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Re: [IP] CGM's



> I was wondering if those of you using a CGMS find that they are worth
>  the money....

The votes seem to be for the INTEGRATED MiniMed Paradigm 722-RT, because
it *can* be covered by insurance (as a pump), and for the Dexcom
(because the Sensors last so long, at least for me). The Guardian RT (a
stand-alone, non-pump model from MiniMed) seems to have much higher
costs than Dexcom, and it's accuracy isn't as good.

There's a comprehensive August 2005 study of Glucowatch vs. "old"
Minimed versus "new" Minimed, and the Dexcom User's guide also contains
very comprehensive tables of accuracy/reliability/alarm probabilities
(correct and incorrect). Dexcom wins by a noticeable amount, although
the 2005 study didn't have enough events in the Severe Hypo range to
draw conclusions about extremely low readings. (It did great, but there
were only 3 events.) Either of these devices is EXTREMELY helpful for
preventing nighttime Hypos, it looks to me like you just end up with a
few more false alarms using Minimed. Minimed might be better if you
sweat : the Dexcom goes completely haywire, reading 100+ mg/dL too high
for 3-4 hours, if you get it wet.

IMO, both should be with the "Low" alarm high enough, 80 or so, to make
detection of real Hypos (55-60) a near certainty.

Cost is not as bad as you may think, definitely not as bad as the
companies are allowed to say. (They can't talk about the off-label usage
of Sensors, the biggest cost factor, for extra time. That's an FDA
no-no!) My last Dexcom Sensor lasted 17 days. I pulled the previous one
after 12 days, looking for irritation and reactions (skin and
subcutaneous). I didn't find any. It probably could have gone several
days longer. The one I'm using now is on Day 9, working great. Therefore
my expected cost isn't  $5400 per year ($4250 for Sensors, plus $1050
for a new Receiver and two new Transmitters). Instead, it's just $1800
($750 for Sensors, the same $1050 for replacement Receiver and
Transmitters).

Others report that the Minimed Paradigm-RT also works well for quite a
bit of extra time, although not as long as Dexcom. Nikos gets 7-11 days
from his.

For HUGE amounts of info, including accuracy, look at the Thread "DexCom
system accuracy and Paradigm RT alerts" started by Sarah Dowdell last
Friday. Among Paradigm 722RT users, Nikos Fillipou offers the most
details. For Dexcom, it's me.  We've all done a lot of posts during the
month, go to the date index and start from the following:

June 3 from me, "Dexcom CGMS (I love this machine !!!). comparison only
against the standalone MiniMed, not the combined Pump-CGMS 722RT, also
my first post, I've learned more since then.

Later that day from me, "Re: [IP] The new Paradigm Pump w/ continuous
glucose monitoring". I take ALL of this back, I was mistakenly comparing
against the standalone RT, not the pump.

See corrections in the same thread from Sarah and Nikos. Look especially
for posts from Sarah and Nikos about the Paradigm 722RT (pump with CGMS)
and from me on Dexcom.  We all use the devices, Nikos and I are
ECSTATIC  with the improved control and hypo avoidance we've achieved.
.
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