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Wednesday, August 23, 2023

Continuous Glucose Monitors Are Game Changers

It has been almost two years since I was diagnosed with diabetes. Since that time I have made a number of life changes, all for the better. I’ve lost about 20 lbs and gotten my A1c down below 7. But during my last follow up visit my doctor still seemed a bit concerned. It seems that he still wants an A1c coming in below 6, plus my glucose reading of my last fasting blood test was still above 100. While these are big improvements, they are still not ideal, coming in the range of what someone would have if they had prediabetes. In response to his concerns I decided to appeal to my insurance company, asking them to pay for a continuous glucose monitor which I have received and it has been a game changer.

What is a continuous glucose monitor or CGM? Just as the name implies, CGMs are systems that give continuous, or at least close to continuous, blood glucose readings. I have the Dexcom G7 which sends a reading to my cell phone once every five minutes. The Dexcom sticks to my arm with a small filament tucked just under my skin, reading my glucose levels from my interstitial fluid (the fluid that is found in the spaces in between our cells). The G7 received FDA approval back in 2022 for use by anyone over the age of 2 and has replaced the previously approved G6 for use by people who have diabetes.

I had applied for the G6 a month or two after my diagnosis but was denied by my insurance company who sent a list of reasons for the denial. To be honest some of the reasons were insulting. For example, they accused me of not caring about my diagnoses, accusing me of not taking my own blood glucose readings. You would think that if this were true they would have wanted me to have a CGM in an attempt to get me to take these readings. They were wrong and I was taking my readings, poking holes in my fingers at regular (and painful) intervals. They also listed a number of other reasons most of which I probably could have successfully argued against on appeal but one stood out as a problem.

When I received my diagnosis my doctor suggested that I attend classes with a dietician. I declined because I’m a researcher at heart and I enjoy finding answers on my own. Over the last two years I have taken the time to dig into the topic of diabetes, including doing research on how to eat. It has been a lot of fun and I still have a lot to learn. (For the record, unless you are willing to put in the time to do the research, I do recommend going to the dietician if you are diagnosed with diabetes.) Because I would not take their classes, the insurance company initially said no to paying for a CGM. But this year something changed.

This year I asked my doctor to once again put in a prescription for a CGM and he did so just after my local pharmacist started carrying the G7. To my surprise the insurance company said yes without any push back (Thank God). It seems the insurance company’s policies concerning CGMs had changed and so this year I got my first Dexcom G7 and it is a game changer. In fact, based on my early experiences I think CGMs should be an automatic part of the treatment plan for people who are diagnosed with diabetes.

I was very diligent with my finger sticks and thought I was doing a good job controlling things based on the numbers I was seeing. Yet, my A1c seemed to hit a plateau in the upper 6s and I couldn’t understand why. Within the first 10 days of wearing the G7 I figured out what was going on. (Each G7 can be worn for 10 days before it needs to be replaced.) In between my finger sticks things were not going as well as I thought. This was leading to an average which was higher than I anticipated and my A1c was based on that average. The G7 told a story that I could not have known without taking finger sticks every five minutes (not recommended). With the information from the G7 I now have a plan for getting my A1c down to where my doctor and I both want it to be.

I believe that living with diabetes and not having a CGM was living with one hand tied behind my back. I wish I had one from the start but all is in God’s timing and He knows why I had to wait. I suspect that had I not had over a year of finger pricks, I would not appreciate the technology and benefits that come with a CGM. This is a tool that will help me improve my health and I believe it is a necessary tool for dealing with diabetes. I’ll say it again: my CGM is a game changer.

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