Josh wore a version of the Medtronic CGMS Gold and we would not recommend this particular model. The sensor and monitor were attached by a wire and could not be detached. The monitor was big and cumbersome and the sensor was uncomfortable, but Josh stuck with it. I am not above bribery as a motivating tool and this definitely warranted some sort of a reward so Josh got an IPOD in exchange for the CGMS trial.
He had to leave the CGMS on when he showered so he had to cover it in a sealed plastic bag (quite a sealing contraption I might add). It was bigger than an insulin pump, visible to friends and strangers and did not fit into his pocket. Unlike the newer CGMS units we could not see the blood sugar numbers as they were recorded by the monitor. At the end of the five days we returned to CHOP and they downloaded the program and presented us a graphical picture of Josh's blood sugars.
CHOP is moving away from using that uncomfortable first generation CGMS and is now using the next generation Medtronic MiniMed REAL Time CGMS, Abbott Freestyle Navigator and Dexcom SEVEN CGM. At our last appointment the a technology team member came down and did a show and tell for Josh with the new CGMS units so that he didn't write them off forever more due to the discomfort of the older model. I thought this was a great strategy for educating Josh and me.
Discomfort aside, we were very pleased with the data the CGMS was able to give us. I would recommend a short term usage of a CGMS to help identify reasons for blood sugar variability, but only if the family is willing to commit to the non-technology requirements needed to successfully translate the data, especially keeping the food log.
We kept a very detailed food log both before and during the 5 days on the CGMS. The technology nurse practitioner told us to make sure to have a couple high fat meals including pizza while Josh was wearing it, to keep him to his regular schedule, and to log as much data as we could. Josh was thrilled with the idea of having pizza twice in five days!! They also suggested we experiment with the combo/extended meal bolus so we could see its effect. We logged what and when he ate and exercised. The CGMS was calibrated with a finger stick a few times a day and we pushed a button to indicate when he was eating so it would show up on the blood sugar graph. The record proved to be invaluable when we looked at it next to the CGMS Blood sugar graph.
Here are some CGMS pictures and links for more information.
Josh wore a previous generation of the Medtronic CGMS Gold, pictured below and link here.
These are some of the CGMS units available now. Note the much smaller sensor sites and that the site is not attached to the monitor by a long fat wire!
Published On: March 10, 2009