As with everything diabetes-related (or maybe just life-related), there are pros and cons to this whole continuous glucose monitoring thing. For those of you who are still thinking about whether you want to make this CGM leap, here are my pros and cons of CGMing to shed some light on the subject.
The sensor is bulky. The sensor isn't tiny (about the size of an iPod shuffle), but it's held securely down by the adhesive gauze, so once it's in place, I can't feel it. This is a big deal for me, since the Minimed CGM was painful for me. However, it's visible underneath the sleeve of my shirts when I wear it on my arm and it's slightly uncomfortable to sleep on when it's on my back.
Can be "too much information." Having blood sugar updates every five minutes is awesome, until you find yourself checking it every five minutes and obsessing over each result. I needed to be psychologically ready for a CGM, and I need to be able to keep it from ruling my life.
Receiver is enormous. The Dexcom receiver is pretty big - bigger than my Blackberry - and it's cumbersome to wear. I usually keep it on my desk, in my purse, or in my coat pocket when I'm out. At night, I strap it to the headboard of the bed using a headband. Not a big deal, but it's hard to miss. Especially when it ...
Beeeeeeeeeeeps! The beeps are LOUD. Mega loud. Loud enough to wake me up during the night if I'm low (thankfully), but during the quieter parts of the workday, it's loud enough to distract my coworkers. I recognize that the beeping is important, but it's not always convenient.
Adhesive sort of sucks. This is my biggest compliant about Dexcom sensors. The things do NOT want to stay stuck for more than five or six days. I shower twice a day (before work and after the gym) and I wear clothes that rub up against the sensor, no matter where I place it. Even with SkinTac, the edges of the sensor start to peel up at about the five day mark, and it's loose and ready to fall at the 7 - 8 day mark. (And sometimes, the SkinTac and the Dexcom adhesive and a not-so-helpful bandaid create a huge and ugly problem: frigging ouch. See the photo on Flickr for a full rundown.)
I do not like when a $60 sensor starts to peel away. This is highly annoying.
Insurance coverage battles. While others have had their requests approved without batting much of an eye, my insurance coverage for the CGM had to be fought for. I battled my insurance company for over eight months before receiving my approval letter. The insurance hurdles are a definite con, and might make some people reluctant to fight for their right for a CGM. (Cheerleader note: But don't let it stop you! Go for it!)
Doesn't feel "sexy." (Yes, I know this "shouldn't matter," but these are my personal pros and cons, so roll with me, okay?) With the pump infusion set stuck into one part of me and the CGM sensor in another, wearing two devices doesn't exactly feel like I'm ready to model for Victoria's Secret. There have been plenty of times when a moment has been interrupted by the CGM beeping or the sensor getting stuck on my clothes and whatnot.
Low blood sugar safety net. This was a huge part of why I wanted to use a CGM in the first place: hypoglycemia unawareness. I was exhausted and frightened of the lows at 3 am, so having the added safety net of the CGM has been a huge improvement. The CGM does its job and protects me from plummeting blood sugars. When Chris is away on business, he prefers that I wear the CGM to keep an eye on those lows. It makes me feel safe, and I value that "pro" above all others.
Helps me avoid staying high. My body reacts to blood sugars that are over 260 mg/dl or so, but those 160's and 180's often go unnoticed. The Dexcom helps me wrangle in these "minor" highs and tighten up my blood sugar standard deviation overall. Staving off both the lows and the highs will be particularly helpful during my future pregnancy.
Excellent for exercise. I go to the gym at least five days a week, and my workouts range from walking/jogging on the treadmill to cardio circuit training. The CGM has been AWESOME at detecting fluctuations in my numbers while I work out, helping me avoid those crash-and-burn lows at the gym and also the highs that sometimes crop up after a hard workout. (And it was great on our hikes when we went to Acadia - excellent tool!)
Driving safety. I spend a lot of time in the car driving back and forth to RI, and the drive time is anywhere from 2 1/2 hours to 4 hours (depending on traffic - I hate CT highways). Having the Dexcom in the center console next to me while I travel is another big bonus. With hypoglycemia unawareness and blood sugars that seem to be affected as much by my moods as by what I'm eating, having an extra eye on those numbers is crucial to keep be safe behind the wheel.
Integration-free works for me. I trialed both the Minimed CGM and the Dexcom and for me, the Dexcom being a seperate device worked best for me. With the Minimed CGM, I couldn't hear the pump alarming in the night because it was buried underneath the blankets. Having the Dex receiver separate from the pump is convenient for the nighttime alarms and also if I want to avoid having to deal with the CGM for a little bit. I can shove it into my purse, bury it in a desk drawer, or even walk away from it for a little while if I want. I like the freedom from being beeped at sometimes. It sounds counterproductive, but in the longrun, this is a bonus for me.
Trending and tracking. Here's the point of CGMs - to track the trends of my blood sugars. The Dex doesn't replace my meter, but instead works with it. I test on my meter and see a result of 100 mg/dl, but with the Dex, I know I'm "100 going down," "100 going up," or "100 holding steady." This makes it easy to go into long meetings at work without fearing a crash, and also lets me go to bed at a blood sugar of 90 mg/dl with confidence.
Pretty darn accurate. I don't expect this thing to be right all the time. I already have my head programmed to accept that a CGM doesn't replace finger sticks, so when things don't match up all nice-nice, I don't flip out. Overall, though, I've found that the CGM rides pretty close to my meter. Dex works better when I'm running a bit steadier, so it's actually a weird sort of incentive to maintain better control to retain the integrity of the sensor. Don't ask me to mentally make sense of that - I need to take whatever motivation I can and run with it. ;)
But it does feel sexy. And this is the flip side to that "con" coin. The Dexcom is sexy. It's stuck to me to gain better control of my diabetes. Good control helps everything from my weight to my hair to my internal organs to my smile. Being healthy is sexy as hell. And being confident enough to wear this machine, despite its cons and because of its pros, makes me feel stronger all the way around. For me, after weighing all these pros and cons, the CGM is definitely worth it.
Readers Beware!!: These are MY pros and cons. I chronicle my personal experiences with diabetes here on SUM and I'm not a doctor or a CDE or a medical professional of any kind. I have decided to use the Dexcom CGM after trialing both the Minimed and the Dexcom, but I know plenty of people who are using the Minimed CGM without issue. For me, the Dexcom was a more comfortable fit into my life, literally and figuratively. It's all about personal preferences, and these are mine.
If you're thinking about trying out a CGM, I recommend trialing as many kinds as you can before making an informed decision. Your mileage on these devices will vary, so it's important to find out what works best for YOU. Contact your CDE and see if you can schedule a week trial session with different devices.
If you want to share your perspectives, feel free! I love that the online diabetes community has become a real source of information for diabetics everywhere who are looking for real information - we are the true mavens of patient experience!