I have funding for CGM!

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This topic contains 18 replies, has 10 voices, and was last updated by  Anonymous 6 years, 5 months ago.

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  • #6131

    lizz
    Participant

    But only for a provisional 3 months. At the end of that time I and my healthcare team have to prove that it has improved my life…

    Not sure what this entails!

  • #9568

    Alison
    Keymaster

    Hurrah! Congratulations Liz, that’s great news.

  • #9569

    Dave
    Participant

    Fantastic. Really well done!

  • #9570

    Anonymous

    Well done Liz. I take it your pump is cgm ready & the funding covers a 3 month supply of sensors & insertion devices? (i really need to read up on how these things work)

    Was it a big fight to get the funding?

  • #9571

    Annette A
    Participant

    Excellent news Liz. I forsee lots and lots of recording and notes and graphs and numbers and words on how you’ve been able to do things with it that you couldnt without etc etc etc – well, you’re the writer, you can do the words, let the healthcare team do the numbers bit :-)

  • #9572

    Anonymous

    Fantastic news Liz. I hope it helps you as much as it has so far helped me. Without hypo awareness you are up the creek without a paddle, using cgm has removed a fair degree of fear from my life. I feel much more confident about going out on my own and to sleep at night. You’ll be glued to your pump screen watching the graph line wobble its way through the day.

  • #9573

    Tim
    Keymaster

    That’s cool Lizz – do let us know how you get on.

    Question: This house believes that CGM would actually be more useful for more people than a pump. Discuss.

  • #9575

    lizz
    Participant

    Yes, funnily enough I noticed in the instructions I was reading this morning that they were saying make sure you put the sensor 3 inches or whatever away from infusion sites OR injection sites. It hadn’t struck me before that you could wear one without a pump.

    I disagree, depending on why you need a pump. with me it is the tiny doses I need, and also the variation in basal I need. I spent most of my life with terrible hypos, unable to eat enough at certain times of day to prevent them happening every day at the same time. nothing helped. I now know this was because in the early afternoon i need hardly any basal. On long acting insulin you cannot replicate this. And at night, I need NO insulin for 4 hours. That too is impossible to replicate without a pump.

    Now I just have to mourn my Cosmo as it will have to be a Minimed. The main thing I’m going to be missing is the site change reminder – I have just managed to leave it in for 6 days!

  • #9576

    lizz
    Participant

    Just adding another note here as I’m not getting notifications of replies…

  • #9577

    Annette A
    Participant

    Agree with Lizz, it does depend on why you need a pump. Although a cgm would be fantastic, I can live without it without major hiccups (I still have a certain amount of hypos signs and a fanatical approach to testing). But without a pump, my life was a misery, mainly due to massive swings in basal rates from day to day (from 70% to 150% at times) that were not consistent so I couldnt tell when they were going to happen nor deal with them properly when happening. And the pretty huge difference in hourly rate needed suring the day (although I dont go down to zero, I do go pretty low during the night, and comparitively high mid morning (a delayed pre-dawn phenomenon, anyone?) which pumps can help with but cgm would only tell me about…

  • #9581

    Alison
    Keymaster

    I think you can use CGM quite effectively to get an overview of what’s going on when you’re on MDI and tweak stuff as much as MDI will allow. So in that way, it could be really useful. But I see the CGM as the data provider and the pump as the tool that allows me to react to that data – with MDI the tool is more of a blunt stick than a surgical scalpal so you can’t react with as much precision.

  • #9582

    Anonymous

    Isn’t using a pump a prerequisite for getting funding for an CGMS?

    Being one who is on MDI, and more interestedly looking at the progressions in the CGMS world than the world of pumps, i would like (well…) to argue that more people will benefit from CGMS over pumps, as pump can be seen as an alternative to MDI, there is really no comparable alternative to CGMS.
    Variations in basal insulin needs can also be filled in MDI by using another type of long lasting insulin or at different time(s) during the day. While pump boluses or shots of (ultrafast acting) insulin by injections are much alike.
    While with a large number of daily injections (say 6-8, a couple more than most people tend to use) one would be able to adjust to most insulin needs, to be able to get the same amount of information about BG levels as a CGMS seems to provide, one might need at least 12-18 BG measurements, including several during every day’s night.

  • #9583

    Alison
    Keymaster

    Hi @Marijin I’m not aware of any national funding criteria for CGM, so there are no pre-requisites it’s very much a case by case approach.

    I agree that CGM can be of benefit on MDI – especially for looking at overnight BGs, and even for things like monitoring the impact of certain foods/exercise.

    But my experience with MDI was no amount of changing of basal insulin type/volume/timing could give me the flexibility that the pump does – I can have my basal set to a different rate every 30mins, so I can adjust it to meet my varying basal needs – low in the middle of the night, rising in the morning, higher around lunchtime, lower mid afternoon, higher in the evening. And because I’m using short acting insulin any changes I make take effect within a couple of hours. It used to take a few days for any change I made to my Lantus dose to truly take effect.

  • #9584

    lizz
    Participant

    Yes, I agree. I tried all sorts of long acting insulin at all times of the day. All of them have times when they peak and fall off in action (apart, allegedly, from Lantus) and even timing that would not have helped me. Because they are ALWAYS working, and their action could never work at the right times for me. I can also turn my basal right down when doing exercise – I take 10% of my basal rate, whatever time I exercise, and this compensates for the energy used, as well as eating. I used to find i couldn’t eat enough to be able to exercise without becoming hypo. It has freed me.

  • #9585

    Peter Childs
    Participant

    In an ideal world it would be nice to see CGMs available for ALL diabetics as a matter of course.

    However they are expensive and someone has to pay for them. hence I think they should be available to people who have a “good” reason for needing them, ie the Pregnant, the newly diagnosed and people who are find it difficult to control.

    but certainly being on a pump, should NOT be a prerequisite, and indeed I suspect that some people not on pumps (even thouse not on insulin) may have more need of them, not to avoid hypos but to try and get diabetes under-control and diagnosed correctly to avoid the complications.

    We are of course talking ideals here not reality.

  • #9586

    Anonymous

    @lizz when I used lantus I was pretty well controlled after I selected the right time to give it…

    Now I’m on a pump i realise I was just getting its sloppy release to match my wonky basals!

    I used to believe it was flat but now I have the proof it’d not!

  • #9587

    lizz
    Participant

    It’s not. In fact in the original research the Dr who reported on ALL the research on Lantus said in his opinion it was no better than two NPH injections given at the correct time.

  • #9592

    Anonymous

    As I said, when I was on it I believed it was flat (compared to what I’d been on) its funny how the situation you’re in can make you perceive things!

    Being controversial,

    I’d say giving cgm to someone who’s not on a pump & can’t adjust their basal is like giving someone who can’t afford their heating bill £50 notes to burn to keep warm.

    Similarly whilst its a nice to have, not everyone on a pump needs it!

    … Retreats for cover…

  • #9597

    Anonymous

    Great news on the funding! Very jealous :)

    If I’d had the option a couple of years ago I’d have gone straight for the CGM. A few months into pump use and I’m slightly more even handed, but I can (and have) seen that the things over which I have control with a pump (or MDI) are often only a small part of the BG balancing act.

    For my money an accurate CGM would probably still be almost as beneficial as a pump, but some of the fancy schmancy jiggery pumpery benefits have won me over so now it’s prob 60:40 pump.

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