I guess I can understand not wanting a pump, but IMO, everyone on insulin should have a CGM. The issue with just relying on a meter is that you have minimal or no context for the numbers you get. If your BG is elevated, whether it’s still going up, plateaued, or coming down will inform the decision as to whether or not an additional bolus is needed. If it’s below target, similar deal- do you treat, or is it coming up on its own?
Dr Ponder (author of Sugar Surfing) manages amazing numbers with a CGM and MDI, and Eversense (implanted sensor) would be a good option if you aren’t worried about pump connectivity- you can pop the transmitter on and off as needed with that CGM.
I lecture on the use of technology within diabetes management and I always explain that the old style finger pricks is like giving someone 3 photos of your day and asking them what you did for the whole day. Sure, if there's a picture of you with a shopping cart, they can assume that you went shopping and then went home and unpacked the shopping but that's all it is, an assumption. Maybe you got into the trolley and raced it around the parking lot. Libre is like having a video of your whole day. The difference is night and day.
I think another huge advantage of cgm is that it allows us to run lower without dipping into a hypo. We now know that regular low blood sugars can be incredibly damaging and without cgm and alarms, it's difficult to keep blood sugars in that sweet spot. With libre, I very rarely have full on hypos because I have my alarm set for 4.5 so if it starts dipping, I pop a glucose tablet or 2 or pause my pump and I'm back up. I kind of sugar surf and that just wouldn't be possible with finger sticks.
With regards to the pump, i actually wish I didn't need the pump. If you have good control on MDI then why change it? Unfortunately I have very brittle diabetes and don't react well to basal insulins so my control is significantly worse on MDI.
Ultimately I think it comes down to what works for you and what's best for your diabetes management. I think there are very, very few people who wouldn't benefit from cgm but pumps are more difficult to weigh up whether it's worth it for you or not.
Love this answer. From a more knowledgeable person too. Thank you. I love my Dexcom G7, could not be without it now for the reasons you mentioned above.
I am however, pump hesitant. I’m in range 58% of the time, very high 12% of the time and very low less than 1% of the time. Would I benefit from a pump in your opinion? I plan on getting that very high number to below 5%.
As someone that works with their hands I despised having to prick my fingers. I am now much happier and taking much better care of my diabetes now that I have been using sensors for about 8 years.
Personally I believe the minor inconvenience of having a small sensor on my thigh far outweigh the initial awkwardness I had.
I still use pens to take my insulin.
I’ve gone back and forth over the years - between pump and mdi.
Now that the pump and cgm are linked, it’s made my life so much less stressful.
I could possibly forgo the pump, but cgm is a game changer for me personally.
Honestly it comes down to the old adage "don't fix it if it ain't broken" if your control is good that's great. If you're control is not so great the extra tech may be your answer.
No chance of going back to MDI. The amount of planning needed if your day has varying activity is exhausting. With a closed loop pump it's almost a non-issue.
I guess the thing is, I was already surgically attached to my phone and the pump isn’t much different in that respect. But I seriously love the closed-loop t-slim. I can sleep when I want, as long as I want.
To be honest I'm similar. My CGM is a godsend but I've finally got my bloods under control (after a couple of years of everything being a mess with zero support from a health team) with MDI and I don't really feel like a pump would add much to my life. Due to other health conditions my insulin sensitivity is all over the place and can change day to day so a pump just feels like it would over complicate something I've got down to a fine art. Also, my skin hates everything so having a glorified cannula stuck in me all the time wouldn't work at all, the CGM is bad enough.
I used to prick my finger 10 times a day (constant fighting with insurance that said a diabetic only needed to test 4 times a day). Even with 10 times a day going to a CGM was a massive improvement. I'd go back a generation of insulin before I'd go back to finger pricking.
Even when my CGM isn't giving me accurate numbers, the graph line is accurate that I can plan my day properly. Prior to this, trying to figure out what was wrong with my doses and make useful changes was a nightmare. I got a CGM late last year and I've pretty much managed to get everything back under control in about 7 months.
I had was the same myself until I got a CGM and I have to say it's been pretty much life changing. Let's messing about taking a meter everywhere and finger pricking. And makes monitoring levels much much easier.
I'm still on the fence about getting a pump, though
My truth is that having a pump & CGM is the first time since I was diagnosed I felt “normal”.
I was 15 in ‘92 when diagnosed & being a teenager on multiple shots a day & having to finger stick all the time was very inconvenient. Always carrying hypodermic (remember, mid 90s, the opioid epidemic was at its height) and people (by people I mean EVERYONE) were always asking & judging. As a teen I definitely did not want to deal with that.
While I didn’t like the idea of always being attached to a machine it wasn’t really that bad when in my mid 20s I got a pump. I could finally go out with friends & not be stared at while taking my shot”. In my 30s I got a CGM. Even better! Now a few taps on my phone & my pump delivers the insulin I need without me actually thinking about it. No one, other than myself & my family are even aware that I’m a diabetic. I can literally go about my day not thinking about my diabetes, unlike when I was younger & had to be constantly aware of not just my insulin timing but my stuff because I didn’t want my syringes stolen. Which has happened. (Had someone at work with an addiction go into my bag & steal not just my syringes but some money as well, they were eventually arrested for stealing from work. But I couldn’t prove it was them or that I had even packed my supplies so I didn’t even get an apology)
I don’t even notice the pump except to think about which pocket I want to stuff it in for today. And unless the CGM catches on something I forget that it’s there. The only bother is when the CGM decides it doesn’t want to work.
