Medical Encyclopedia
Will my insurance cover the cost of a CGMS?
Depending upon your individual insurance policy most plans will cover the cost of the insulin pump, but many plans still refuse to cover the cost of the CGMS equipment and supplies.
You will need to contact your insurance administrator to see if a CGMS is covered under your plan.
Summary of the types of CGMS available
Summary of the types of CGMS available in the U.S.
Real time systems display results for the user to see and sound alarms when blood sugars are too high or too low.
There are three real-time systems:
-- Two non-integrated, "real time" CGMS available: The Guardian RT and the DexCom STS CGMS; and
-- One integrated real-time system (MiniMed Paradigm REAL-Time System).
There is also one more CGMS, the MiniMed Gold CGMS, which is not a real-time system and is intended for diagnostic purposes as requested by a doctor.
Continuous Glucose Monitoring System (CGMS)
Definition of a Continuous Glucose Monitoring System (CGMS) - medical device that measures and logs blood sugar readings frequently during the day and night. It then averages the blood sugar readings.
MiniMed Paradigm REAL-Time CGMS
The MiniMed Paradigm REAL-Time System is the world's only system to integrate an insulin pump with REAL-Time continuous glucose monitoring.
The MiniMed Paradigm REAL-Time System is a true, integrated CGMS. The system includes a Paradigm Insulin Pump, a MiniLink Transmitter, and a sensor which is inserted into the abdomen.
How does it work?
The MiniLink Transmitter is attached to a small sensor which is inserted under the skin using a cannula. The sensor and Transmitter are placed on the abdomen. The sensor senses blood sugar (glucose) levels every 10 seconds and the readings are sent via a Radio Frequency (RF) wireless pager (the CGMS monitor) to a Paradigm insulin pump. The transmitted data is displayed on the insulin pump every five minutes.
If blood sugar is too low or too high the pump will alert the user. Blood sugar readings are also averaged and can be graphed on the insulin pump so that important trends can be seen. Trends can show the effects insulin, food, exercise, and medications have on blood sugars. The pump can also display trends to show the rate and direction of blood sugar changes (whether blood sugars are going up or down).
The sensors are waterproof (as is the MiniLink Transmitter) and sensors last up to 72 hours when they should be replaced.
The sensor does not administer insulin and a separate cannula must be worn to infuse insulin from an insulin pump or you will need to continue taking shots.
Misconceptions about MiniMed's CGMS Gold
Some key points about the MiniMed Paradigm REAL-Time System include:
- It does not replace the need for finger-prick blood sugar tests.
- It does not administer insulin.
- It is a "real-time" system. That is, the patient can see what readings are being taken as they occur.
- The MiniLink Transmitter is intended to integrate only with specific Paradigm insulin pumps (currently the model 522 and 722).
What the MiniMed Paradigm REAL-Time System can do for you
Like other CGMS devices, the Paradigm REAL-Time System can pick up blood sugar readings during the nighttime when the patient is sleeping. An alarm will sound if the person becomes too low or too high. Since the System can also evaluate how a person's blood sugar reacts to exercise, food, illness, etc .you and your doctor can make more informed decisions about changes in your diabetes care plan to help better control your blood sugar.
With CGMS technology you have to calibrate the system with each sensor change and in some cases daily. It will not do away with finger sticks. The sensors on both the Gold and Guardian RT systems are only good for up to 72 hours. Both devices don’t begin working for about 2.5 hours after set up and must be calibrated (with a finger stick blood sugar check) at 2 hours after insertion, again at 6 hours after insertion and then every 12 hours afterwards.
The FDA warning label on CGMS specifically states not to act (treat lows or take insulin) based on sensor readings but to do a finger stick before acting.
CGMS are valuable tools for learning trends, but they do not replace finger sticks and require you to wear to a separate cannula.
The cost of transmitters, sensors and other CGMS-related items can average as much as $400 per month (in addition to your test strips and insulin pump supplies).
Continuous glucose monitoring is not the same thing as a closed loop system.
A closed loop system, which is not yet available, would deliver insulin automatically based on readings taken by CGMS sensors. This would mimic the normal function of the pancreas by constantly making insulin adjustments based on current blood sugar readings and history of insulin already delivered.