Five myths of CGM

Text: CGM Myths

When first thinking about insulin pump therapy or continuous glucose monitoring (CGM), did you have questions or thoughts of what it might be like and how it would work? Maybe you were concerned about what taking the next step would be like? 

Or, you may have used CGM in the past, but with so many advancements over the last couple of years there may be other things you could learn. Today, we address a few misconceptions or myths people associate with CGM, and tell you the real answers. 

 

Myth 1: If I go on CGM, it will replace my fingerstick tests. 
 

Reality: While this is the goal for the therapy in the future, today’s CGM devices do not completely replace fingerstick testing. Since sensor readings are taken from your interstitial fluid and not your blood, you still need to test using a BG meter. This is required to calibrate the sensor throughout the day, to make sure the glucose sensor maintains accuracy over time and always when deciding whether or not to make a treatment decision. 

 

Myth 2: CGM devices are not accurate. 
 

Reality: An oldie but goodie. It is important to note that sensor glucose readings are taken from your interstitial fluid (fluid surrounding the cells in your tissue), whereas fingerstick tests are taken directly from your blood. Because the readings are from two different places, there is a natural lag between glucose levels in the interstitial fluid and glucose levels in the blood. Therefore, it’s normal, and should be expected, for your sensor glucose readings and BG readings to be different but for the most part they should be close. Learn more here

One thing to keep in mind is that when you check your BG other CGMs automatically change the sensor number to match the BG number. This does not necessarily mean it’s more accurate. Often, it doesn’t make sense to just match the BG since the sensor is measuring glucose from interstitial fluid, a different part of the tissue (not the blood). Our sensors take into account multiple factors in the calibration to provide an accurate glucose sensor reading. 

 

Myth 3: CGM is only about knowing your glucose levels at all times. 
 

Reality: Actually, CGM is a lot more than just readings every five minutes. Yes, sensor glucose readings and threshold alerts let you know where you are at in any given moment or where you’ve been – but more advanced CGM systems can mimic some of the functions of a healthy pancreas by stopping insulin when your sensor glucose level reaches or goes below a preset limit. With the introduction of SmartGuard™ technology, exclusive to Medtronic devices, CGM can now do more than just alert you, it takes action to reduce lows* without increasing A1c levels**1. Learn more here

 

Myth 4: Wearing CGM will give me information overload. 
 

Reality: With alerts, graphs, and sensor glucose readings occurring every 5 minutes, it may seem like your CGM devices give a lot of information at first, but with the right product training and an explanation of how to use the information, you will have the tools to help you take control of your glucose management. To help you ease into it, you may want to turn off the alerts for the first few weeks. We recommend working closely with your diabetes team to make sure you have the right settings in place and over time you will gain the expertise to use the more advanced features like predictive alerts or rate of change. Take it at your own pace so you can get the most out of the therapy and ultimately help fine tune your glucose management. 

 

Myth 5: Data from CGM can only be viewed on my pump screen or monitor. 
 

Reality:  Your CGM data can be viewed by your healthcare provider and care network in a variety of ways. One option is therapy management software, which for Medtronic is called CareLinkTM software. CareLink software creates reports that can help you and your doctor discover trends and patterns, so that you may adjust your personal treatment plan. 

In addition to reports, now others can see how you’re doing right on their phone with MiniMedTM Connect.  MiniMedTM Connect makes it easy to view your pump and CGM sensor glucose details by linking your MiniMedTM system to an app on your iPhone® or iPod touch®. MiniMed Connect can also share your information online with those closest to you, and send alerts automatically by text message. They’ll know how you’re doing – anywhere, anytime. Learn more here

Did we answer your questions? Ready to get started on CGM? Click here to learn more about the MiniMedTM 530G system or call us at 800-646-4633 for a free insurance check. 

 

References: 
* Measured as sensor glucose values. 
** Based upon limited sample size and duration of ASPIRE In-Home study 
1Bergenstal RM, Klonoff DC, Garg SK, et al. Threshold-based insulin-pump interruption for reduction of hypoglycemia. N Engl J Med. 2013;369(3):224–232.