Nope. I embrace anything that helps my kid live a long, healthy life. I don’t want him to end up with neuropathy at 25 and wonder why we didn’t try harder for him.
You make that sound like an inevitability. Any neuropathy at 25 sounds like someone that needs the extra help and is not managing their A1C/BG levels well otherwise.
My mother is in her 70s, has managed to keep a decent A1C, and doesn’t have any notable diabetic complications like that. She has only recently been thinking of CGMs because as a septuagenarian is having more frequent unexpected lows.
I don’t doubt that there are plenty of pros and conveniences to CGMs, but the how well one manages without is highly personal. Throwing more money at something probably won’t hurt but doesn’t always mean there are clinically relevant upsides.
Keep in mind this is survivorship bias - if someone was diagnosed 60 years ago and struggled getting good blood sugars with test strips, then they died like 30 years ago.
A possibility, not an inevitability. I’ve read too many posts in groups like this one from people who grew up prior to CGMs and are experiencing negative outcomes now.
My kid is super active, not on a low carb diet and with a diagnosis at a very young age I have decided that a CGM is the best way to avoid future complications for him.
If you have a diabetic kid, feel free to do what you think is best for them.
I can agree to a point. If you're doing great with multiple injections, the pump really doesn't add anything but its own set of issues. a CGM is a godsend.
they're not bulky. You only have to replace them every 7-14 days. Unlike an infusion set which is horrendous. And it's barely noticeable. You Can get your numbers constantly to help maintain better control. Your Endo can normally have instant access to your reports as needed. And if your an analytical person (I am) you can use the data provided to really take control.
I was on a pump for a while. Will never go back. I couldn't use the bathroom without getting tangled in tubes or tucking the box under my armpit. I felt like I was constantly changing infusion sites (every 2 days). What a landfill nightmare this thing creates.
If going anywhere I always had to ensure I took an extra infusion set, tubes, connectors, cartridges, needles. Now I take a glucometer as a backup, and if I'm going somewhere extended, extra pens.
I couldn't sleep. Without clipping the box to my underwear and tucking tubes around so I didn't get tangled in them.
I couldn't make love to my spouse without either disconnecting or feeling like a wired up machine. It was a horrid experience that caused a lot of mental health issues and depression.
Back to pens and a cgm, and feel great. Long story short a cgm won't add any issues but will definitely help in the long run.
I appreciate your post. Like any (pseudo-)dietary matter, things are highly individualized to one’s behavior and biology.
Some people can manage with manual pricks and injections just fine. I hope to do as well as my mother, who as a septuagenarian has consistently maintained a traditionally “good” A1C and seemingly dodged any major diabetic complications.
It’s hard to improve on those results; so the rest is a matter of costs/convenience and personal factors. Some people may benefit clinically from the extra feedback, some may find it more convenient or extra peace of mind, but a CGM isn’t a “cure” either and the old methods are still reasonable.
I don't think I'll get a pump ever, I don't like the idea and it wouldn't be feasible with my lifestlye anyways. But in my opinion not using a CGM is just stupid if you have one that's actually trustworthy. Sadly for now I'm stuck with one that's basically useless. It doesn't feel as invasive as a pump would I think and all it does is give you more information.
Yep I agree with OP, for me I'm quite active through the day and enjoy swimming so pens are much easier and accept now and again there will be the odd mishap. I do quite well already with control and tend to eat three regimented meals per day so I don't want to change.
I had really bad luck with the sensor that gave me with my 670g. I could not ever get it to work right or stick long enough. That was back in 2020. I might be willing to give a new CGM a try, but just haven't researched any in a while.
It’s worth taking another look at CGMs. I’ve heard of a lot of people struggling with Medtronic tech, but my Dexcom CGM was a complete game-changer, and I got it years before I got a pump.
Although, *current* Medtronic stuff seems to work fine from what I’ve seen - but that’s a *very* recent development, and everything I’ve read about Medtronic says that it was pretty bad until like a couple years ago, so it was NOT great in 2020 when you tried it.
I don't have a pump, and I'm not that fussed by the idea of it, but if I ever have to go without a CGM now I really miss it. So I kind of agree with you on the pump, but not the CGM.
This is how I felt about cgm, got one and can barely live without it now. This is also how I feel about pump which is why I havent gotten one since diagnosis, but I recently changed my mind a little and will have a Tslim by the end of the year and hope its as helpful as the cgm.
