CGMS and the D.O.C.

D.O.C. in this case stands for “Diabetes Online Community”.

For those who are familiar with type 1 and in many cases of Type 2 diabetes, taking exogenous insulin or some forms of medication to lower one’s blood glucose can result in Hypoglycemia. Hypoglycemia is a condition where the blood glucose value falls too low, and usually effects one’s ability to think or reason clearly. If left untreated with a fast-acting source of sugar, people can actually lose consciousness. There have even been stories of people getting arrested for being intoxicated in public when in reality, they were in an episode of severe hypoglycemia. Most people can feel a bt off, telling them to check their blood glucose with a kit we may carry.

Symptoms usually are similar to intoxication, with sweating, shaking, inability to speak clearly, to US it can feel like a panic attack. caused by a push of adrenaline from the body in its’ attempt to make the liver release glycogen stores, desired result would be to raise our blood glucose levels. Unfortunately, it doesn’t always time well with the meds one has taken.

In 2006, The FDA allowed the Technology in the form of what is called a CGMS to be purchased/prescribed. This stands for “Continuous Glucose Monitoring System”. Normally, it is comprised of a little sensor, injected through one’s skin, a tiny transmitter is fastened onto this and signals reading the glucose value in the person’s interstitial fluid by the sensor are sent to a receiver. Two main brands here in the USA are Minimed Real-Time and Dexcom G4 “Platinum” and their Dexcom 7+ system. The Navigator is no longer on the market. Diabetesnet.com has a nice ‘summary’ of the items and dates of release here.

The Minimed Pump is used also to receive CGMS data

The Minimed Pump is used also to receive CGMS data. I’ve been using it as a CGMS receiver alone.

Most insurance will cover a CGMS system if the person is known to be at risk of losing consciousness and/or having had a history of EMS (Emergency Medical Services) intervention. I have been in that shape years ago when I got my first CGMS system. My insurance worked with the Medtronic/Minimed system. They still do.

So, recently, when I found my CGMS transmitter had passed its’ lifespan and was no longer covered, I had Minimed go to the insurance company for me. Typically, this is not an easy task, and now that I’ve past my 55th birthday, I am now on what is known as “OneCare”. OneCare is a mix of Medi-Cal and Medicare. Medi-Cal covered CGMS, but now because of that magical number of my years, I am more at the Mercy of Medicare, who typically denies CGMS technology to it’s patients. I’m waiting now to see what will happen with this request for a replacement.

I feel this is incredibly “Ageist”. I work, I am doing my part in Society and feel that they are devaluing older People with Diabetes by –in a sense– saying “You’re not worth the money. You can pass out, we don’t really care”. What is this saying to older Americans who have worked and paid into the system for many years? It actually hurt my feelings, even though I know it is not personal, it’s Government.

Right now, I do have an amazing case worker who warned me about this, but she said ‘Don’t give up yet…” As Minimed JUST sent me 30 more sensors, I have indeed been getting CGMS replacement “Parts”, so it may work out for me. I posted to Facebook about my concerns, and I now know there truly are angels out there!

It lasted actually about 3.5 years.

It lasted actually about 3.5 years. I’ve been lucky in this.

With some of the FaceBook People who use CGMS, they have upgraded to the Dexcom G4 “Platinum” and had a Dexcom 7+ laying about. I have been gifted with one of these kits! Another had 3 boxes of Sensors, and sent me those too! I have been overwhelmed by those who would “Have my back” so I have a CGMS unit while insurance can be dealt with.

This is reading my Actual glucose level at work. Note that DOWN arrow. That's the direction my glucose is going.

This is reading my Actual glucose level at work. Note that DOWN arrow. That’s the direction my glucose is going!

I can’t thank these lovely people enough! Getting ‘buzzed’ with a -Possibly lifesaving low alarm from my Dexcom 7+ is worth it, even if it does happen at 4AM or so! 

I think PWD’s like us have a deep empathy for others in our shoes. We’ve been helpers, and we have been helped. I, for one, see the ‘Circle of Caring’ as I call it, first hand.

I love every one of us.

I love Social Media for taking away the isolation many of us would feel without it.

I put in my second sensor today for another round of CGMS love. At least I can get on my bicycle, ride to work, go out and not be nervous about having a low. After 28+ years of type 1 diabetes, I don’t feel a lot of the symptoms I used to. While I do not use this to actually dose insulin, It does alert me to trends, maybe as I’m going along and feel nothing out of the ordinary, but the receiver buzzes me “Low” and shows me a value of 46, I stop and do a conventional test. Meter bg was 44, by the way…!

Wish me luck, with the whole insurance dance, nothing that us PWD’s don’t know only too well!

*************   UPDATE  **************

Facebook pals came thru again when I was trying to get a data upload cable. 2 people have spares and so one of them is sending me their spare Data cable.

I also heard on Monday from MM and “Tom” is working on getting me a replacement transmitter. I will say though, the Dexcom 7+ is darn accurate!  Onlt down side would be no Software that is compatible with Mac. As T:Slim’s T:Connect IS compatible with both Win and Mac, I hope this changes soon. In a video interview I saw with Terry Gregg- the CEO of Dexcom on TuDiabetes.com he *DID* say he was a Mac user, so I’m not getting this exclusion in their software.  The talk of Dexcom eventually integrating with my T:Slim is VERY positive!

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6 Responses to CGMS and the D.O.C.

  1. paulk91 says:

    I use a dexcom g4 and highly recommend it or essentially any other CGM for people with diabetes. They are truly remarkable pieces of technology

    • I love the look of the G4’s screen! I do want that one, but my insurance… IF they actually cover the transmitter will mainly work with MM.In my opinion, sometimes ANY CGMS is better than NO cgms…. Will be finding our what insurance says about this hopefully in the next week or two. In the meantime, I’ll be saving a few bucks every payday and see what can happen.

      • paulk91 says:

        I agree, any CGM is better then no CGM. My insurance has not decided to cover it yet either, they are still deciding if it is necessary for diabetics. I decided (we’ll see if it pays off) to go ahead and buy it to show that it was SO necessary I didnt wait for them to cover the cost. Hopefully they will reimburse me, but either way it is a good purchase i think.

      • What gets me, is because of my insurance, I’d possibly lose it if I “buy” equipment or service they wouldn’t cover. Nuts, huh? I could understand if it is something they did cover, but, it’s goober-ment! :-/

      • paulk91 says:

        Wow really? I dont think i have ever heard of that before.

  2. A mix of Medicare and Medi-Cal (A form of Medicaid in California) They sort of see it that If I could afford to buy a service, they could say “Well, you don’t need us…” So it’s a sticky situation here.

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