Whenever I post a high blood glucose photo on Twitter or a high #bgnow guessing game video on Vine, people often reply that I need to wear a continuous glucose monitor (CGM). I appreciate their advice, but I don’t want a CGM.
It seems like wearing a CGM has its good points and bad points. As a long-time diabetic who has never used a CGM (I currently check 4-5 times a day with a OneTouch UltraMini), I understand the good points but tend to shy away from CGMs due to the bad points.
Equally, I think CGM users themselves shut their eyes to the bad points and only see the good points. (The same can be said of insulin pumps.)
The truth must lie somewhere in between, and the only reasonable conclusion to draw is that CGMs fit into some people’s lives but not others.
What’s good about CGMs?
First and foremost, the chance to watch minute-by-minute trends, see post-meal spikes or dips in detail, and get a warning when your BG is going out of range is, medically speaking, a huge benefit. The worry that a CGM must alleviate when, say, getting some long-term exercise, or when eating some huge Pakistani meal in Lithuania, I imagine would be a significant selling point for a CGM.
So, I do recognize that about continuous glucose monitors. I’ve seen the pictures people post of their CGM screens, and I am always a little jealous of that amount of real, live data. All I can do with my OneTouch is spot check it and weigh it against how I feel and what I did, ate and drank recently. Then try to imagine what the trend has been and what might happen now.
So why don’t I want one?
Blood glucose isn’t always perfect when relying on a traditional meter. But it isn’t with a CGM either.
I avoid CGMs because I don’t want to wear that little machine all the time. It’s as simple as that. As a Type 1 diabetic who has to scamper off and shoot up every time he goes out to eat, or has to get out of bed, go get another Lantus pen from the refrigerator, needle it and prime it when I just wanted to quickly inject and go to sleep, I like to think I can handle inconvenience with dignity and aplomb. (Obscure R.E.M. reference for you there.)
But wearing a little R2D2 on my stomach (is that where CGMs go?) all the time is quite an added inconvenience, and since it isn’t actually necessary like a Lantus shot is, it is quite a big decision to make.
Meters and CGMs are both useless if you’re too tired to even take a selfie correctly.
As cool as the continuity of the BG checks is, I question how helpful they really are. People have told me that their A1C dropped significantly after using a CGM, and I can believe it. But more people have told me their site got super painful or fell out overnight, or have also posted CGM photos where their BG spiked up to 300+ or went low for a few hours. I don’t need a CGM to help me do that!
As a guy who has been doing multiple daily injections (MDIs) and finger checks since 1982, I am fine with that system. I get unexpected high BGs, of course, but so do CGM users. And by staying attuned to my own feelings and my experience with different foods and different schedules, I bet my control is as good as a sizable percentage of CGM users who may not have been able to develop a decent intuition about BG.
[inlinetweet prefix=”” tweeter=”@T1DWanderer” suffix=””]Continuous glucose monitors (CGMs) have good points and bad points. To each their own![/inlinetweet]
So, CGMs have benefits over multiple daily finger sticks, but there are down sides to it that don’t quite justify the apparent medical benefits for me. I would never suggest that someone happy with their CGM switch to a traditional meter.
Let’s just agree that CGMs fit into some people’s lives, and to each their own!
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I didn’t get my CGM until recently and have had T1D for 15 years. I wear mine on my arm and it’s really been accurate and not much of an inconvenience at all. In fact, it’s definitely more of a convenience than not since I can go out with it and not have to carry around bulkier testing supplies. I feel my lows, so it helps more to know when I’m going high. There has been a learning curve for sure, but it’s nice to be out, reach down in my pocket and see where my BG is currently. Now I have shied away from pumps for many of the reasons you stated about site irritation and more “stuff” hanging off you. Happy travels!
That’s interesting, that you put it on your arm. How big is it? What does it look like from the outside?
It’s a Dexcom and you can see a small bump when wearing a semi-form fitting shirt or sweater. About 1″X1/2″. I admit, I occasionally bang it on a doorway, but it’s not too bad. Sleep wise and in every other way it is way more comfortable there for me than on my torso.
Thanks for the details. And you can take it off whenever you want and just spot check with a regular BG machine, I presume…?
Yes, but the problem with taking it off is you lose a sensor (or whatever it’s called I forget) and have to reapply one when you want to use the CGM again. The manufacturer recommends one week per sensor, but I get two out of mine. The biggest issue with traveling would be more bulky supplies I would think. Fewer test strips though?!
Fewer strips but some hassle of its own, it seems. As I say, to each their own! I don’t mind a few bottles of strips. This is how I carried many weeks’ worth to Europe with very little bulk: https://www.t1dwanderer.com//diabetes/how-to-travel-with-400-onetouch-ultra-test-strips/
Freestyle libre is the answer!! 🙂
Why Freestyle Libre? 🙂
I feeeel you on this Jeremy! When I was first diagnosed my hyper-paranoid mother and over-zealous doctor (who was probably receiving kick backs from Dexcom) insisted I get on a CGM immediately. I hated it! Applying the device hurt, the warning beeps were loud and obnoxious, often embarrassing me in public and I couldn’t keep the dang thing on my body. I constantly sweated them off while exercising or cycling and forget about wearing it while surfing. I understand the benefits and would never suggest someone get off theirs but like you, I am just fine without one.
Right Zach, if they work for some people, great. But they just don’t work for others. Glad you actually tried it and can speak from experience. Thanks!
Freestyle LibreLink 14 days.
I have never related to something more I’m a highly active and extremely busy teenage with type one diabetes and to be honest I don’t see any flaws with my current routine and I look at it as “if it’s not broke why fix it” I understand that people forget they’re wearing and it’s comfort but to be honest I’d have to try it myself which would be a big hassle and my a1c causes me no problems at all so quite frankly why would I??
Cgm expensive use it sometime. Most time manual check 6-10 times.
How about pump therapy?