CGMs Upon Diagnosis Moving Forward? Thoughts?

I’m sure there was a time when people were dealing with their diabetes; and were used to peeing in a cup, boiling water, dropping in tablets to match a color chart, and check the color of urine to see how much insulin was needed, they were content with the procedure because it was really the only choice. You did it this way because that is the way it was.  And along came a study that showed close control of blood sugars could help enhance the life style of those with diabetes and even prolong lives.

What happened?

Well the pharmaceutical business EXPLODED with devices and treatments never seen before in our diabetes world.  What was a 30 minute process, minimum, was now being done in 30 seconds…….but there was a catch.  The individual needed to harpoon themselves 4-8 times daily to produce a drop of blood used to measure the glucose when applied to a strip attached to a meter.  That was the tradeoff.  It was better and faster but to the individual, was it ‘better’ to stab oneself in the exchange of faster and more accuracy?  That is the way it was.

You see if you have been around in this diabetes world twenty years or less, you really do not know anything else but glucometers as THE DEVICE to use.  You became used to ‘harpooning’ yourself because that was the way of the world and you were taught nothing different.

What happened?

An all-out war broke out in the pharmaceutical world to be the fastest meter, the most compact meter, and the most accurate meter.  And work began to improve upon ‘the norm’; to make it so no blood drop was even needed.   A way or a means to check one’s glucose constantly and on a device where the information was sent electronically, constantly……..like predecessor management tools, it seemed like a dream come true.   But it happened and the continuous glucose monitor (CGM) is now a part of our every day life……..for some.

“I do not want to wear something all of the time?”
“I’d rather do it the old-fashioned way with a meter.”
“Being attached does not seem right to me.”
And if you did not always use a CGM……that is your call.

But we bought up a generation of kids who knew nothing else when it came to harpooning themselves to obtain that drop of blood…..it almost seems archaic, doesn’t it?  But they surely accepted it as ‘the norm’.  It’s time to bring up a new generation of kids.  Kids who know nothing else but wearing a CGM………because it makes sense.   The glucometers are becoming less and less and more people are on a CGM than ever before.  Sure we need glucometers, but now they are mostly a back up.

It makes sense that there is something that can alarm when you are low and warn you.  It makes sense to have a management tool almost the time you are diagnosed that can help prevent those swings from low to high and back low again that leaves the person with diabetes feeling like that they are in a spiral in all sorts of directions.  It makes sense to wear something that checks one’s blood sugar constantly.   I’m sure when the choice was to pee in a cup instead of harpooning yourself, it seemed likely to stay with the old way, it was easier………but we now know it was NOT better.  Was it?

It’s time to once again challenge ourselves with something better and not necessarily easier. A CGM should be given as soon as a diagnosis occurs.  We need to ask those questions once again?  From the moment one is diagnosed.

What do you think?

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9 thoughts on “CGMs Upon Diagnosis Moving Forward? Thoughts?

  1. Hi Tom – I agree 100% that CGMs are becoming the new normal, and I think it can help bring peace of mind to parents of newly diagnosed kids. CGMs are a game changer. What parents must remember is that there must be boundaries when their child is not with them (primarily at school). Parents who call their child’s classroom or nurse for a BG of 80 are not good for the child. Boundaries should be set with both the child and the school nurse. Thanks, as always, for your insights!

    • AMEN—–the psyche-social aspect MUST be monitored——Boundaries and choices and not everyone being the one to contact the child…..one teenager told me that she gets a call from teh school nurse….her mom….and her dad——-it is too much. Thanks for writing.

  2. Yes, CGM’s are wonderful! I think they should be available to all kids at diagnosis. It could help the parents feel more secure, especially at night. The new Dexcom 6 doesn’t require any fingersticks. My daughter rarely does them anymore. (and I have boxes and boxes of strips!). The endo I work for is now implanting the Eversense CGM. Things have come a long way since 2006 since my two kids were diagnosed!

    • first one in 1992—2nd in 2009—-and even between those years—it all changed. I was told that diabetes management landscape is now completely changing every 18 months……very fast—-we must all keep up.

  3. I think that pumps and CGM’s should be available almost immediately on diagnosis. There is no need to withhold life changing technology because of the way we used to do it. I for one never had to boil syringes. Should I have been forced to boil some in order to know how to do it? Yeah right.

  4. I got on the FreeStyle Libre in March, and I think it’s fantastic for seeing patterns. Especially overnight, and the stupid Dawn Phenomenon. It was awesome for helping me see that stupidity and what I was dealing with, forever. I just needed a graph to see and understand what my blood sugars were doing, and when.
    One issue I have with it though, is that it is often not nearly as accurate as my meter.

    For example, I just tested on my FreeStyle Libre and got a reading of 51 mg/dL on it. I checked on my meter, and got a reading of 89 mg/dL.

    One I would correct. The other, I wouldn’t.

    I’m guessing the technology will get better over time? If it can? I don’t know with the interstitial fluid vs. blood readings.

    I definitely do think the CGMs help give a peace of mind though, and not checking using finger sticks is awesome.

  5. I would love for my son to try it and we are still working on it. But he has a severe sensory processing disorder and cant handle things on his body. He was diagnosed two years ago at the age of four and is finally now tolerating his shots. I love this idea but it wouldnt be good for my son unfortunately. He would pull it off of his body bc he can’t even tolerate a bandaid.

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