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Continuous Glucose Monitoring and Me
March 6, 2008
About a month ago, I told you that I was thinking about continuous glucose monitors (CGMs) and that I’d take you along on my exploration of these little devices and share my experience. Then, last week, I said that on Monday I’d start wearing one for a week.
Monday came. I was prepped and fitted with a CGM. And then I lived with it…
…for only two days.
Okay, a little more than two days. About 56 hours.
I took my CGM off last night and put it back in its little trial kit that I’ll soon return to the DexCom rep.
Why did I take it off? If, like me, you’ve read blog entries and articles about CGMs on the Web and in some magazines, you might think that I was getting inaccurate readings from the receiver. I wasn’t. In fact, given that the CGM lags 5 to 7 minutes behind my actual blood glucose level (because it reads the interstitial fluid in my abdomen rather than fingertip blood), I found that it coincided pretty closely with the blood glucose levels I was getting from the meter on my insulin pump. It was nice to confirm that I have tight control on my blood glucose.
Or you might think that I abandoned the CGM because it was painful to insert the CGM’s sensor. I’ve read those stories from other users about the CGM’s long needles, and those large insertion devices do look a bit intimidating. Yes, I had some trepidation at first. But the DexCom Seven system’s insertion device didn’t hurt at all, and it was actually less noticeable upon insertion than the infusion set for my insulin pump.
Or maybe it was because I’m daunted by paying for a CGM out of pocket and then going through the hassle of trying to appeal to get my insurance company to cover the device and sensors. Nah. I’ve had enough run-ins with my insurance provider that if I really wanted a CGM, I’d gladly go through the process of buying and then appealing for reimbursement.
But you see, the reasons that I took off the CGM…well, I’m still working on how to articulate exactly why I don’t want one. My decision to rip off the sensor (and, by the way, ouch!) while watching a movie last night wasn’t knee-jerk. For now, here’s the short version:
I’m only one year into living with Type 1 diabetes. If you’ve followed my blog, you know that I pay an incredible amount of attention to the condition, and that I don’t mind scrutinizing my self-management. (See my entry “Diabetes In My Hierarchy of Needs” for more on this topic.) My endocrinologist and my family physician tell me that I’m taking care of myself extraordinarily well. I mean, they have these blood tests they can do, not to mention their years of medical training, so I like to consult them for confirmation!
Therefore, I don’t see a CGM as a tool I need in my diabetes repertoire right now. It’s yet one more diabetes thing to worry about, and I found it an added burden when added to my insulin pump, glucose meter, medicine, and so on. I do know from experience with other diabetes-related gadgets that it’s possible—and eventually it does happen—that I’d get used to having a CGM around. But at what point do I say “No, I don’t need another sensor on my body or one more cell-phone sized gizmo on my belt”?
At this point, I guess.
I don’t want to get used to one more diabetes thing. Not now. Not when I’m maintaining good self-management. It’s awesome that the CGM provides me with readings every five minutes and a graph of my blood glucose levels. But there’s the catch. This is also a problem for me. The CGM was really with me all of the time. Too much with me, in fact, because I was drawn to checking the readout, drawn to thinking about my blood glucose even more than I already do, more than I need to.
Really, do I need that?
I decided that I didn’t, and I decided that I don’t need four more days of using a CGM to make a decision.
Don’t get me wrong. The technology’s great, and I see many advantages for people who are worried about their glucose levels and are doing everything they can to maintain tighter control but can’t seem to get a handle on it. Nighttime lows? The CGM would be great for that.
I’m also excited to see where CGM technology goes in the next few years. I’m pretty sure I’ll revisit them somewhere down the road.
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