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[IP] MiniMed continuous blood glucose monitor (CBGM) review -- long

I just finished a 3 day trial using a loaner MiniMed continuous blood glucose
monitor.  My notes/thoughts:

The sensor itself is inserted much like MiniMed's SofSet QR.  There's even a
SofSerter-like gadget that shoots the needle into place (at about a 30 degree
angle), then the needle is removed, leaving only the sensor unit.  Then the
cable to the monitor unit is attached to that, and the whole thing taped into
place -- much like the SofSet, but the wire is bulkier than the tubing.

The monitor is a little wider and thinner than the MM508, and a little heavier.
It comes with a belt clip.  (I'm told they're working on a new belt clip -- the
current one doesn't grip as well as it could.  I had no problems with it coming
off my belt, but if I tried clipping it to my shirttail when I got up at night,
as I do with the pump, it came loose too easily.)

There are five buttons: the SEL, ACT, up and down arrows are very similar to the
508.  Down arrow also acts as backlight.  The fifth button is the power button
-- you use this to turn the monitor off at the end of the study period.  One
thing I found a little annoying is that while the four main buttons are the same
as the 508, their configuration is different.  The buttons are laid out on the
monitor in a diamond pattern, with the SEL and ACT on the left and right, and
the arrows on the top and bottom.  This is different from the 508 layout, where
the buttons are SEL and ACT on the left, and arrows on the right.  If you're
used to the 508, you have to be careful about how you enter data in the monitor.
(Kevin told me this may not have been much of a design issue because most of the
patients who've used the sensor are not on the pump.)

It takes an hour for the monitor to initialize.  The countdown in minutes shows
on the monitor.  After it initializes, it beeps, and that's when you do a bg
check on your meter, and enter that number into the CBGM.  That data entry
starts the sensor collecting bg data.

The monitor lets you enter bg readings from your meter.  This has to be done at
least four times a day, but preferably as many times as you test.  (Note that
you need to use the same lot of test strips for the study period.  If you're
close to the end of your current box, you'll need to open a new vial.)

You also enter "events" as numbers, where the events are defined as: 1=meals,
2=insulin, 3=exercise, 4=hypo/low bg.  The more you're willing to enter, the
more useful data there is to analyze after downloading.  Since I'm already
keeping a detailed log of bgs, insulin and food, this wasn't a nuisance,
although I did stop keeping the other log during this test period (I'm not going
to keep double sets of books ;-) ).

The monitor comes with an accompanying pocket guidebook.  The back has four
pages of logs, where you enter as much data as possible during the study period:
time, bg, insulin, meal and snack amounts, and events.  Again, NBD.  Extra pages
in the log book would have been helpful.  The reagent in the sensor lasts at
least three days; I got four and a half out of it, and it was still going when I
took it off and powered off the monitor.

The monitor isn't waterproof, and there's no way to disconnect.  MiniMed has
one-time-use ShowerPak bags that you put the monitor into, and then you hang the
bag around your neck while you shower.  (Taking a bath or swimming are no-nos
while the monitor is in use.)

The only problems I had were with the tape used to fix the sensor in place.  The
wire from the sensor to the monitor is about six to eight inches shorter than
the SofSet 42" tubing, so there were a couple of times when I outstretched my
"leash," and the tape tore a little.  After the second day, I replaced the tape
with another piece of IV3000, and a piece of Tegaderm over that, which seemed to
work out pretty well.  I do have some leftover irritation at the site where the
sensor and tape were, but it's not bad.

By the fourth day, I was significantly more aware of the sensor, and I was ready
to have it come out!

Downloading the data from the monitor takes only a few minutes.  The printouts
cross-reference all the events entered, including meter bg readings, meals,
insulin, etc.  My trends were pretty consistent, and showed I'm still going too
high overnight.  We'll have to adjust the overnight basal, and possibly tweak
the daytime basals.  Insulin-to-carb ratio isn't quite correct either; I'm
spiking pretty high after most meals.  It also appears that I may need to test
sooner than two hours after meals to check my insulin-carb ratios.

All in all, this was a *great* way to look very closely at how we're managing my
diabetes.  I'd recommend it to anyone who's looking for tight control.

A *big* thank-you! to Kevin Harrington, MiniMed's diabetes care specialist in
the New England area, who got me set up with the loaner CBGM, and worked with my
dr and CDE in interpreting the data and fine-tuning my control and basals.

-- Cathy

"Living in the laidback lane...."

email @ redacted
(978) 640-5279 (tel)
(978) 640-0216 (fax)
Avid Technology, Inc.
Mailstop B2-3
1925 Andover Street
Tewksbury MA 01876
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