 

Important Safety Information
Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems. MiniMed 530G with Enlite is intended for the delivery of insulin and continuous glucose monitoring for the management of diabetes mellitus by persons 16 years of age or older who require insulin. 
Pump therapy is not recommended for people who are unwilling or unable to perform a minimum of four blood glucose tests per day. Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately. 
The information provided by CGM systems is intended to supplement, not replace, blood glucose information obtained using a home glucose meter. A confirmatory fingerstick is required prior to making adjustments to diabetes therapy. MiniMed 530G with Enlite is not intended to be used directly for preventing or treating hypoglycemia but to suspend insulin delivery when the user is unable to respond to the Threshold Suspend alarm and take measures to prevent or treat hypoglycemia themselves. 
MiniMed Connect is intended to provide a secondary display of CGM and insulin pump information on a suitable consumer electronic device to care partners and users of a MiniMed 530G system or Paradigm REAL-Time Revel system for the purposes of passive monitoring. 
MiniMed Connect is not intended to replace the primary display of continuous glucose monitoring and insulin pump information on the primary display device. All therapy decisions should be based on blood glucose measurements obtained from a blood glucose meter. MiniMed Connect is not intended to receive information directly from the sensor or transmitter of the sensor-augmented pump system. 
Please visit www.medtronicdiabetes.com/importantsafetyinformation for more details.
 

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Submitted by Tracy Lyall (not verified) on

In reply to by Commenter (not verified)

I like the minimed connect very much - I would suggest that a smaller designed uploader would make it much better. As you know we have to carry lots of diabetic supplies and devices and I find the size of the uploader cumbersome.

Submitted by LOOP Blog Editorial on

In reply to by Tracy Lyall (not verified)

Thank you for your feedback, Tracy. Future generations of Medtronic products will not require the uploader and will transmit automatically from the pump to the smartphone.

Submitted by Pat Thomas (not verified) on

In reply to by Commenter (not verified)

I don't think you make it clear that cgm's are NOT covered by Medicare. It's such a shame that sensors are not available to all. Seems discriminatory and in humane to me. All for 1 little word-precautionary. You mean, precautionary so you don't have to call 911? Don't mean this for you, Naomi just didn't know how to comment

Submitted by LOOP Blog Editorial on

In reply to by Pat Thomas (not verified)

Hi Pat, please know that we hear you and understand how this can be frustrating. If you’d like to learn more about expanding access to CGM in Medicare and how you can help please read our blog here - http://bit.ly/1B1qHDB

Submitted by pat Thomas (not verified) on

In reply to by LOOP Blog Editorial

Have you noticed the dates on the site you refer to? As far as I can tell, nothing has happened regarding congress and cgm's since it was sent to committee in March, 2015. Nothing will come of this unless we unite and decide we're mad as hell, and are not going to take it anymore!

Submitted by Mike Morris (not verified) on

In reply to by Commenter (not verified)

The delay in the CGMS update to the pump is both frustrating and often sleep depriving. If I get a low warning while sleeping or just before dropping off, I do a finger stick to ascertain the accuracy of the CGM. Often a warning at 80 is actually higher, say 120. The 120 is transmitted to the pump (Contour Link meter or manual upload) and I'll try to go to sleep only to be warned again. And again. The new reading of 120 can be many minutes away from being accepted by the pump. It gets so bad that I sometimes turn off the CGMS overnight so I can sleep.

There needs to be some mode to instantly update the pump or a countdown to show me how long until the new reading is accepted.

Submitted by LOOP Blog Editorial on

In reply to by Mike Morris (not verified)

I’m sorry to hear this, Mike. I understand how this may be frustrating. I’m going to connect you with a member of our HelpLine team to talk this through to see if they may be able to help. If there is anything else I can do please let me know.

Submitted by Mike Morris (not verified) on

In reply to by LOOP Blog Editorial

Thanks, the update delay is really frustrating.

Submitted by stan (not verified) on

In reply to by Mike Morris (not verified)

I so agree with that comment regarding sleep deprivation. Hopefully the next gen CGM will eliminate that problem.

Submitted by Dagmar Keenan (not verified) on

In reply to by Commenter (not verified)

I have been living with Type 1 diabetes for 40+ years now. I started using a pump 20 years ago; I also started using CGM before it was FDA approved, paying out of pocket. Fortunately, once the FDA granted approval, my insurance covered those costs as well. My A1C has been consistently <7 (6.4-6.9) for the past 5 years, while working at a position where I was likely to be up for 24 hours at a time. I read extensively, and do my best to stay up to date, so I was aware of the nonpayment issue with Medicare.
Fast forward: I am now on Medicare and, of course, will now need to pay for my sensors again. Not using CGM is NOT an option!!
In the past 2 years, I have signed multiple petitions, written to my senators and representatives several. They ignore me - one senator sends a form letter response promising to get back to me (and doesn't). It certainly appears there has been no legislative activity since this issue was targeted more than a year ago.
I stand with all the people who have commented: what more should we do???????

Submitted by LOOP Blog Editorial on

In reply to by Dagmar Keenan (not verified)

Hi Dagmar, thanks for your comment. It sounds like you have taken all of the right steps to make your voice heard and I understand how this can be frustrating. I do not have a timeline on when Medicare will provide CGM coverage, but please know we are actively working with the Centers for Medicare and Medicaid services to establish coverage consistent with other healthcare insurance companies. We suggest that you talk with your health care team, so they can advocate for CGM coverage on your behalf.

