CGM Technology – A Life Changer

February 26, 2013, that’s the day my life as a type-1 diabetic changed forever. Okay, I know it sounds a bit melodramatic, but 38 years after being diagnosed as a “juvenile diabetic” (actually misdiagnosed as suffering from stomach flu by my pediatrician who shortly thereafter died of a heart attack, and then being rushed to hospital by my podiatrist neighbor, glucose level of 1,000mg/dl on arrival!), the ability to know my blood sugar level at any given moment in time is finally becoming a reality. A far cry from 1975 when I urinated on a stick to know how my sugar level was a few hours prior.

After receiving approval for a CGM device from the Maccabi HMO – a process that required me to visit the hospital emergency room twice in a six-month period – I immediately contacted the Israeli agent of Abbott Labs to try out the FreeStyle Navigator; I have been using the FreeStyle family of glucometers for 15 years now (the FreeStyle Lite is my favorite), and am a very satisfied user.

I met Ella, the pleasant & knowledgeable medical associate who works for the Israeli agent of Abbott Labs, Geffen Medical, to hook me up. First she showed me the spanking brand new FreeStyle Navigator II that I will receive, and it looks like this:

In the meanwhile she left me with what the Israeli Abbott Labs agent calls  the FreeStyle Navigator 1.5. I understand that the original Navigator device was discontinued in the U.S. to the chagrin of many users. Here’s my quick take of the 1.5 version:

The Good

1. Sensor and its interstitial plasma cell readings initially seems to be quite accurate. This thing can actually distinguish between all of the sugars, salts, fatty acids, amino acids, coenzymes, hormones, neurotransmitters, and waste that is in these cells.
2. Sensor insertion was pain-free, and I didn’t really feel it under my skin.
3. As a very active exerciser and experimental foodie, the ability to get an accurate reading each and every minutes is absolutely AMAZING & LIBERATING!
4. I can fully program and customize alarms for low/high/rising/dropping blood glucose levels. On the Navigator II you will be able to select a unique audible notification for each event.
5. After three calibrations in day one, it was great to know that I would only have to do a traditional blood glucose test twice over the course of the next four days. The main reason that I chose the Abbott Labs Freestyle Navigator II over the Medtronic Enlite is the fact that the Enlite needs to be calibrated 2-3 times daily, and then the blood sugar levels from my FreeStyle Lite glucometer manually entered into the Paradigm Veo pump.
6. My wife Meirav loved it too. I found her looking at the readings early and often. Those who have suffered from hypoglycemia themselves, or those whose loved ones have insulin reactions, know that people with low blood sugar often behave like jerks, easy to annoy or to be annoyed by. I would use hypoglycemia as an excuse when behaving improperly or inappropriately, which in fact was often the case. But now that blanket excuse is no longer, Same goes for my tennis matches when I am ineffective and playing lousy. My glucose levels can now be found out with a glance at the screen! This will also help avoid the lethargy associated with elevated glucose levels.

The Bad (Less Good)

1. The transmitter on the FreeStyle Navigator 1.5 is rather large and cumbersome for the stomach and upper arm locations approved for use. I am looking forward to the 2.0 version, which is about half the size.
2. Transmission range on the Navigator 1.5 is only 3m/10ft. This simply wasn’t enough for me. And the reconnection was not always automatic, often requiring a manual reconnection taking 70 seconds. The Navigator II offers an extended transmission range of 30m/100ft, and automatic reconnection if you go out of range. When playing tennis, the new version will allow me to leave the receiver on the bench as opposed to in my pocket for real-time updates.
3. On day two, while in the shower, the transmitter disengaged itself and fell on the ground. Granted, there is good water pressure in our jetted shower, but I was surprised that it would disconnect so easily. The sales associate told me that in five years of use her transmitter had only fallen off once, while in a jacuzzi, but my sample fell off twice in four days (see #5 below).
4. On my third day of use the sensor had a panic attack and lost its accuracy. I got numerous low glucose alarms which were not accurate based on how I felt – Navigator CGM indicated sugar levels of around 50mg/dl while the FreeStyle Lite test strips confirmed my feeling, showing levels in the 90-100mg/dl range. After talking to the 24/7 customer service rep and doing some calibration blood tests, the sensor suddenly returned to life and resumed its accurate readings.
5. On day four, while with my wife doing what people do in the bedroom when not sleeping or watching TV, the transmitter fell off again. When I went to reconnect the transmitter after we finished what we were doing, the interstitial sensor had disappeared, Thus my brief trial of the FreeStyle Navigator 1.5 screeched to a premature (self-degrading sexual pun intended) halt .

I’m now in a few-day waiting period before I receive the spanking brand new, hot-on-the-shelf FreeStyle Navigator II. In the very near future I will be doing an unboxing of this device as well as a full written and video review.

What I can say is that once you have a CGM device, you can never go back to pricking your finger eight to ten times a day like I was. I am suffering from CGM withdrawal – these past few days without it have been difficult, though I am comforted by the fact that I will be reconnected later in the week.

More to follow: tomorrow I will share with you how diabetics in the Israeli socialized healthcare system can get approved for a CGM…