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Why have a CGM?

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CGMThis is something I get asked by a lot of people that don’t have Diabetes.  In the UK we have to self-fund CGM’s, we don’t get insurance paid CGM’s and our National Health Service (NHS) rarely give CGM’s out to Diabetics unless you have frequent hospitalisation occurring.  So why would I want to spend about £1,300 a year on CGM Sensors and on top of that pay around £1,000 for the CGM transmitter and CGM receiver?  The look I get from family, friends and even some people on the Diabetic Online Community….Are you MAD?!  Followed by…That’s a lot of money! and then He must be loaded!

No I’m not loaded but do make a good living and yes it is a lot of money, if you think that if I were to run CGM over a 10 year period, sensor cost alone would total £13,000 or over 20 years £26,000.  However, Diabetes is a long term disease, it’s progressive which means my Blood Sugars will get higher over time requiring more insulin, the higher the blood sugars are the more toxic or treacle looking my blood becomes, this makes it toxic to my organs and my organs gradually start to shut down.

The fact is that Doctors and GP’s are restricting test strips on the UK NHS, many are very lucky to get 200, most get 150 or 100, and some get nothing.  We need test strips to achieve a good A1c and to keep complications at bay.  Recently I’ve had my test strips restricted from 150 per month to 50, my lancets from 204 a month to 50 and been forced to use a meter, test strips and lancets that I don’t like or trust thanks to NHS Cost Cutting.

Many Diabetics manage just fine without a CGM, test their blood using fingerpricks 6-8 times a day on average (usually before and after meals), and that’s what I have been doing for a year.  So even if you do get enough test strips or you pay for test strips, then there’s  the fingerprick conundrum.  You have to take a needle and STAB, yes STAB yourself 6-8 times a day, make yourself bleed to test your Blood Sugar.  It simply hurts, it’s painful!  Oh but we must get used to it surely?  We get used to it, but it doesn’t mean it hurts any less!  I only test with my middle and fourth finger on each hand, it’s strongly suggested not to use your pinky finger or thumb and my index fingers are valuable to me for using my mobile devices and tablets so I don’t use that to BG test with.  So I can test on each side of the finger once, that’s 4 fingers, 2 sides which equal 8 tests.  That’s a complete day of tests.  Now these holes don’t heal that you make in your fingers, they bruise, they hurt, especially the next day if you get a lancet plummeting into the same hole or close by it.  Over days and weeks your fingers become red raw, painful, they look sore.

fingerprick

With a CGM you have to insert a sensor into your arm or stomach for 5-10 days, but that’s once, and that’s it.  You still have to test your Blood Sugar for calibration of the sensor, some like Dexcom G4 still require you to test every 12 hours or 10 times in 5 days where Abbott FreeStyle Navigator only require 5 calibrations in 5 days.  You also have to test now and again if you think you’re going low or high however, it means you can test a lot less and save your poor little fingers.

lancet

That’s the first reason for me having CGM, the second being that over time I am going to have complications.  It’s not a matter of IF it’s a matter of WHEN.  Higher Blood Sugars over time lead to complications.  Now this could be Nerve damage (which I am already suffering from) which leads to pain and tingling and numbness in your feet and legs, retinopathy where you could go blind, kidney disease, foot problems with infections that set in because of nerve damage as I can’t feel the cuts which leads to amputation, sexual dysfunction (let’s not even go there), liver problems and even heart problems.  The lower I can keep my Blood Sugar over time the better I will be to keep myself away from Diabetic Complications.  It will very much not stop them from occurring as it’s a slippery slope, but it will prolong them a little longer.

Then there’s the severe hypoglycaemia I was suffering from for nearly a year, I was just about managing it in a day but one day I had 17 hypo’s.  Every hypo drains the every living ounce out of you, makes you feel tired, lethargic, sick and just plain lifeless.  That’s when you can treat them, but for me having hypo’s of 1.2 through the night, not knowing if I would wake up from a hypo was worrying at best, that’s another reason why I went for a CGM.  One morning I may just not wake up from one of these severe hypo’s, surely that must be worth the cost?

I myself am thinking not of now, I am thinking of the future.  I am 40 now, I already feel like I’m an old man and Diabetes certainly isn’t helping how I feel right now, and if I don’t feel great now, then what will I feel like when I’m 50 or 60 or god forbid 70 or 80?  Many doctors say but it takes years for Diabetic Complications to occur, e.g. eye problems or loss of limbs.  However, there are Diabetics that I talk to in the #DOC (Diabetic Online Community) that are 16 to 22 where they are already suffering from these same eye complications.  Likewise it’s also been shown that limb amputation can happen in as little as 5 years if your blood sugars are high for this long, and once it starts in one area it spreads to other areas because your blood has been toxic for too long.  It’s the feet, toes, hands, fingers that are at the most risk.

If paying for a CGM extends my life by 5 or 10 years by reducing the chance of having a heart attack or postponing it by 5 or 10 years than I would rather keep good control of my blood sugar now, then it’s done it’s job and it’s worth the money.  Unfortunately you’ll never know for sure if it has helped for this point, but it certainly helps giving your fingers a rest, it’s a relief, and that alone is worth it!

So I will not be shamed or bullied into thinking that CGM is an expensive toy and is really not necessary, when it’s your health you make your own decisions, and it’s my decision to go with CGM, even though it costs £1,300 a year for me in sensors to monitor and maintain my Blood Sugar level.  If I didn’t use CGM and in 10 years time start suffering more Diabetic Complications, then I would look back and kick myself (if I had any feet left) to think why didn’t I use CGM?  As with everything in life, CGM is an insurance policy, some people don’t choose to take out insurance and some do.  If you have perfect control of your A1c and it’s in the 5-7% range then great, you probably don’t need a CGM, but if your A1c is higher than a CGM can help you take the stress and effort out of reducing your A1c to a better more safer level, and if you are getting too many hypo’s it may just very much make you wake up in one of those severe hypo attacks and keep you alive for you to see another day.



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