Submitted by Zion (not verified) on

In reply to by LOOP Blog Editorial

I believe the underlying frustration is coming not from Medicare and some insurance's coverage but more from the unjustifiable high cost of a sensor. About $35 a piece for a device that cost close to $3 to manufacture. I am naive about the R&D cost to get CGM to market but I can't justify 1200% markup. CGM sensors should cost much less and this is why Medicare refuses to cover it.

Submitted by Vince (not verified) on

In reply to by Zion (not verified)

Hello Zion. I have been pumping with Medtronic for 10+ years and using CGM for 8. I cannot justify ANY price tag for CGM as it has saved me countless times as an active runner currently training for my first marathon. I would not be able to do this if I did not have access to CGM. I recently had the opportunity to visit the plant which manufacturers the Enlite in Northridge, CA. Wow! I was blown away by the care and precision by the countless number of workers I met who construct the Medtronic CGM BY HAND! Keep in mind the costs of services which you can take advantage of from Medtronic which goes into any overall cost--local reps who are there to support you on an ongoing need and the wonderful support at the 24 hour support center are just a few.

Submitted by Dagmar Keenan (not verified) on

In reply to by LOOP Blog Editorial

My endocrinologist is very proactive; I will certainly enlist his assistance.
One final irony: my Medicare supplemental insurance is with the same provider that I had when coverage was through my employer. Because they need to follow Medicare guidelines, they now will no longer cover a device they felt was essential to my health for the past 12+ years :(

Submitted by Pat Thomad (not verified) on

In reply to by Dagmar Keenan (not verified)

March on Washington; file a class action lawsuit; jdrf needs to get on a more active lobbying effort. This issue called cgm's has been in committee for a year and a half. My Niece works for the legislature and days this bill will never get out of committee unless it's attached to another. This has to change! I've done everything that respondents have done-contacting senators, representatives, with exactly no results. Form letters and certainly nothing personal. Maybe it's time to sue...

Submitted by Randy James (not verified) on

In reply to by Commenter (not verified)

I have been trying to get back on the CGM since my pump was replaced in November but have not have not been given info on who to contact about this - even though I send in monthly logs to you and requests about what to do to get back on the GCM. What do I need to get contact information to get this done?

Submitted by LOOP Blog Editorial on

In reply to by Randy James (not verified)

Randy, I’m sorry to hear about your experience. I’ll have one of our specialists reach out to you to explore your options. If there is anything else we can do for you please let me know.

Submitted by Zion (not verified) on

In reply to by Commenter (not verified)

Myth 2 is not a myth is reality. CGM is inaccurate by the noted reasons. Granted, it beats 4 finger sticks per day making up in volume of calculated (approximation) BG readings, but far from accurate

Submitted by Vince (not verified) on

In reply to by Zion (not verified)

I will disagree, Zion. I have had GREAT success with Enlite, lowering my A1c from 7.7 to 6.8. With proper calibration I have been able to certainly bolus more accurately which has helped lower my numbers. The 24 hour helpline can offer great calibration tips. You can also reach out to your local rep for the same wonderful support.

Submitted by Dagmar Keenan (not verified) on

In reply to by Vince (not verified)

I agree with your comments. I too find the Enlite sensor more accurate than its predecessor. It does help to use common sense when calibrating (ie: don't do it when high or low as it then takes a significant time for the interstitial fluid changes to catch up to the blood values). I also could not perform my job without CGM, as it is vital for me know my values at any given moment, and to avoid lows at all cost. So, I will pay the cost of CGM. Since I have never been hospitalized for diabetes related issues, I will consider worthwhile.

Submitted by Tim (not verified) on

In reply to by Commenter (not verified)

I just received my Enlight and new pump and think it is great. One question though... It appears by everyone's benchmarks (although the numbers vary), that Android is more popular than iPhone. Why is carelink only available for the iPhone? I'm not interested in starting a "which is better" debate, just wondering why it is available for the less popular system?

Submitted by LOOP Blog Editorial on

In reply to by Tim (not verified)

Tim, I’m glad to hear you’re enjoying the MiniMed 530G with Enlite! Right now, MiniMed Connect app is compatible with an iPhone and iPod Touch. When we validate a new system, it’s faster to complete the process with Apple as you can validate on one type of device and cover the entire iOS family. For Androids you need to validate on a number of device/software versions prior to submitting for approval. This is why we chose Apple for the first version, but we’re working on the Android platform. Your care partners can remotely monitor your glucose levels through a web browser from most smartphones, tablets, or computers with internet connectivity.

Submitted by Tim Midboe (not verified) on

In reply to by LOOP Blog Editorial

I didn't know that. Thank you for the info!