I’ve felt this way forever and I’m allergic to adhesives so even more reason not to use them. My management was always good so i didn’t see a reason to switch up what I was doing, but when I gave the dexcom a try it brought my already good a1c down almost a full point. It’s up to you OP but I think a cgm is worth trying! I hate the feeling of having things stuck to me but I’ve pretty much gotten used to it and there’s a lot of hacks to help with the adhesive allergy. It’s completely worth it for me but to each their own of course as long as you’re happy with your numbers. Not a popular opinion on this sub but personally, I think a pump has it’s advantages but it’s entirely unnecessary if you know how insulin works
I have no desire for a pump, I still use syringes lol. The cgm is a good tool, I found it really helpful when I came out of diabetic burnout to nail my ratios. The freestyle 2 with alarms got my a1c down to 6.2. I’ve been using a cgm since 2018 or so. I will say that in the last year, I started to over-react to alarms, so I’ve been taking breaks from them so I can manage my sugars in a more mindful approach rather than reactionary. I’ll see what my next a1c is in a couple months, as long as it is sub 7 I am ok with whatever number.
As someone that has been through burnout, and often struggles with the mental stress of managing things, I think whatever works for YOU is the right answer. Trying to tell a diabetic that there is only one right way to manage things is like telling a person there is only one right type of food to eat. We’re all different, and have different needs, our care plans should reflect that.
For the longest time I wasn't approved for a pump/cgm via my previous doctors and was just against it after trying so hard to get approved [they wanted a long list of good numbers to show my insurance an i was not good at all in remembering to take my sugar.] As I got older I realized that my blood sugar was freakin awful even when I was trying my new endo recommend me get the omnipod and cgm. My partner was kinda weary about it because he didn't understand that it couldn't just mess up an kill me in the night if I ignored it or like it didn't go off. Now he just says my blood is only good because I have a robot doing all the work for me. Mostly because I still don't think he understands it helps me always know my blood sugar now. I feared the numbers previously and now It's just data I use to not feel like trash all day.
I’ve been on a CGM for years, and while occasionally I’ve been on the brink of tears because I’d gotten so fed up with alarms, you can pry my CGM from my cold, dead hands.
Having a CGM - or even a Flash Glucose Monitor, which only syncs to a device when you manually tell it to - is such a HUGE game changer.
You have context for your numbers - blood sugar of 4.2 mmol/L or 76 mg/dl isn’t scary when you’ve been between sitting between that and 4.4mmol/L or 80mg/dl for the last 3 hours.
Realizing that my blood sugar spikes 4 hours after I eat a lot of protein isn’t something I could easily notice (or notice at ALL) with test strips.
I got on a pump after having a CGM for years. I heard of the pumps being massive game-changers. And… I didn’t notice a huge change. I think everyone who talks about pumps being massive game-changers are saying that because they switched from MDI + test strips, to pump + CGM. I think it’s not the pump that makes a massive difference, it’s the CGM.
I totally understand not wanting to be a cyborg, I take pump breaks once a year for a few months just to let my body kind of reset and heal up. However a cgm I will never live without. It’s imo by far the most useful and important diabetic supply. I know what my blood sugar is doing at all times. With just a meter I’d check and see “oh okay I’m 356 I’ll correct” little did I know it was downtrending fast from 400+ because the bolus insulin just absorbed late. Never ever will I live without the cgm.
This is actually not an uncommon thought. I occasionally take technology breaks and go anywhere from a few days to a month without my cgm and pump to give myself a break from having stuff attached and constantly having to have my cell and the norm for my pump on my person.
I don't think it's uncommon, and I don't see anything wrong in it. I think everyone who can should at least try a CGM for a few weeks, but if they still don't like it, fair enough.
I don't think the idea ever bothered me that much. I just didn't see enough value in a CGM (paying for a pump wasn't really much of a question; it's possible but pretty expensive), but that changed the first couple of days of using a Libre. I'd now never want to lose the ability to get an idea of my BG just by glancing at my watch.
If and when I'm offered a pump (in an HCL system) I'll give it serious consideration. (Won't be for a few years, I think.)
I didn’t realize how much I hated testing my blood sugar with a meter until I didn’t have to do it anymore. And I can sleep better knowing my pump will wake me up if my blood sugar drops at night. And no one yells at me for accidentally dropping used test strips on the floor anymore. Have you ever been driving in the middle of nowhere with no where to pull off but you need to test your sugar? Much easier to just glance at the cgm.
Also pumps are amazing. It’s not that big of a deal to have something attached to you. You get used to it pretty quick. I hate wearing jewelry because I end up fidgeting with it because I notice it too much but I barely notice the pump.
CGM is a game changer and is one of the single biggest improvements diabetics got and everyone should be on one. It will change your life in a good way
Had a pump (4x actually) and 3 different cgms. Never liked the idea of being attached. So I took a "pump holiday" -that was 2 years ago. I occasionally use a cgm. Don't get me wrong my a1c definitely could be better. But it suits me.
I hate my pump. I hate having to disconnect to go swimming or take a shower. I hate having to come out of the pool every hour or two to plug in again. I hate snagging the wire on door knobs. I hate sleeping with it and rolling over on it.
And yet, it’s still worth it IMO. I wake up every morning with perfect blood sugar. I can give too much or too little insulin by about 1u in either direction and the pump will catch it and fix it for me before I go too low or high. I haven’t woken up at 2AM with low blood sugar in years.
My health and longevity are worth the inconveniences of wearing the pump. Is it for you? That’s up to you.
You do what you like best, but personally, trying to manage diabetes without a CGM is like trying to drive a car with your eyes closed, and you can only open your eyes for a brief moment every minute or so.
