# CGM



## SB2015 (Apr 22, 2016)

Can anyone advise on the cost of CGM?

If I was able to get a pump that is capable of linking with a CHM is it possible to get the pump on NHS and then self fund the CGM?  I suspect that it is going to be prohibitive but I might as well know the info before I dismiss it.

Also what is the difference between this and the Libre.  Does it do the readings the same way but with a different algorithm for calculating the BG and instructing the Pump?


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## Northerner (Apr 23, 2016)

This page from INPUT is very useful:

http://www.inputdiabetes.org.uk/cgm/


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## Redkite (Apr 23, 2016)

Hi, yes you can get a pump funded by the NHS and choose to fund CGM yourself.  The INPUT website that Northerner mentioned is very useful.

The main choice of CGM is between Dexcom (can be used as a standalone CGM or integrated with the Animas Vibe), and Medtronic Enlites (which are used with the Medtronic 640G).

Both these CGMs involve wearing a sensor which samples glucose in the interstitial fluid, and is connected to a transmitter which relays the readings to the pump or to the Dexcom handset (or iPhone for the Dexcom G5).  Unlike the Libre, you have to calibrate the CGM by entering a blood glucose reading when you first start the sensor, and at intervals thereafter (every 12 hours for the Medtronic).

CGMs are better than the Libre because they will alert you (alarm on pump or Dexcom handset) if your levels drop too low or rise over a threshold that you set.  In addition, the Medtronic CGM/pump will suspend your basal insulin if you are heading for a low, and restart it when levels are back in target, which is fabulous for avoiding hypos.

I think the start off cost for a transmitter etc is in the region of £1000, and the ongoing cost of sensors is £55 per sensor for the Enlites (officially lasts 6 days, but some people manage to restart them and get more life out of them).

I would definitely recommend CGM if you can afford it.  Even occasional use can be beneficial - when I was paying out of my own pocket, I'd make sure my son wore one for things like exams week, sporting events, etc.  He has recently been granted funding because he has an additional condition, although he still doesn't wear them full time due to a shortage of suitable sites on his skinny body


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## Sally71 (Apr 23, 2016)

The Libre is a standalone system which will not communicate with any pump. So you have to carry the reader around with you (although it isn't very large). And it won't tell you anything until you scan it, so you don't get alarms when you're dropping low - case in point the other night, checked my daughter at 2am, blood test read 2.6, Libre was reading LO and had been flatline since 11pm - oops 
I think you get all the same information, you just don't get a live readout all the time. I'd love my daughter to have a Medtronic pump plus sensors, but she wanted a Libre, and that's better than nothing at all, I think it's a good second best.


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## pottersusan (Apr 23, 2016)

Ive got a dexcom g4, which im self funding...ouch! Bizarrely i bought it second hand on ebay from the States! The sale caused the ebay shop to be taken down for a while as apparently they shouldnt sell medical devices. I had a couple of nail biting weeks waiting to see if it arrived.
If you go to http://www.advancedtherapeuticsuk.com you can find out all the costs.
It is a wonderful thing. The accuracy varies quite a lot, but the warnings are invaluable. Since ive had it the only hypos ive had are when im waiting for the 'new' sensor to start. I say 'new' rather than new, because i usually manage to restart it at least once, sometimes up to three times.
Im on a quest to get it funded by the NHS, but no success so far.
It is fascinating seeing whats going on when you're asleep and its helped me reduce my hba1c significantly.
To me, its literally a life saver - I cant afford not to have it.


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## pottersusan (Apr 23, 2016)

I should add - my cgm is a standalone. It would be good to have a pump and cgm that work together, but im not holding my breath!


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## Pumper_Sue (Apr 23, 2016)

If you have an Animas vibe this is integrated with the Dexcom CGM a starter kit for the CGM is the transmitter and 4 sensors which cost £500. Sensors cost £186 for a box of 4, sensors are meant to last for 7 days but most people can get 21 - 50 days out of each one with restarting the sensor.

The CGM does not instruct the pump though except for the Medtronic which shuts the pump down if you are reaching hypo territory.
You also have to remember the CGM reading is 20 mins behind a finger stick test so never ever rely on a CGM reading for bolus etc.


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## HOBIE (Apr 23, 2016)

More reasons to go with a Medtronic ?


