From Paonia, Colorado, USA:
In your opinion, is the time for continuous glucose sensing now?
My 14-year-old son is pumping (MiniMed) successfully. His last A1c was 6.8 and he recognizes his hypoglycemia. We don't have a compelling need right now for continuous sensing, but I think that continuous sensing is the future for patient's with type 1 diabetes. I believe that someday (soon?) continuous sensing will be compared to fingerstick blood glucose monitoring like we now compare fingerstick monitoring to urine glucose monitoring.
So, is that time now? Should I push for insurance coverage or pay out of pocket to provide the best care for my son?
I am very happy to hear that your son is doing well. I would encourage you to read Getting Started with Continuous Glucose Monitoring on this web site.
Continuous monitoring is an incredible breakthrough in day-to-day diabetes care. It is not for everyone, however, as in order to get the most from it, you have to work at it. As you mentioned in your question, the cost/reimbursement by payors can be a challenge, but certainly worth the effort if you feel it would help.
I would have a discussion with your son to see what he wants to do at this time and to have realistic expectations of sensors. They are a great way to learn how food and exercise affect your glucose levels and how the insulin action works. They also help you respond to the unpredictable nature of diabetes on a day by day basis, and find highs and lows before they happen. They can be worn some of the time or all of the time. They are not foolproof and sometimes, just as a pump infusion set can be frustrating, the sensors can fall out or need early replacement, etc. He needs to understand that he would still check blood glucose to calibrate the sensors (to let the system know what the sensor generated current means in glucose terms and to adjust for any changes.) He would also be wearing two "things" on his body, which is a consideration for some teens. I have been told by some people with diabetes that they don't know how they ever lived without the sensor, while others have not had that same feeling. I do believe that getting the help from a diabetes educator or physician with experience in CGM is critical to understanding sensors. Also, do expect things to take a little while to settle in for your son, perhaps similar to starting an insulin pump.
Original posting 18 Jun 2008
Posted to Continuous Sensing
Last Updated: Tuesday April 06, 2010 15:10:16
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