companies for you. I've been on an Animas pump for about 5 years, but they don't have a CGM system -yet. Are you on a pump now? You can check the CGM out on www.medtronics.com. I'll keep you posted as to the efficacy of the system. I will be training at Joslin in two weeks!


(DocHam) #3

I have the Dexcom and it communicates with an independent monitor. While this may seem cumbersome, it does have its advantages. Interestingly, I also have the Paradigm pump! Both my brother and I have found the data from the Dexcom to be much more reliable than that of Medtronic's system. I believe this is because the Dexcom has a 5 minute lag time whereas the Medtronic may lag as much as 20 minutes after your blood glucose. I actually use my Dexcom to determine my real-time glucose level.  I'm not certain what the Dexcom is selling at currently - I purchased mine for approximately $400. In order to get one, you need your physician to write a prescription for one. Depending on your insurance, it may cover both the system and the sensors. Its important, however, that your physician write a letter of necessity that is convincing.

As far as accuracy, mine usually ranges within 5-10 points from the readings on my glucometer. That being said, during periods of rapidly changing glucose levels, the lag can increase. No system is perfect and there are intermittent defects/issues that you learn to work through.

Using CGM has transformed my life as a person with diabetes. However, optimizing the use of it took time. Now I could not live without mine (well I could but wouldn't want to). If you have any other questions, feel free to contact me!


(plaidjack) #4

Wow, $8000! comolivier why so much when Hayley got one for $400?  Is it an insurance thing?Also, why are these things being protected like uranium from Iran?  Shouldn't every type 1 diabetic have one? 

I'm perplexed.


(BrianC) #5

I just heard about a free information session from Medtronic, coming up on Wed, Dec 10. It's a 1-hr online event. The email I got only has links for registering to either the 6pm Eastern or 8pm Eastern session. There's no individual page I can find.

It's described as:

New Technologies in Diabetes Management for Better Control

Learn how to maximize your current therapy to better control and manage your diabetes.

You are invited to attend a FREE educational teleconference/webinar designed for people with diabetes who take multiple daily injections for insulin. This sessions will cover options for treatment, the latest therapies available including continuos glucose monitoring for better diabetes management.

A LIVE Question & Answer session with people on insulin pumps will follow to answer you questions. You are encouraged to invite family or friends with diabetes who may benefit from this information.

Questions on the program, call 800-646-4633 x3149

--------------

Register for the 6 pm time: https://medtronic.webex.com/mw0305l/mywebex/default.do?nomenu=true&siteurl=medtronic&service=6&main_url=https%3A%2F%2Fmedtronic.webex.com%2Fec0600l%2Feventcenter%2Fevent%2FeventAction.do%3FtheAction%3Ddetail%26confViewID%3D128974901%26siteurl%3Dmedtronic%26%26%26

Or the 8 pm time: https://medtronic.webex.com/mw0305l/mywebex/default.do?nomenu=true&siteurl=medtronic&service=6&main_url=https%3A%2F%2Fmedtronic.webex.com%2Fec0600l%2Feventcenter%2Fevent%2FeventAction.do%3FtheAction%3Ddetail%26confViewID%3D128974905%26siteurl%3Dmedtronic%26%26%26


(schustrs) #6

We have the Abbott, it is an amazing product once you get used to using it.


We were among the first, if not the first, to get Cigna approval (case specific).  It took 12 months and many appeals but we got it.


(misstifyde) #7

My son has the Dexcom...We chose this because it is smaller then the Medtronic version (which I also have) and he is a skinny thing. You don't have to put adhesive all over it to make it stick etc like the Medtronic version. I could go on and on! LOL

It also has pretty accurate record keeping and checks his blood every 5 minutes. Also, you can keep the sensor in for up to 2 weeks, which REALLY helps with cost. Also the sets do not have to be refrigerated like the Medtronic version The "perscription" can be downloaded from their website. I will give you some advise..

 

1. They want you to have lows (to justify insurance paying for it)

2. You will need to provide a log with about 6 weeks of data. if you have a pump, then it's easy enough to download.

3. Of all the GMS's out there I have been told the Dexcom version is far more cost friendly...

Go to their website. You can really learn alot on it and even call customer service.