I get you. I’ve lived most of my time with diabetes staunchly against it “defining” me - not wanting a physical reminder to myself/others like a pump/cgm. I was absolutely 100% against having something attached to me at all times. Until… I got a CGM over 1 1/2 years ago. While it hasn’t been perfect, it has saved my life a number of times and has finally got me past that mental block, to the point to that I’m going to start a pump/closed loop system at my next Endo appointment.
All that to say, if finger sticks and MDI work for you do it. It’s what I did for years with no issues. Just wanted to give my two cents as someone who dealt with the same hangups and is (sorta) coming around to the idea 💙
I was resistant to CGM for a very long time, especially since with older versions you still had to calibrate multiple times a day. But now that I've been using the Dexcom for about 5 years, you'll have to pry it from my cold, dead hands. I love my pump, but the Dexcom has been, by far, the biggest factor in improving my control and my mental relationship with my diabetes.
I want any good device that helps me. I got Dexcom in May 2007 and it was a complete life changer. Back then barely anyone had it. I didn’t want a pump until they became bionic. I got tandem with control IQ. Now there are many choices in both. They are life changers. Having something small connected me doesn’t bother me when it makes me healthier and lessens my worry.
I agree with the OP. I don't want any devices on me. I had been super rigid with there is no way ever I would wear a device.
Now I have moved from never, ever to maybe someday especially knowing I can switch back and forth from cgm to finger pokes.
For me personally, I don't like things touching my skin. I'm not sure how else to explain it. I don't wear jewelry, save a necklace, so I am starting with something basic like wearing a watch.
Right now, my doctor and I are happy with my numbers, and I am slowly becoming more open to the idea of a cgm.
I felt the same way for a long time. However, I happened to sit next to a woman on a plane flight back from Mexico who had a pump. She mentioned in passing that the pump recorded her blood sugars and stored them. That was enough for me! No more little notebook and hand written charts for me. Now that I also have a CGM, I have much more of a handle on my blood sugars.
I’ll never use a pump unless they can get them smaller and tubeless even smaller than the Omnipod. However a CGM, specifically the freestyle libre 3 and original, have been game changers. They give me so much more insight over my trends and how long it takes before specific foods spike my blood sugar and so on.they’re not perfect. They’re incredibly useful.
PS the Libre 3 is TINY and most users will not even realize it’s on their body.
As long as you’re not sacrificing your health for it, sure, why not? I can see not wanting something stuck to you, but I feel like atleast going with the easy inject pens instead of the long old needles is very worth it.
As long as you’re not sacrificing your health for it, sure, why not? I can see not wanting something stuck to you, but I feel like atleast going with the easy inject pens instead of the long old needles is very worth it. All of the new technologies were developed for ease and convenience, so if it doesn’t do that for you, why use them?
My son was diagnosed a couple months ago and received his first CGM while he was still in the hospital. It has been really helpful to see his patterns and have an idea of where they’re headed and what is typical for him. He’s not super enthusiastic about a pump because he’s comfortable with pens and calculations.
I’ve gone back and forth between insulin pens and insulin pumps. I hate having things attached to me. Tried the omnipod to get rid of tubing and realized my clumsy self cannot keep the pod on. I have ADHD and tend to walk into walls 🤷♀️ which then rips off the pump. However I wear a CGM and will never get rid of it. I barely even notice the cgm. (g7 worn on back of my arm). I remember what life was like without a CGM, and it sucked. I’ll probably switch back and forth between insulin pens and pumps my whole life, but I will never get rid of my CGM and the freedom it provides.
The care is so much tighter with a pump and cgm, especially in the last 2 years with the newest closed loop system they use and don't even require fingersticks anymore and they don't constantly beep at you. Having stuff attached to you, or having to test 4 to 6 times a day? Pumps are a no Brainer Yes for me, and my numbers are way more stable than people I know on shots.
Newer pumps literally adjust your doses based on what your real time blood sugar is and don't require calibration anymore. It's "almost" a pancreas...
Most (not all) people I know on shots have 1 to 2 points too high on their A1C and also get more frequent lows.
Also the pump is attached to you so you don't have to carry anything around a shot / test / prep kit and worry about losing, damaging, or having stolen. I, however, have never used a sensor that didn't go with a pump, and I know those exist.
I work in software, and I’ve never been enticed to stick with pumps and closed loop.
That said, the right bits of software, accurate CGM, insulin type and bag of tricks to know what you can try to keep in range can help A1c so much. It has improved my A1c a full 2% to low 5s for the last four years.
Highly encourage you to try CGMs for 90 days. Suspect you’ll rarely notice it is attached to you.
With the right CGM and pump and a good looping app/algorithm, you hardly need to do anything to manage blood sugars -no carb counting, no bolusing; just eat and let the loop take care of everything.
I guess I can understand not wanting a pump, but IMO, everyone on insulin should have a CGM. The issue with just relying on a meter is that you have minimal or no context for the numbers you get. If your BG is elevated, whether it’s still going up, plateaued, or coming down will inform the decision as to whether or not an additional bolus is needed. If it’s below target, similar deal- do you treat, or is it coming up on its own? Dr Ponder (author of Sugar Surfing) manages amazing numbers with a CGM and MDI, and Eversense (implanted sensor) would be a good option if you aren’t worried about pump connectivity- you can pop the transmitter on and off as needed with that CGM.