Submitted by SALVATORE F. V… (not verified) on

In reply to by Commenter (not verified)

Obtaining Supplemental Insurance can be a big help, I think. As a senior, AARP is always pointing that out. It may cost $ but could help.

Submitted by Dagmar Keenan (not verified) on

In reply to by SALVATORE F. V… (not verified)

Supplemental insurance will not cover anything that Medicare does not cover!

Submitted by Pat Ash (not verified) on

In reply to by Commenter (not verified)

I am a pumper for a little over 8 years. I too had insurance coverage for about 3 years but not now (Medicare!) My frustration is that I did not even know about last year's CGM bill. I certainly would have called/written/ lobbied my federal representatives.
Will you please send emails to ALL your current/former CGM customers so that we can act.

Submitted by LOOP Blog Editorial on

In reply to by Pat Ash (not verified)

Hi Pat. We keep the community updated on the Medicare CGM bill on our social media channel and the LOOP blog, so keep checking back.

Submitted by JOHN C STUDDLEFIELD (not verified) on

In reply to by Commenter (not verified)

Didn't have any questions like that but did wonder why when I went to reordered why Medicare thought it would be better to pay for the cost of a hospital stay or surgery then the CGM.

Submitted by LOOP Blog Editorial on

In reply to by JOHN C STUDDLEFIELD (not verified)

Hi John, thanks for your comment. I do not have an answer for your question, but can tell you we are actively working with the Centers for Medicare and Medicaid services to establish coverage consistent with other healthcare insurance companies. We suggest that you talk with your health care team, so they can advocate for CGM coverage on your behalf.

Submitted by Dagmar Keenan (not verified) on

In reply to by LOOP Blog Editorial

Supplemental insurance will not cover anything that Medicare does not cover! I wonder if Medicare "lumps" all diabetes under an umbrella. My endocrinologist feels the sensor will prove more valuable even than the pump for those using it. Perhaps a focus shift to coverage for T1D would make some progress?

Submitted by Mark (not verified) on

In reply to by Commenter (not verified)

I am fairly new to the CGM world and getting training has been aggravating. My Medtronic salesman has told me I would be contacted by a sales rep but that has never happened. My doctors office is very busy and a quick get started was all they could do. I often find my blood glucose all over the place from extremely high to extremely low because of the glucose lag and insulin pump stopping delivery. I almost almost always know my blood glucose is going low, I eat to correct it, then the insulin pump will cut of automatically. It will do this for an hour and each time I try to resume my basil delivery. I feel like I'm fighting my pump because often it will have cut my insulin off, I don't realize it until my glucose level is 300 plus. Then it seems to go from low level alarms straight to high level alarms except it is difficult to lower my glucose level now that my system has no on board insulin. CGM can be helpful if I could get the support.

Submitted by LOOP Blog Editorial on

In reply to by Mark (not verified)

Mark, I’m sorry to hear that, and can imagine the frustration this has caused. I will have someone from my team connect with you to help and get the training you need.

Submitted by Lesa Kaitz (not verified) on

In reply to by Commenter (not verified)

I have been on CGM for years and the old sensors were much more accurate and reliable for me. The new sensors seem to take much more time to catch up to my current glucose values. The new sensors sometimes get stuck at a high reading. I often have to shut it off overnight and start it up again in the morning, this usually gets it unstuck...but at almost $65. a sensor I am disappointed in the new elite sensors.

Submitted by LOOP Blog Editorial on

In reply to by Lesa Kaitz (not verified)

Lesa, I’m sorry to hear you’re disappointed in the Enlite sensor. I will have a member of my team connect with you to try and help.

Submitted by J Swanson (not verified) on

In reply to by Commenter (not verified)

I have lived with IDDM for 44 years now. CGM has been life changing!
The occasional discrepancies between CGM and blood glucose results can usually be explained. The help line is always available to assist with questions.
I am thankful everyday for the improved blood sugar control CGM has afforded me.
I am thankful for all who are working on improving Diabetes care.
I look forward to more advancements in diabetes care.
Thank you Medtronic!

Submitted by Wahaj Hakam (not verified) on

In reply to by Commenter (not verified)

I bought the new 630g a month ago and it worked excellent.I used the enlite sensor for only 3 times and It just only worked good, last night Inserted a new sensor but now it's saying that please insert a new sensor again.
Kindly improve your skills on the sensor and please improve your customer service too.
Thanks

Submitted by Karrie Hawbaker (not verified) on

In reply to by Wahaj Hakam (not verified)

Hi Wahaj, I apologize for any issues you may have had with the sensor or our customer service teams. That is not the type of service we strive to provide. If you'd like to discuss your experience, please email us at dhelp@medtronic.com and we can have someone reach out to chat with you.


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