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## SB2015 (Apr 23, 2016)

Thanks to you all for the info.
I am currently using a Libre ( or was until the sensor fell out) and getting a lot of useful info from that, using the patterns that show on the printouts.  The costs of CGM seem a lot higher although it sounds as if some have cheated the time for each.


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## stephknits (Apr 23, 2016)

The Medtronic CGM costs around £450 for the device which is guaranteed for a year, but can last longer and then £52 per sensor which lasts 6 days.  As others have said, it will enable the pump to stop releasing insulin Automatically until your bs rise.


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## AJLang (Apr 24, 2016)

I really benefited from the Dexcom but I had to stop using it because it doesn't work if you have paracetamol.


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## Pumper_Sue (Apr 24, 2016)

AJLang said:


> I really benefited from the Dexcom but I had to stop using it because it doesn't work if you have paracetamol.


I just used a different pain killer it solved the problem


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## AJLang (Apr 24, 2016)

Unfortunately I can't change because I use cocodamol/paracetamol as well as ibuprofen. The consultant did suggest tramadol the other day because Cocodamol isn't great for the Gastroparesis but tramadol makes me ill. I'm not aware of any other alternative. Strongqer NSAIDs arent good for my stomach plus they make me feel spaced out.


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## Pumper_Sue (Apr 24, 2016)

AJLang said:


> Unfortunately I can't change because I use cocodamol/paracetamol as well as ibuprofen. The consultant did suggest tramadol the other day because Cocodamol isn't great for the Gastroparesis but tramadol makes me ill. I'm not aware of any other alternative. Strongqer NSAIDs arent good for my stomach plus they make me feel spaced out.


Naproxen works very well for me. It's odd because Ibuprofen gives me awful belly ache but OK with Naproxen.


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## AJLang (Apr 24, 2016)

lol Sue I have naproxen as an emergency - I've only had it twice and I felt like I was away with the fairies.


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## Annette (Apr 25, 2016)

AJLang said:


> lol Sue I have naproxen as an emergency - I've only had it twice and I felt like I was away with the fairies.


A lady I used to work with, we always knew when she'd had cocodamol, cos she almost literally was away with the fairies! She wouldnt take any other painkiller, and couldnt see what the problem was, until we videoed her one time...


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## Pumper_Sue (Apr 25, 2016)

Annette Anderson said:


> A lady I used to work with, we always knew when she'd had cocodamol, cos she almost literally was away with the fairies! She wouldnt take any other painkiller, and couldnt see what the problem was, until we videoed her one time...


Cocodamol sends me manic so sounds like we make a right pair lol. Mind you it's very addictive as well.


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## HOBIE (Apr 25, 2016)

SB2015 said:


> Thanks to you all for the info.
> I am currently using a Libre ( or was until the sensor fell out) and getting a lot of useful info from that, using the patterns that show on the printouts.  The costs of CGM seem a lot higher although it sounds as if some have cheated the time for each.


The Libre is a good tool for seeing patterns etc with graphs


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## Diabetic_Aspie (Jun 11, 2016)

Ok, everyone says it, but who can share HOW you restart the cgm sensors?  I'm on Animas Vibe, so Dexcom would make perfect sense, and if you do restart the sensors, it may be cheaper than Libre sensors.

But how?


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## jocat (Jun 12, 2016)

I tell the Dexcom that I'm changing the sensor but don't actually do it, you have to still go through two hour warm up/set up time but it carries on reading fine after this, you have to " change" the sensor every seven days,. So far I've stretched it to fourteen days but have only been using Dexcom a short time so still learning with it
Jo


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## Pumper_Sue (Jun 12, 2016)

Diabetic_Aspie said:


> Ok, everyone says it, but who can share HOW you restart the cgm sensors?  I'm on Animas Vibe, so Dexcom would make perfect sense, and if you do restart the sensors, it may be cheaper than Libre sensors.
> 
> But how?


Very simply all you do is restart the sensor as if a new one once you have the end of sensor session notice.
The secret to a long sensor life is to make sure it is well stuck down because once movement starts that's the end of reliable readings.


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## pottersusan (Jun 12, 2016)

I stop the sensor (at a convenient time) and then Start sensor. it's not clever enough to know it's not a new one! Most last a fortnight, some a bit more, some a bit less.


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