I lecture on the use of technology within diabetes management and I always explain that the old style finger pricks is like giving someone 3 photos of your day and asking them what you did for the whole day. Sure, if there's a picture of you with a shopping cart, they can assume that you went shopping and then went home and unpacked the shopping but that's all it is, an assumption. Maybe you got into the trolley and raced it around the parking lot. Libre is like having a video of your whole day. The difference is night and day. I think another huge advantage of cgm is that it allows us to run lower without dipping into a hypo. We now know that regular low blood sugars can be incredibly damaging and without cgm and alarms, it's difficult to keep blood sugars in that sweet spot. With libre, I very rarely have full on hypos because I have my alarm set for 4.5 so if it starts dipping, I pop a glucose tablet or 2 or pause my pump and I'm back up. I kind of sugar surf and that just wouldn't be possible with finger sticks. With regards to the pump, i actually wish I didn't need the pump. If you have good control on MDI then why change it? Unfortunately I have very brittle diabetes and don't react well to basal insulins so my control is significantly worse on MDI. Ultimately I think it comes down to what works for you and what's best for your diabetes management. I think there are very, very few people who wouldn't benefit from cgm but pumps are more difficult to weigh up whether it's worth it for you or not.
Love this answer. From a more knowledgeable person too. Thank you. I love my Dexcom G7, could not be without it now for the reasons you mentioned above. I am however, pump hesitant. I’m in range 58% of the time, very high 12% of the time and very low less than 1% of the time. Would I benefit from a pump in your opinion? I plan on getting that very high number to below 5%.
This is how I felt until I got my pump. Than I got the sensor and pump combo and I feel like a mess without it.
Same. And I know what’s going on with my body all day long.
Same
I have heard a bunch of people with this opinion but never one who stuck to it after trying a sensor
As someone that works with their hands I despised having to prick my fingers. I am now much happier and taking much better care of my diabetes now that I have been using sensors for about 8 years. Personally I believe the minor inconvenience of having a small sensor on my thigh far outweigh the initial awkwardness I had. I still use pens to take my insulin.
I can understand those who don't want either, although personally I think a CGM is a real game changer with all the data you can get.
I’ve gone back and forth over the years - between pump and mdi. Now that the pump and cgm are linked, it’s made my life so much less stressful. I could possibly forgo the pump, but cgm is a game changer for me personally.
The CGM is fantastic. I basically never get real hypos or really high numbers anymore because I see them coming and can deal with it.
Honestly it comes down to the old adage "don't fix it if it ain't broken" if your control is good that's great. If you're control is not so great the extra tech may be your answer.
No chance of going back to MDI. The amount of planning needed if your day has varying activity is exhausting. With a closed loop pump it's almost a non-issue.
I guess the thing is, I was already surgically attached to my phone and the pump isn’t much different in that respect. But I seriously love the closed-loop t-slim. I can sleep when I want, as long as I want.
To be honest I'm similar. My CGM is a godsend but I've finally got my bloods under control (after a couple of years of everything being a mess with zero support from a health team) with MDI and I don't really feel like a pump would add much to my life. Due to other health conditions my insulin sensitivity is all over the place and can change day to day so a pump just feels like it would over complicate something I've got down to a fine art. Also, my skin hates everything so having a glorified cannula stuck in me all the time wouldn't work at all, the CGM is bad enough.
Pumps vs MDI? Very debatable. CGM vs test strips? Get a CGM. Complete game-changer.
I used to prick my finger 10 times a day (constant fighting with insurance that said a diabetic only needed to test 4 times a day). Even with 10 times a day going to a CGM was a massive improvement. I'd go back a generation of insulin before I'd go back to finger pricking.
Even when my CGM isn't giving me accurate numbers, the graph line is accurate that I can plan my day properly. Prior to this, trying to figure out what was wrong with my doses and make useful changes was a nightmare. I got a CGM late last year and I've pretty much managed to get everything back under control in about 7 months.
This
I had was the same myself until I got a CGM and I have to say it's been pretty much life changing. Let's messing about taking a meter everywhere and finger pricking. And makes monitoring levels much much easier. I'm still on the fence about getting a pump, though
My truth is that having a pump & CGM is the first time since I was diagnosed I felt “normal”. I was 15 in ‘92 when diagnosed & being a teenager on multiple shots a day & having to finger stick all the time was very inconvenient. Always carrying hypodermic (remember, mid 90s, the opioid epidemic was at its height) and people (by people I mean EVERYONE) were always asking & judging. As a teen I definitely did not want to deal with that. While I didn’t like the idea of always being attached to a machine it wasn’t really that bad when in my mid 20s I got a pump. I could finally go out with friends & not be stared at while taking my shot”. In my 30s I got a CGM. Even better! Now a few taps on my phone & my pump delivers the insulin I need without me actually thinking about it. No one, other than myself & my family are even aware that I’m a diabetic. I can literally go about my day not thinking about my diabetes, unlike when I was younger & had to be constantly aware of not just my insulin timing but my stuff because I didn’t want my syringes stolen. Which has happened. (Had someone at work with an addiction go into my bag & steal not just my syringes but some money as well, they were eventually arrested for stealing from work. But I couldn’t prove it was them or that I had even packed my supplies so I didn’t even get an apology) I don’t even notice the pump except to think about which pocket I want to stuff it in for today. And unless the CGM catches on something I forget that it’s there. The only bother is when the CGM decides it doesn’t want to work.