Insurance paid all but $195. The sets (4) are $56/Mo (but I can go 2 months on them by changing less frequently).

 


(Dan N) #8

I got the Dexcom for my 15-year-old son in February of 2008.  Insurance would not cover it, and it never worked at all consistently.  We learned from the rep that the system just works better for some people than others.  It has a 30-day money back guarantee, but we were still trying new sites and new sensors to try to resolve the problem beyond 30 days.  They then gave us a great deal of trouble over getting our money back, even though the system never worked.  Finally, after eight months, they returned our $450 for the original system.  I am now planning to wait until the next generation is out before trying again, probably with the Navigator. 


(BrianC) #9

Do all the available CGMs still require the use of a separate fingerstick/meter process? 

It seemed that a few years ago regular use of a "standard" glucose monitor was necessary, and the CGM couldn't be relied upon for accurate measures from which to adjust insulin, etc. This seemed to make a CGM more like an additional treatment or care measure rather than a replacement for a standard glucose meter.

Would someone using a CGM speak to this?

Thanks.


(misstifyde) #10

Brian, For meals it is recommended to always do a finger stick, as well as if you are going to bolus.

My son is on the Dexcom pump. It checks every 5 minutes. The main reason I got it is because I use it to trend to see if I need to make changes to his pump settings. He seems to have highs in the afternoon. This allows me to adjust and not have him check his blood every 30 minutes.

It is no different in terms of the pump. You wouldn't want to rely on the pump to automatically bolus you. It's a safeguard basically.


Tammee


(DocHam) #11

Personally I think all patients with type 1 should have one. You'd be amazed at what your blood sugar does in between "fingersticks." Dexcom is the most cost effective for 2 main reasons: initial start-up cost has been cheaper than the other models and the sensors are FDA approved for 7 days. However, you can get a sensor to last up to 14 days. My experience with the Minimed is that it was not re-startable.

 

The advantage of the Minimed is that it communicates directly with the paradigm pump. The disadvantage is that it is not really real-time.

Insurance coverage has improved dramatically since the publication in the New England Journal of Medicine (October I think) about the improvement in glycemic control using the CGM. I know for Aetna the key factor is the physician's letter of necessity. Your physician can send all of your records with glucometer downloads.


(DocHam) #12

Brian - it is strongly recommended that you use a finger stick for all management issues. That being said, I use my Dexcom as a glucometer frequently when I'm out and about. It took some time to get it to work optimally for me but now I feel comfortable using it off-label as a substitue for a glucometer periodically to frequently.


(A-D) #13

Hayley,

Just one quick add - I tried the minimed Guardian RT and had no problems restarting the sensor and I have seen posts from a number of Navigator users who have been able to restart their sensors also.  They are not approved for the longer use but a lot of folks are using them longer...

Cheers!

A-D


(BrianC) #14

[quote user="Hayley"]

Brian - it is strongly recommended that you use a finger stick for all management issues. That being said, I use my Dexcom as a glucometer frequently when I'm out and about. It took some time to get it to work optimally for me but now I feel comfortable using it off-label as a substitue for a glucometer periodically to frequently.

[/quote]

I just really wish there were a CGM that was as reliable and useful as a finger stick glucometer reading. However, the more I read on the these boards, the more I'm considering the option. When my doc had me do a three day test  few years ago (with a rather clunky and not user friendly machine that didn't even display readings) I found having something connected to me 24/7...er 24/3 in this case....to be really uncomfortable, and couldn't wait to get rid of it. 


(DocHam) #15

I agree. It is difficult to make something so accurate and they are working out the kinks. But just to give you an idea - I've tested my blood sugar twice today for initial calibration and have pumped and eaten for high/lows accordingly with confidence the Dexcom is confident. Naturally, this is using it off-label but I really feel like once you figure out how to get it to work for you, its much easier to use as a replacement. However, it does take time.

Just an FYI for anyone interested in CGM, as the year nears its end and most of us have likely reached our insurance deductibles, now is the time to buy. Speak to your physician and the insurance liason for the device company in which you are interested. Nothing beats a free CGM!!!