A month or two before I got my insulin pump, I was lucky enough to see the fantastic Gary Scheiner MS, CDE, author of Think Like a Pancreas present at a Diabetes Australia – Victoria event. One of the things that stood in my mind was when Gary remarked that he finds Continuous Glucose Monitoring as useful as insulin pumps – possibly even more useful.
Since that time, I’ve got my insulin pump, and on to my 5th or 6th sensor (trying to average one every 4-6 weeks due to cost – see below) and the value of these sensors to diabetes management is becoming glaringly obvious.
Over recent weeks, I’ve been having real issues managing meal spikes, particularly around breakfast, and have been going through a fairly arduous process of refining basal rates, tinkering with carb ratios, reviewing insulin sensitivity numbers and also changing my standard breakfast fare. Muesli and I are not talking at the minute, and don’t even get me started on Weetbix.
The usual diabetes fun and games.
The CGM has been fundamental to putting the finishing touches to this campaign, allowing me to review the trends forensically over the past 4 or so days and confirming to me that I’m that close to getting these settings pretty spot on. For the moment anyway.
Yesterday afternoon I had a look at my 12-hour trend graph to see the following:
People often talk about the value of CGM being alarms, low glucose suspend features and ability to see the direction of BSL’s. These are all unquestionably useful, but the real value for me is something more intrinsic and intangible – validation and reinforcement presented on a nice little graph. I believe one of the overarching aims of any diabetes technology should be enabling people with the condition to feel confident about their decision making.
The cost of CGM is evidently still an issue. I purchased the recent Medtronic CGM offer of a receiver and 5 sensors for $375.00, but I’m now down to my last sensor. Will I buy another box? In time, most certainly. But due to the cost I’ll be sticking with my sensor per 4-6 weeks rule. The cost (~$4,500 per year if you really wanted to go nuts over the year) is still problematic for a significant portion of the diabetes community, particularly given the other extensive costs involved of living with type 1.
I think Mr. Scheiner is pretty spot on. Whether it’s Medtronic or Animas, Enlite or Dexcom, CGM technology is a world of awesome and I’m holding out hope that accessibility of these products will increase across Australia. Whilst I’m sure diabetes technology companies are pushing to increase access, I think the responsibility will largely fall to the diabetes community to mount the case. It is easy for decision-makers to ignore companies making a profit from diabetes technology. It is harder for them to ignore the people that live with diabetes due to the pure value it offers for diabetes management. As Renza has pointed out, CGM is certainly the next “battle line“ for diabetes advocacy.
That value for me yesterday, was an peek at a 12 hour graph after lunch in sunny Melbourne that provided a bit of validation and reinforcement in the daily grind of T1.