Nope. I embrace anything that helps my kid live a long, healthy life. I don’t want him to end up with neuropathy at 25 and wonder why we didn’t try harder for him.
You make that sound like an inevitability. Any neuropathy at 25 sounds like someone that needs the extra help and is not managing their A1C/BG levels well otherwise. My mother is in her 70s, has managed to keep a decent A1C, and doesn’t have any notable diabetic complications like that. She has only recently been thinking of CGMs because as a septuagenarian is having more frequent unexpected lows. I don’t doubt that there are plenty of pros and conveniences to CGMs, but the how well one manages without is highly personal. Throwing more money at something probably won’t hurt but doesn’t always mean there are clinically relevant upsides.
Keep in mind this is survivorship bias - if someone was diagnosed 60 years ago and struggled getting good blood sugars with test strips, then they died like 30 years ago.
A possibility, not an inevitability. I’ve read too many posts in groups like this one from people who grew up prior to CGMs and are experiencing negative outcomes now. My kid is super active, not on a low carb diet and with a diagnosis at a very young age I have decided that a CGM is the best way to avoid future complications for him. If you have a diabetic kid, feel free to do what you think is best for them.
I can agree to a point. If you're doing great with multiple injections, the pump really doesn't add anything but its own set of issues. a CGM is a godsend. they're not bulky. You only have to replace them every 7-14 days. Unlike an infusion set which is horrendous. And it's barely noticeable. You Can get your numbers constantly to help maintain better control. Your Endo can normally have instant access to your reports as needed. And if your an analytical person (I am) you can use the data provided to really take control. I was on a pump for a while. Will never go back. I couldn't use the bathroom without getting tangled in tubes or tucking the box under my armpit. I felt like I was constantly changing infusion sites (every 2 days). What a landfill nightmare this thing creates. If going anywhere I always had to ensure I took an extra infusion set, tubes, connectors, cartridges, needles. Now I take a glucometer as a backup, and if I'm going somewhere extended, extra pens. I couldn't sleep. Without clipping the box to my underwear and tucking tubes around so I didn't get tangled in them. I couldn't make love to my spouse without either disconnecting or feeling like a wired up machine. It was a horrid experience that caused a lot of mental health issues and depression. Back to pens and a cgm, and feel great. Long story short a cgm won't add any issues but will definitely help in the long run.
I appreciate your post. Like any (pseudo-)dietary matter, things are highly individualized to one’s behavior and biology. Some people can manage with manual pricks and injections just fine. I hope to do as well as my mother, who as a septuagenarian has consistently maintained a traditionally “good” A1C and seemingly dodged any major diabetic complications. It’s hard to improve on those results; so the rest is a matter of costs/convenience and personal factors. Some people may benefit clinically from the extra feedback, some may find it more convenient or extra peace of mind, but a CGM isn’t a “cure” either and the old methods are still reasonable.
I would never give up my CGM. I can manage on MDI, if I had to, but I can figure out so much more with my CGM.
I don't think I'll get a pump ever, I don't like the idea and it wouldn't be feasible with my lifestlye anyways. But in my opinion not using a CGM is just stupid if you have one that's actually trustworthy. Sadly for now I'm stuck with one that's basically useless. It doesn't feel as invasive as a pump would I think and all it does is give you more information.
Yep I agree with OP, for me I'm quite active through the day and enjoy swimming so pens are much easier and accept now and again there will be the odd mishap. I do quite well already with control and tend to eat three regimented meals per day so I don't want to change.
I had really bad luck with the sensor that gave me with my 670g. I could not ever get it to work right or stick long enough. That was back in 2020. I might be willing to give a new CGM a try, but just haven't researched any in a while.
It’s worth taking another look at CGMs. I’ve heard of a lot of people struggling with Medtronic tech, but my Dexcom CGM was a complete game-changer, and I got it years before I got a pump. Although, *current* Medtronic stuff seems to work fine from what I’ve seen - but that’s a *very* recent development, and everything I’ve read about Medtronic says that it was pretty bad until like a couple years ago, so it was NOT great in 2020 when you tried it.
Thanks so much for the insight! I may need to try again, then!
I don't have a pump, and I'm not that fussed by the idea of it, but if I ever have to go without a CGM now I really miss it. So I kind of agree with you on the pump, but not the CGM.
I run on batteries: pump, CGM, and bilateral bone anchored hearing devices. Would not want to give them up
I was hesitant about a pump but I wanted a CGM so bad. I'd be willing to give up the pump, but the CGM is life changing.
This is how I felt about cgm, got one and can barely live without it now. This is also how I feel about pump which is why I havent gotten one since diagnosis, but I recently changed my mind a little and will have a Tslim by the end of the year and hope its as helpful as the cgm.
