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Do My Test Strips Define Me?

Eric Lagergren

January 24, 2008

I’m considering getting a continuous glucose monitor (CGM). Or maybe I should say that, for the past few days, I’ve been thinking about CGMs. I never really gave them much thought over the past 10 months, what with my Type 1 diabetes diagnosis and the acclimation to my new diabetes lifestyle. There’s only so much one man can do.

I mean, there was this new relationship to almost everything I put into my body; then the initial adjustment to injecting insulin; and then an adjustment to infusing insulin with an insulin pump; and of course a long list of the dozens if not hundreds of other little things that go along with living the Type 1 life.

So for those of you who remember your first year with diabetes, I’m sure you’ll cut me some slack for neglecting CGMs.

This past week, though, I’ve had a few problems with test strips. Nothing major, mind you, but it was enough to cause me anxiety. And anxiety breeds anxiety, so as rational as I tried to be about these “stick, bleed, test, read” hiccups, I continued to think about how this seemingly insignificant 8- to 10-times-a-day task really is a major part of my life. Do my test strips define me? Is my monitoring kit my security blanket? Is it only when I’m well-stocked with quarter-inch wide, inch-long pieces of plastic that I can go about my day without positing a worst-case scenario?

I hope not.

However, on Sunday evening, the blood glucose monitor that attaches to my insulin pump stopped sending signals, and after troubleshooting to no avail, I felt pretty stressed. Yeah, I have a stand-alone monitor as a backup, but nonetheless, something wasn’t working right. So I went to bed and, on Monday, called the Cozmo people (Smiths Medical). An incredibly friendly representative walked me through a cleaning procedure. It worked!

Two days later, I got into the office (a 20-minute drive from home) and realized I’d forgotten to refill my test-strip supply. With only two strips and a long day ahead, including a haircut after work, I worried about how I’d make it through the day, especially because I’ve had a tendency these past few weeks to flirt with lower blood glucose levels (I’ve really increased my exercising, and I’ve been adjusting basal rates accordingly—although I never get the perfect match the first time).

I also know that I can’t rely solely on how I feel to give me an accurate indication of my blood glucose. But is it in me to not know, to keep ingesting carbohydrates and risk going high? That was my best option (because I wasn’t about to go to the pharmacy across the street and pay $60 for a box of strips). I am pretty dedicated to keeping a low HbA1c (it was 5.7% at my December checkup). That’s a good thing. And I’m sure I’ve built up grace points so that maybe I could slack a little…you know, suck it up and say, “Okay, go a little high today. It’ll be okay.”

Instead, I thought, “How nice it would be to be able to pull out a little monitor out that would give me a comprehensive indication of where my blood glucose has been over the past few hours, days, weeks, months…”

My initial Web research into the CGM piqued my interest. Readers of my blog may recall that I wrote about my insulin pump acquisition process over a series of entries that filled up quite a few weeks. Most of those entries were written months after I’d gone through that experience. Now, however, with the knowledge that CGMs are pretty good and only getting better, and with my—dare I say this?—love affair with diabetes technology and the thought of having yet more diabetes accoutrement to line my diabetes supply shelf, I figured I’d blog about it and bring you along as I consider the question “To CGM or not to CGM?”

I hear both the good and the not so good about continuous monitoring. Mostly what I hear is the somewhat skeptical “the technology’s still pretty new (and expensive); you still have to check your blood glucose with finger pricks a few times a day; they’re not as accurate as finger sticks; most CGMs don’t communicate in a closed-loop system with insulin pumps.” And, of course, the kicker is that most insurance companies won’t cover CGMs, at least not yet.

So there you go. Test-strip dilemmas beget continuous glucose monitor exploration.

I don’t plan to write about CGMs every week. And until insurance pays for my continuous glucose monitor and supplies, there’s little chance I’ll get one. I know that Jan, another blogger here on The Diabetes Self-Management Blog, has a CGM. I’ve read her entries. Who else out there uses one? If you don’t have a CGM, aren’t you just a little curious? If you do have one, I’d love to hear more about your experience with it, from actually wearing it to your experience with insurance, with supplies, with…well, just about whatever you’d like to say.

Those of you who follow this blog and don’t want to comment, that’s fine—we’ll let you lurk. But really, feel free to chime in. You can help me as much as my laying bare my diabetes soul in some small way helps (or at the very least entertains) you.



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