Type 1's not using a cgm

Any T1’s not using a cgm? It seems like many do from reading posts. I’m 53, diagnosed 7 mos ago. I tried Dexcom for a couple weeks and while I can see the convenience factor, it feels extreme to have a device stuck to my body 24/7. I don’t mind finger sticks and I prefer to be working with the most accurate data, especially as I’m still in a learning phase. I may feel different down the road. From my experience to date, blood sugar is pretty stable if doing all the right things.

Hi @Kerio i did close to 20 years without using a CGM so I have tons of experience with just using finger sticks. Of course at the beginning of those years there was no such thing as a CGM and most of the way through after that the early CGM were so bad I was better off without them. You can certainly have decent control and plenty of data if you are testing about 7-10 times a day. Type 1 for a lot of us requires watching blood sugar trends (noticing blood sugar rising or falling) so that treatment considerations can be made. Others lose their sense of hypoglycemia and so the CGM represents a low level alarm system for overnights. Anyway, if you are doing something, and it’s working, then keep doing it. Good luck.

Thanks so much for the information @joe, very helpful!

I know of two T1Ds who don’t use a CGM. Both complained that they kept failing, and I think one found the alerts and the constant data overwhelming.

I love my CGM for the convenience, but I can understand the hesitancy about the inaccuracies- I’ve had several bad lemon cgms that just don’t work. My dex is mainly helpful for me since I don’t feel my low blood sugars. I was shopping with a friend yesterday and my BG dropped to 52. I didn’t feel a thing. My dex caught it for me.

Hi @Kerio. I understand your feelings about being connected to something: My doctor first started suggesting I switch to an insulin pump about two years before I actually did: initially the idea of being attached to something 24/7 (and with a tube, no less!) didn’t appeal to me; but gradually I started reconsidering: eventually changed my mind, and I’ve never looked back.
As far as accuracy, here is a quote from Dexcom about their device (italics are mine):

“The test your doctor does is considered a more accurate glucose number than any products you use at home. Both meters and Dexcom G6 are compared to that doctor’s test to measure accuracy in clinical studies. They aren’t compared to each other. Because of this, the Dexcom G6 reading (G6 reading) and meter value are unlikely to be exactly the same number, but they should be close. Compare the meter and your Dexcom G6 to see how closely the numbers match each other: if your G6 reading and meter value are within what we call the 20 rule (also known as the %20/20 rule), they match closely.”

CGMs measure from interstitial fluid, while BG meters measure in the blood - this causes a slight variance in the numbers so they will rarely match 100% (although mine have on a few occasions!). And we CGM users don’t give up fingersticks entirely - we can and do use them if what we feel does not match the CGM read, or if our CGM sensor tends to give false lows during the first 24 hours, which happens for some people. That said, we are encouraged to otherwise set aside the fingersticks and learn to rely on the CGM. The value of trend information and notifications off pending lows and highs cannot be overstated.
I was diagnosed in 1963 and home BG meters were introduced sometime around the time I finished college. They’ve been on the market for so long we come to see them as “the” standard for measurement. But even testing 7-10 times a day will not show trends - “What happens when I eat pasta - or steak?” “How does yoga affect my numbers?” “I’m feeling funny during my spin class - do I need to stop for a snack, or am I just dehydrated? Do I need to adjust something before class next time?” You could certainly stop to test (which might involve stepping away to be discrete), but a glance at your receiver would give you the answer in a moment.
One key to adapting to a CGM is - resist the urge to look at it too much! New users may look every 5 or 10 minutes or so to see what’s going on, and want to take immediate action if they see :small_red_triangle_down:or :small_red_triangle:, when it may not be necessary. .
I am obviously “pro-CGM but it is a personal choice. As the saying goes, if it’s not broke, don’t fix it”; and if you are able to sense hypos and prefer not to wear a CGM, carry on with fingersticks if that’s what you prefer. If that ever changes you might want to reconsider as it could become a game changer, particularly for times you’re alone. I eventually changed my mind and selected a pump. I was pleasantly surprised that the tubing didn’t bother me, although now I’ve switched to the tubeless Omnipod. Sometime after getting my first pump I started on a CGM as well. I’ve learned to trust it and haven’t looked back. I do keep a meter and strips in case I need to double-check something or calibrate, but I rarely use them.
Part of not wanting to switch may be mental: “I don’t want to have to rely on a connected device to tell me what’s going on” - for some that feels like a personal failure and it’s something they may need to adapt to. Another reason may be great of discomfort, or not wanting others to see you with one. When I place my Dexcom I truly forget it’s there - sometimes I forget where I’ve put it and have to tell around for it! And you can be as discrete or open as you like. I often wear mine on my my arm even with short sleeves on - people don’t seem to notice or care. On the other hand, the abdomen and other locations can be good “hidden places.”