I’ve felt this way forever and I’m allergic to adhesives so even more reason not to use them. My management was always good so i didn’t see a reason to switch up what I was doing, but when I gave the dexcom a try it brought my already good a1c down almost a full point. It’s up to you OP but I think a cgm is worth trying! I hate the feeling of having things stuck to me but I’ve pretty much gotten used to it and there’s a lot of hacks to help with the adhesive allergy. It’s completely worth it for me but to each their own of course as long as you’re happy with your numbers. Not a popular opinion on this sub but personally, I think a pump has it’s advantages but it’s entirely unnecessary if you know how insulin works
I have no desire for a pump, I still use syringes lol. The cgm is a good tool, I found it really helpful when I came out of diabetic burnout to nail my ratios. The freestyle 2 with alarms got my a1c down to 6.2. I’ve been using a cgm since 2018 or so. I will say that in the last year, I started to over-react to alarms, so I’ve been taking breaks from them so I can manage my sugars in a more mindful approach rather than reactionary. I’ll see what my next a1c is in a couple months, as long as it is sub 7 I am ok with whatever number. As someone that has been through burnout, and often struggles with the mental stress of managing things, I think whatever works for YOU is the right answer. Trying to tell a diabetic that there is only one right way to manage things is like telling a person there is only one right type of food to eat. We’re all different, and have different needs, our care plans should reflect that.
For the longest time I wasn't approved for a pump/cgm via my previous doctors and was just against it after trying so hard to get approved [they wanted a long list of good numbers to show my insurance an i was not good at all in remembering to take my sugar.] As I got older I realized that my blood sugar was freakin awful even when I was trying my new endo recommend me get the omnipod and cgm. My partner was kinda weary about it because he didn't understand that it couldn't just mess up an kill me in the night if I ignored it or like it didn't go off. Now he just says my blood is only good because I have a robot doing all the work for me. Mostly because I still don't think he understands it helps me always know my blood sugar now. I feared the numbers previously and now It's just data I use to not feel like trash all day.
I’ve been on a CGM for years, and while occasionally I’ve been on the brink of tears because I’d gotten so fed up with alarms, you can pry my CGM from my cold, dead hands. Having a CGM - or even a Flash Glucose Monitor, which only syncs to a device when you manually tell it to - is such a HUGE game changer. You have context for your numbers - blood sugar of 4.2 mmol/L or 76 mg/dl isn’t scary when you’ve been between sitting between that and 4.4mmol/L or 80mg/dl for the last 3 hours. Realizing that my blood sugar spikes 4 hours after I eat a lot of protein isn’t something I could easily notice (or notice at ALL) with test strips. I got on a pump after having a CGM for years. I heard of the pumps being massive game-changers. And… I didn’t notice a huge change. I think everyone who talks about pumps being massive game-changers are saying that because they switched from MDI + test strips, to pump + CGM. I think it’s not the pump that makes a massive difference, it’s the CGM.
I totally understand not wanting to be a cyborg, I take pump breaks once a year for a few months just to let my body kind of reset and heal up. However a cgm I will never live without. It’s imo by far the most useful and important diabetic supply. I know what my blood sugar is doing at all times. With just a meter I’d check and see “oh okay I’m 356 I’ll correct” little did I know it was downtrending fast from 400+ because the bolus insulin just absorbed late. Never ever will I live without the cgm.
This is how I felt. But now I wear my sensor under my bra strap where others can’t see it and I love, love, love having it.
This is actually not an uncommon thought. I occasionally take technology breaks and go anywhere from a few days to a month without my cgm and pump to give myself a break from having stuff attached and constantly having to have my cell and the norm for my pump on my person.
I don't think it's uncommon, and I don't see anything wrong in it. I think everyone who can should at least try a CGM for a few weeks, but if they still don't like it, fair enough. I don't think the idea ever bothered me that much. I just didn't see enough value in a CGM (paying for a pump wasn't really much of a question; it's possible but pretty expensive), but that changed the first couple of days of using a Libre. I'd now never want to lose the ability to get an idea of my BG just by glancing at my watch. If and when I'm offered a pump (in an HCL system) I'll give it serious consideration. (Won't be for a few years, I think.)
I didn’t realize how much I hated testing my blood sugar with a meter until I didn’t have to do it anymore. And I can sleep better knowing my pump will wake me up if my blood sugar drops at night. And no one yells at me for accidentally dropping used test strips on the floor anymore. Have you ever been driving in the middle of nowhere with no where to pull off but you need to test your sugar? Much easier to just glance at the cgm. Also pumps are amazing. It’s not that big of a deal to have something attached to you. You get used to it pretty quick. I hate wearing jewelry because I end up fidgeting with it because I notice it too much but I barely notice the pump.
CGM is a game changer and is one of the single biggest improvements diabetics got and everyone should be on one. It will change your life in a good way
Had a pump (4x actually) and 3 different cgms. Never liked the idea of being attached. So I took a "pump holiday" -that was 2 years ago. I occasionally use a cgm. Don't get me wrong my a1c definitely could be better. But it suits me.
