My name is Clemma and I am writing about my experience with the Dexcom Seven continuous glucose monitoring system. I live in Minneapolis with my young son and my not so young husband. I was diagnosed with Type 1 diabetes 11 years ago, when I was almost 21 years old. I started pumping 7 years ago, first with a Minimed 508, then an Animas IR1200, and now with the OmniPod. Friday, June 29 I hooked up to my newest constant companion, the one and only Comrade Dex...

Thursday, July 5, 2007

Why CGMS?

In these early days of CGMS, these dark times before widespread insurance coverage, people have all sorts of reasons for choosing to fork out thousands of dollars each year for this technology. Besides medical research suggesting that people who use CGMS have improved glucose control, here were my reasons:

1. Unexpected highs, often overnight, which meant they lasted for hours before I caught them. After 11 years I have pretty much figured out my dawn phenomenon, but I'm not as adept at bolusing for high-fat Indian food right before I go to bed.

2. Severe hypoglycemia unawareness. The week before I started my Dexcom, one day I was feeling a little spacy, and when I checked my blood sugar was 28. Huh??? Plus, I almost never wake up low at night, so I can only assume I sleep through the hypoglycemia and that some of my morning high readings are rebounds. I do have my husband sleeping next to me, and I love him dearly, but he is not one of those magical people who can wake up out of a deep sleep because my breathing changes and he senses trouble. I know someone whose husband can do that, the lucky duck, but the love of my life sleeps through just about everything. I needed some mechanical backup.

3. To avoid unexpected nighttime highs I had to wake up at least once each night to test my sugar. I started doing this when I got pregnant in January 2005, which means I have not slept straight through a night for 2 1/2 years.

4. My husband and I are considering another pregnancy, and 15 finger sticks each day, including 2-4 times each night, just isn't feasible now that I have my son running around, sleeping with us at night, and just making it generally impossible to have my second pregnancy be all about me.

5. Now that I have a kid, the potential consequences of severe hypoglycemia unawareness are much more frightening. They were easy to dismiss when it was just me and random hapless pedestrians at risk, but if I don't feel a bad low coming on, and I'm alone with my son...I can't even bear to think about it.

6. Now that I have a kid, the cumulative effects of sustained high blood sugars scare the pants off me.

Let me say more about those last two. Before my son was born, I was vaguely afraid of diabetes complications and I was vaguely afraid of death. I felt that a long life was preferable to a short life, all things considered. Post son-birth, this preference for long life and good health became a crushing need. I must see this little person turn into a big person. I must be there to help launch him into adulthood. I want to be around to help him in the way my parents are still around to help me. I want to drink sangria on the porch with my 50 year-old baby boy. Of course, he might decide as an adult that he wants nothing to do with me, but heck I'd at least like to be around to give him that choice.

I'd liked the idea of a CGMS, but I knew insurance wasn't covering them yet, and I thought I'd give it a few years and see if I could get it paid for. I think it was one morning in May, when I skipped my middle of the night sugar check (still didn't sleep all the way through since my little leech sleeps in bed with us and still nurses), I woke up and my sugar was over 300, and it hit me, really hit me, that these highs and lows are very dangerous. I turned to my husband and said I needed one of those continuous glucose monitor thingies, no matter how much it cost. Other than being an excessively sound sleeper he's a really good guy, and he agreed with me. So I started to research the various options.