From: BW
Hello. I’m not diabetic yet, but am getting close, and diabetes runs in my family. I’m considering continuous glucose monitoring so I can track how my diet and exercise affect my glucose levels throughout the day. This would not be covered by insurance. I’d like to learn more about my options, and would like to hear suggestions to do this at a reasonable cost.
John:
Thanks for your question B,
Most people have insurance coverage for CGMs, although for some individual’s beta cells still produce insulin and their C-peptide level that measures insulin production is too high to qualify. Anyone on a pump or long-acting and short-acting insulins can usually qualify for a CGM. Given that, your desire to see how your glucose is affected by food choices, activity, and multiple other daily interferences is exactly what you want to do. Diabetes is all about glucose control, so what better way to manage it than with a CGM’s immediate feedback?
The Dexcom CGM that has alarms for high and low readings, or the Freestyle Libre without alarms, are currently the best ways to go. Checking readings becomes more discreet when using the G6 cellphone app. The G6 provides 10 day use and the Libre 14 days.
Attachment is critical for CGMs. A good method is to place a layer of Skin-Tac (from wipes or a bottle, available at some pharmacies) onto the skin first with a clean area in the middle where you insert the sensor. Let the Skin-Tac dry and then insert the sensor and press down firmly on the white cotton adhesive around the base of the sensor. This will usually hold it firmly in place for 2 weeks. Mastisol adhesive and Detachol remover can also be used to secure the sensor.
The G6 transmitter that signals your readings from the sensor base to the separate receiver does cannot be recharged like the Medtronic CGM but it does need to be replaced every 3 months. The Libre uses a short Bluetooth connection when swiped closely by its receiver. If you cannot get coverage, Dexcom has a somewhat lackluster pricing plan where the transmitters costs over $500 if you don’t sign on to their automatic sensor reshipping plan, which you may not want to do since you may not need to use a sensor all the time like most of us. They charge $199 if you approve automatic shipping. You may want to explain to them what you are doing and get a pre-purchase agreement to buy the transmitter at their $199 price. Dexcom ought to be open to this as they’d love to have more people with Type 2 and pre-diabetes use their system. The Libre system has much better pricing if you can get by without alarms.
A CGM, like windshield wipers on a muddy windshield, only shows you what you’ve been missing once you use it!
John