I have been using CGMS since 2007 because it allows me to better manage my diabetes. My current Veo Medtronic pump works with the Enlite sensor to measure my interstitial glucose level every 5 minutes. This level correlates with my blood glucose and is displayed as a graph on the insulin pump. You may ask, why is such close monitoring necessary? Dr. Steven Edelman of UCSD said it best when he made a presentation at the Best Center (Ajax), Type 1 Diabetes Educational session May 2013, “ I use CGMS because every day is different”. This is very true. We do not expend the same energy, or eat or experience exactly the same stress every day. CGMS allows a user to micro manage his/her diabetes because we can see the trend of the glucose level and make decisions regarding more or less insulin or more or less food instantaneously. In my own personal situation, I experience some delayed digestion (gastroparesis) and CGMS allows me to gauge my insulin needs. I have experienced a reduction in A1C of ½ percent (7.2 to 6.7) with the help of CGMS.

There are 2 CGM systems available in Canada. Animas sells a standalone CGM system called the Dexcom G4 Platinum CGM as well as the Vibe Insulin Pump which features Dexcom CGM. Medtronic sells a standalone CGM system called the Guardian as well as the Veo Insulin Pump which features the Enlite CGM system. Each system has a disposable sensor which is specific for their system.

Anna of http://www.insulinindependent.com/ has written a blog comparing both systems. Anna is based in the UK where these systems were available before they were introduced in North America.

An adapted version of the chart on Anna’s blog

http://www.insulinindependent.com/2013/07/dexcom-g4-vs-medtronic-enlite-low-down.html

 

Vibe with Dexcom G4

Medtronic Enlite

     

Calibrations needed

2 per day although more results can be entered

2 per day. No more than 4.

Length of wear (according to manufacturer’s guidance)

7 days (CE approved)

6 days (CE approved)

Actual wear by customer’s choice (not advised)

Personal experience of between eight and 36 days wear before sensors expired

Personal experience of only 8 days before sensors expired

Comfort

Extremely comfortable. Longest time worn for 36 days ith no irritation and very small entry hole.

Extremely secure when in place

Comfortable.

Longest worn for 8 days, but aware of the sensor site at this time and reasonably irritated on removal.

Not as secure feeling when in place

Integrated into pump

Yes, only with Animas Vibe

Yes, only with Medtronic Paradigm Veo

Low Glucose suspend (safety feature to suspend pump temporarily when hypo)

No

Yes , when integrated with Paradigm Veo pump

Alarms

Very good. Audible, simple, easy to amend upper and lower limits

Good but less audible when pump under covers. Somewhat over sensitive (alarms when changing very slightly).

Paracetamol use while wearing sensor?

No. It interacts with the fluid giving a false high

Yes. No issue with fluid interaction.

Range

20 ft, can work between rooms (with stand alone unit)

6 ft (with standalone unit)

Accuracy (MARD score – the gold standard of glucose testing. The lower the MARD, the more accurate the device is considered)

14%

15.3%

Sensor technology has been improving over the last few years with smaller and more sensitive sensors however they still require calibration with a blood glucose meter 2-4 times daily. CGMS will not eliminate the need for a finger poke. Coverage for the sensors is not universal. Some insurance companies pay for these while many do not.

If you have used CGMS, please share you experiences with others through this blog.