Should I get a CGM? | Diabetesnet.com

Should I get a CGM?

From: BW

Hello. I'm not diabetic yet, but am getting close, and diabetes runs in my family. I'm considering continuous glucose monitoring so I can track how my diet and exercise affect my glucose levels throughout the day. This would not be covered by insurance. I'd like to learn more about my options, and would like to hear suggestions to do this at a reasonable cost.

John:

Thanks for your question B,

Most people have insurance coverage for CGMs except those on Medicare and those like yourself whose beta cells produce insulin and their C-peptide level that measures insulin production is too high to qualify. Given that, your desire to see how your glucose is affected by food choices, activity, and multiple other daily interferences is exactly what you want to do. Diabetes is all about glucose control, so what better way to manage it than with immediate feedback?

Many people, including myself, have to cut corners to afford this optimal diabetes therapy. Right now, the Dexcom CGM is the best way to go. It is currently the most accurate and least interfering CGM, with a great color display. Plus the receiver is small, does not look like a medical device, and is lighter and really easy to carry. Approved for 7 day use, the sensor can generally be used for 10 to 14 days once it has been well attached to the skin. At about $90 per sensor, your ongoing out of pocket expense comes out to roughly $7 to $9 a day for the sensors.

Attachment is critical for cost savings. A good method is to place a layer of Skin-Tac (from wipes or a bottle, available at some pharmacies) onto the skin first with a clean area in the middle where you insert the sensor. Let the Skin-Tac dry and then insert the sensor and press down firmly on the white cotton adhesive around the base of the sensor. This will usually hold it firmly in place for 2 weeks. Mastisol adhesive and Detachol remover can also be used to secure the sensor.

The reusable transmitter that signals your readings from the sensor base to the separate receiver does not require any recharging like the Medtronic CGM but does need to be replaced, usually after a year or more. Dexcom has a somewhat lackluster pricing plan where the transmitters costs over $500 if you don't sign on to their automatic sensor reshipping plan, which you may not want to do since you may not need to use a sensor all the time like most of us. However, they charge only $199 if you approve automatic shipping. You may want to explain to them what you are doing and get a pre-purchase agreement to buy the transmitter at their $199 price. Dexcom ought to be open to this as they'd love to have more people with Type 2 and pre-diabetes use their system.

A CGM is like windshield wipers on a muddy windshield -- you won't know what you've been missing until you use it!

John

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