Keri @Kerio, to answer your question “are there any” very directly, I’ll answer with a very resounding “YES!”. And there are many reasons that there are [still] many people living with T1D who do not use a CGM given that a “reliable” glucose sensor has only very recently [8 years] been available.

Like you, there are others who prefer to rely on the conceivably less accurate fingerstick BG method rather than a good CGM, but for me, my reason extends well beyond “convenience”. That said, being able to know a ballpark glucose level on any day is a huge step forward for managing my diabetes. My diabetes dates from the time [1950s] when a blood sugar test, available only at a hospital outpatient facility, took a couple of days and cost a day’s wage.

Thank you Lise, helpful info!

Thank you for all of info @wadawabbit and sharing your experiences and insights, much appreciated! I understand the variance w/the cgm and did my own testing against finger sticks. I’m not concerned with what anyone thinks so that’s not a consideration in my decision. I did find the trend info helpful, as Joe also mentioned. I’m very active and while it would be helpful to put a cgm for a run or long bike ride, I’ve learned the actions to take to keep #'s stable during and after.

Thank you @Dennis appreciate it! Very helpful to hear your perspective, especially considering your length of time w/the condition.

Dexcom’s CGM is probably more well known but another one to look at if you’re interested in checking out a CGM a is the Freestyle Libre. For those who don’t need to loop their CGM with their pump, this can be a (I think) less expensive, simpler alternative, and could be at the very least a good starter to try if you think you might be interested.

Thanks @wadawabbit I had tried the Dexcom.

I’ve been T1 for over 50 years myself, and was resistant to using a CGM or pump as long as they’ve been available. Just like you, I didn’t think I would do well with something attached to me 24/7. But about a year ago, I had a routine visit with my endo and he pushed me again on getting a CGM. It was a conversation we had had many times over many years, but that visit he told me about the Freestyle Libre 3, which was fairly new on the market at that time. So I read up on the L3, and decided to give it a try. I have not looked back - I’ve been using the L3 for just over a year now and it has changed my perspective. I will admit that I was wrong about my concerns for having something stuck in me 24/7, as it has been very non-invasive in my life and wearing it has been a very different experience than what I thought it would be. I greatly appreciate the safety margin that the CGM provides, which is something I never had with fingersticks.

Thanks for sharing your perspective @JTR19 very helpful!! I appreciate it.

I’ve used a CGM (either Dexcom or Medtronic) for the last 7 years. After watching numerous endos talk about BG accuracy and cgms. I discovered that the meter may not be as accurate as you think. So, I don’t get that focused on that. Large discrepancies get my attention. I will say that most of the time, my Medtronic cgm and blood meter are very close.

Peace of mind and safety attracted me to the cgm. It alerts me I’m going low, before I’m low. That’s huge. I think if you have a couple of bad lows, it gets your attention. I’ve always been able to function and treat myself, but ……When I got on a pump, it only took a couple of weeks to get used to being hooked up. Eventually, it’s a source of comfort.

In making a decision, I’d watch some speakers address it, Taking Control Of Your Diabetes (TCOYD) has some wonderful videos in their online vault. Their live seminars are awesome too! You can browse and find something of interests.

Kerio- I am totally with you! I have had T1D for 32 years and at the start, there was no CGM. I have maintained a A1C of 7.2-7.6 on finger sticks. I ran several marathons, had a baby, trekked in the wilderness, and lived life without all the technology. I tried CGM with my Minimed 670G and it was a disaster (putting it mildly). The CGM was incorrect more than it was correct and it would automatically adjust my pump! Totally unsafe and I still don’t understand how FDA thought that was okay for us (different story). Lately, I tried a Dexcom CGM and the information was so helpful. I agree that having this on me 24/7 was absolutely overwhelming. I try to manage my expectations. I have learned that timing of my bolus makes a big difference and I am able to keep my BG closer to goal. However, I do not let it run my life. I can’t be someone who micromanages my BG. You might try using the CGM for a month and then taking a break. See if you still feel the same way. Make your own management plan that fits your style and expectations.

Thank you @Catham very helpful, especially considering your activity level (I’m very active). I can see diabetes is very manageable so I think it’s just a matter of determining which tools are best suited to the individual. I’ll probably try the Dexcom again at some point. Appreciate hearing your perspective and the advice.

Hi - I’m a T1, 65 years since diagnosis, now 77. I have never used a CGM. I also feel as you do about not wanting something stuck to my body. I also start everyday in my hot tub spa; something I wouldn’t be able to do with a CGM. I am well controlled and in excellent health, considering the length of my disease. Good luck to you.

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Hi @ebaird11 I’m glad what you are doing is working for you - that’s awesome! For the record, you can absolutely use a CGM in a spa, hot tub, sauna, jacuzzi, even a steam room! Cheers!