Continuous Glucose Monitors

[skb]

This study gives a thumbs up for CGMs. Our user members would love to read and add their comments.

https://www.uchicagomedicine.org/research-and-discoveries-articles/continuous-glucose-monitors-proven-cost-effective

[Tamagno]

Thanks, SKB, an interesting article/study.

Judging by comments from Dexcom reps as well as their new phone server menu they're experiencing a pretty big growth rate as CGMs become covered by Medicare.

Definitely, especially when paired with their mobile apps, it reduces the number of severe highs and lows experienced previously. While I've never calculated the cost, I'm guessing that even one episode of DKA with a Hospital visit is more expensive than their calculated six-month cost of CGM usage including the initial buy-in cost.

Medicare still will not allow usage of the mobile apps for some reason. It crosses my mind in reading this article that they may be fearful that they also will become responsible for mobile phone bills.

[Grammabear]

The study is small if it looked at 158 people.  It would have been more valuable if it had looked at people with an insulin pump also.  I find the cgm valuable during the nighttime hours when it alerts me if my glucose levels are going low.  It is also valuable in monitoring the basal rates on my insulin pump.  Medicare is new to the game of covering the cost of cgm and I also wish they would allow the use of apps on a smart phone.  Maybe they will someday?

[Tamagno]

Grammabear, with so many large firms wanting in on the health monitor and CGM business (including Apple) I'd imagine there will be more push on Medicare...

[walkerwally1]

I think that a CGM would be valuable for a T-2 also but now it is considered not necessary.  We take a snapshot with a test maybe 3-4 times a day but really have no idea what is happening 95% of the time.  I think insurance companies are more and more looking at prevention as a cost savings.  I know Anthem has a new plan that requires people to follow certain requirements to be healthier or the cost goes up a significant amount.  I don't know if it is a good thing to have the insurance to call the shots but maybe.  Medicare has always had the stance that they are only interested in treatment and not in prevention. 

[skb]

I think that a CGM would be valuable for a T-2 also but now it is considered not necessary.  We take a snapshot with a test maybe 3-4 times a day but really have no idea what is happening 95% of the time.

That's where systems like Libre or the new patches being developed would come in handy. I agree that continuous monitoring would be a welcome step towards better control.

[Grammabear]

Since the last post, Medicare has allowed the mobile app and it proves to be very convenient - especially if the Dexcom receiver is plugged in for charging.

A cgm is NOT without aggravation however.  Just today I put in a new sensor, waited the obligatory 2 hour warm up period only to have the sensor fail before I even got a reading from it.  That "failure" makes it necessary to get in the phone line and wait, wait, and wait somemore to talk to a 'global' representative.  Dexcom does replace sensors that have failed and rightly so.  They are expensive enough without wasting the cost of one that never, ever worked to begin with.

[skb]

Gadgets come with their problems. I had to buy a new AccuChek monitor last night.

AccuChek was one of the first companies to do away with the coding of strips, and then somewhere down the line they changed their manufacturing policy and started shipping out strips with a code chip that came with the strips and needed to be inserted in to the monitor for it to work.

Somewhere between the time that I had stopped checking and now they have gone back to no coding and the new machine and strips do not require the chips. Having exhausted my old strips and expecting my new strips to be delivered yesterday, I threw away the chip that I had thinking that the new box would arrive with the coding chip inside.

When I received it in the evening, there was no chip in it and the monitor was unusable without one. I even searched my garbage in the hope of recovering the old box with the chip that I had thrown away. Alas, the garbage had been cleared in the morning and I had to go out and buy a new monitor to be able to use the new strips.

Rant over.

[Grammabear]

skb - That situation IS indeed most aggravating.  I understand how you can be frustrated.  I used to have the Accu-chek monitor and liked it quite a bit until I had a similar situation as you did.  That is when I decided to 'shop around' for a monitor that didn't require a code for the strips.  I ended up with the Bayer Contour Next monitor which doesn't require code.  In the U.S., test strips are getting harder and harder to get through insurance.  I have taken to buying them online and watching for the "best price" there.  I don't know if that is an option for you as opposed to buying from a retail store, however it works for me most of the time. 

[skb]

In India, consumables are not covered under the health insurance. The insurance will cover only for hospitalization and surgical procedures. Even dental procedures are not covered. I also buy my strips from whole-sellers or online. I use Accu Chek only for their cheap strips.

Over the years I have used and now have in my collection, 4 Accu Chek (Roche) meters, 2 of which use the drum of strips, 1 (Bayer) Contour, 1 One Touch (Johnson & Johnson),  1 (Bionime) Right Test and 1 (Abbot) Optium Omega.

They've all had their ups and downs, but IMO the Bionime was the most accurate and the One Touch was the runner-up.

[Sweety]

I use the One Touch Select meter. Strips cost about Rs. 900/- per 50. At Rs 18.00 per test I do find it expensive.