CGM's & Me - Or Not...
Sorry to hear about the thyroid, Jerry - definitely keep an eye on it. To me, it's a bigger pain than diabetes, simply because it takes longer to fine-tune.
Thanks for the comments re: my A1C's. It's that nice run of them will likely keep me off CGM for the foreseeable future - 50% because I'm not sure what benefit I'd gain and 50% because no insurance company will believe I can benefit enough to warrant the expense.
Since Alan's asked about me and CGM's, here's my complete spin. HOWEVER, I always says that diabetes is a personal disease and my circumstances are different than anyone else's. Thus, this shouldn't be read as the CGM Gospel According to Marcus, but rather, The CGM Gospel FOR Marcus.
1.) I rarely have no awareness of my current bloodsugar. 90% of the time, I can very closely predict it. Maybe once a month, I'll be surprised by a blood sugar test. Many diabetics are not so fortunate, and if I weren't, I'd be more inclined to get a CGM.
2.) I'm pretty boring. Simply put, my days don't vary that much. As such, my blood sugars often don't either. It's not uncommon for me to go 16 hours without testing - not because I'm lazy (though I am) but simply because what I do and eat one day can often be identical to what it was on previous days. If I had a more varied existence or diet, I'd be more inclined to get a CGM.
3.) I don't have a very progressive doctor. Some docs have a way of working w/ insurance companies. Though I go to the most progressive bunch in Lancaster, they're not that progressive and never seem to get cutting-edge stuff for their patients.
4.) I have a double standard. Allan's asking about his son, and I promise you - if my kid were diabetic, I'd put them on a CGM. Period. To be honest, though, it would be as much for my peace of mind as for their health. As a parent, I feel duty-bound to keep my kids as safe as possible.
5.) I'm not rich. Oh, I'm not poor by any stretch, and I have a figure in my head of how much I'd pay for CGM. At this time, though, it's not that cheap. Again - it's all relative. If my insurance wouldn't pay for insulin pump supplies, I WOULD pay that out of pocket, but given factors 1-4 above, I'm not willing to pay for CGM.
6.) My A1C is 6.5 or less. Allan's point is well taken: (4 x 50) + (1x200) = an average blood sugar of 100, despite the fact that none of those readings are good. But given #1 - I always know when I'm 50 or 200.
7.) I think I can get to Boston without it. If I were to get a CGM - given everything above - it would be to get a handle on my blood sugars during very long runs. However, I came up with a personal system last year that enabled me to complete a marathon without testing my blood sugar (NOTE: I only did this through LOTS of dry runs.). If I had to stop to test OR if I felt it was my blood sugars that kept me from making Boston (rather than just not being fast enough), I'd do it.
So, that's my reason for not getting a CGM. However, as mentioned, all of this is subject to change and that's why I keep up with Jamie (CGM user), Kerri (who's tried Medtronic and is now testing the Dex) and Anne (another potential Dex customer).
Thanks for the comments re: my A1C's. It's that nice run of them will likely keep me off CGM for the foreseeable future - 50% because I'm not sure what benefit I'd gain and 50% because no insurance company will believe I can benefit enough to warrant the expense.
Since Alan's asked about me and CGM's, here's my complete spin. HOWEVER, I always says that diabetes is a personal disease and my circumstances are different than anyone else's. Thus, this shouldn't be read as the CGM Gospel According to Marcus, but rather, The CGM Gospel FOR Marcus.
1.) I rarely have no awareness of my current bloodsugar. 90% of the time, I can very closely predict it. Maybe once a month, I'll be surprised by a blood sugar test. Many diabetics are not so fortunate, and if I weren't, I'd be more inclined to get a CGM.
2.) I'm pretty boring. Simply put, my days don't vary that much. As such, my blood sugars often don't either. It's not uncommon for me to go 16 hours without testing - not because I'm lazy (though I am) but simply because what I do and eat one day can often be identical to what it was on previous days. If I had a more varied existence or diet, I'd be more inclined to get a CGM.
3.) I don't have a very progressive doctor. Some docs have a way of working w/ insurance companies. Though I go to the most progressive bunch in Lancaster, they're not that progressive and never seem to get cutting-edge stuff for their patients.
4.) I have a double standard. Allan's asking about his son, and I promise you - if my kid were diabetic, I'd put them on a CGM. Period. To be honest, though, it would be as much for my peace of mind as for their health. As a parent, I feel duty-bound to keep my kids as safe as possible.
5.) I'm not rich. Oh, I'm not poor by any stretch, and I have a figure in my head of how much I'd pay for CGM. At this time, though, it's not that cheap. Again - it's all relative. If my insurance wouldn't pay for insulin pump supplies, I WOULD pay that out of pocket, but given factors 1-4 above, I'm not willing to pay for CGM.
6.) My A1C is 6.5 or less. Allan's point is well taken: (4 x 50) + (1x200) = an average blood sugar of 100, despite the fact that none of those readings are good. But given #1 - I always know when I'm 50 or 200.
7.) I think I can get to Boston without it. If I were to get a CGM - given everything above - it would be to get a handle on my blood sugars during very long runs. However, I came up with a personal system last year that enabled me to complete a marathon without testing my blood sugar (NOTE: I only did this through LOTS of dry runs.). If I had to stop to test OR if I felt it was my blood sugars that kept me from making Boston (rather than just not being fast enough), I'd do it.
So, that's my reason for not getting a CGM. However, as mentioned, all of this is subject to change and that's why I keep up with Jamie (CGM user), Kerri (who's tried Medtronic and is now testing the Dex) and Anne (another potential Dex customer).
great points. I definitely don't think it is necessary for some people to have a cgm all the time, or even part of the time--especially if you have a very predictable routine. Have you ever tested one out, though? It is pretty interesting. For example, I discovered my BG was rising and falling again between about midnight and 3, which I had not known before. I ended up shifting my basal rate increase a few hours earlier than was originally recommended. I get up around 5/5:30 usually so I think this is why...
ReplyDeleteCongrat's again on your great control. Yay!
Thanks Marcus for your post on CGM's and you. Your points are well taken. Our son's college routine is anything but predictable, which is why we think a CGM will help him even out the peaks and valleys….if he uses it.
ReplyDeleteWe haven't perused the CGM for our son for insurance reasons also. However two weeks ago, we convinced an insurance specialist at Medtronic's to contact BC/BS. BC/BS kept telling me it was approved and to order it through our DME supplier. Anyway, BC/BS told Medtronic it was approved. So, we are planning on ordering one to start using in early June. Our son uses a Medtronic pump, which is why we chose the Medtronic CGM. But, after reading Kerri's experience with CGM's, I’m not sure now. I want our son to use the CGM, but if it isn’t convenient he won’t.
Anne...Were you able to test the different systems out before deciding? That would be nice. Did your dr have the different units to try?
Al