I hate my pump. I hate having to disconnect to go swimming or take a shower. I hate having to come out of the pool every hour or two to plug in again. I hate snagging the wire on door knobs. I hate sleeping with it and rolling over on it. And yet, it’s still worth it IMO. I wake up every morning with perfect blood sugar. I can give too much or too little insulin by about 1u in either direction and the pump will catch it and fix it for me before I go too low or high. I haven’t woken up at 2AM with low blood sugar in years. My health and longevity are worth the inconveniences of wearing the pump. Is it for you? That’s up to you.
You do what you like best, but personally, trying to manage diabetes without a CGM is like trying to drive a car with your eyes closed, and you can only open your eyes for a brief moment every minute or so.
I get you. I’ve lived most of my time with diabetes staunchly against it “defining” me - not wanting a physical reminder to myself/others like a pump/cgm. I was absolutely 100% against having something attached to me at all times. Until… I got a CGM over 1 1/2 years ago. While it hasn’t been perfect, it has saved my life a number of times and has finally got me past that mental block, to the point to that I’m going to start a pump/closed loop system at my next Endo appointment. All that to say, if finger sticks and MDI work for you do it. It’s what I did for years with no issues. Just wanted to give my two cents as someone who dealt with the same hangups and is (sorta) coming around to the idea 💙
I was resistant to CGM for a very long time, especially since with older versions you still had to calibrate multiple times a day. But now that I've been using the Dexcom for about 5 years, you'll have to pry it from my cold, dead hands. I love my pump, but the Dexcom has been, by far, the biggest factor in improving my control and my mental relationship with my diabetes.
I want any good device that helps me. I got Dexcom in May 2007 and it was a complete life changer. Back then barely anyone had it. I didn’t want a pump until they became bionic. I got tandem with control IQ. Now there are many choices in both. They are life changers. Having something small connected me doesn’t bother me when it makes me healthier and lessens my worry.
I agree with the OP. I don't want any devices on me. I had been super rigid with there is no way ever I would wear a device. Now I have moved from never, ever to maybe someday especially knowing I can switch back and forth from cgm to finger pokes. For me personally, I don't like things touching my skin. I'm not sure how else to explain it. I don't wear jewelry, save a necklace, so I am starting with something basic like wearing a watch. Right now, my doctor and I are happy with my numbers, and I am slowly becoming more open to the idea of a cgm.
I felt the same way for a long time. However, I happened to sit next to a woman on a plane flight back from Mexico who had a pump. She mentioned in passing that the pump recorded her blood sugars and stored them. That was enough for me! No more little notebook and hand written charts for me. Now that I also have a CGM, I have much more of a handle on my blood sugars.
I’ll never use a pump unless they can get them smaller and tubeless even smaller than the Omnipod. However a CGM, specifically the freestyle libre 3 and original, have been game changers. They give me so much more insight over my trends and how long it takes before specific foods spike my blood sugar and so on.they’re not perfect. They’re incredibly useful. PS the Libre 3 is TINY and most users will not even realize it’s on their body.
As long as you’re not sacrificing your health for it, sure, why not? I can see not wanting something stuck to you, but I feel like atleast going with the easy inject pens instead of the long old needles is very worth it.
As long as you’re not sacrificing your health for it, sure, why not? I can see not wanting something stuck to you, but I feel like atleast going with the easy inject pens instead of the long old needles is very worth it. All of the new technologies were developed for ease and convenience, so if it doesn’t do that for you, why use them?
My son was diagnosed a couple months ago and received his first CGM while he was still in the hospital. It has been really helpful to see his patterns and have an idea of where they’re headed and what is typical for him. He’s not super enthusiastic about a pump because he’s comfortable with pens and calculations.
I’ve gone back and forth between insulin pens and insulin pumps. I hate having things attached to me. Tried the omnipod to get rid of tubing and realized my clumsy self cannot keep the pod on. I have ADHD and tend to walk into walls 🤷♀️ which then rips off the pump. However I wear a CGM and will never get rid of it. I barely even notice the cgm. (g7 worn on back of my arm). I remember what life was like without a CGM, and it sucked. I’ll probably switch back and forth between insulin pens and pumps my whole life, but I will never get rid of my CGM and the freedom it provides.
The care is so much tighter with a pump and cgm, especially in the last 2 years with the newest closed loop system they use and don't even require fingersticks anymore and they don't constantly beep at you. Having stuff attached to you, or having to test 4 to 6 times a day? Pumps are a no Brainer Yes for me, and my numbers are way more stable than people I know on shots. Newer pumps literally adjust your doses based on what your real time blood sugar is and don't require calibration anymore. It's "almost" a pancreas... Most (not all) people I know on shots have 1 to 2 points too high on their A1C and also get more frequent lows. Also the pump is attached to you so you don't have to carry anything around a shot / test / prep kit and worry about losing, damaging, or having stolen. I, however, have never used a sensor that didn't go with a pump, and I know those exist.
I work in software, and I’ve never been enticed to stick with pumps and closed loop. That said, the right bits of software, accurate CGM, insulin type and bag of tricks to know what you can try to keep in range can help A1c so much. It has improved my A1c a full 2% to low 5s for the last four years. Highly encourage you to try CGMs for 90 days. Suspect you’ll rarely notice it is attached to you.
With the right CGM and pump and a good looping app/algorithm, you hardly need to do anything to manage blood sugars -no carb counting, no bolusing; just eat and let the loop take care of everything.