If I were the parent of a child with diabetes, my opinions about the new-to-the-market and highly praised Medtronic MySentry CGM monitoring device might be different.
But I'm not a CWD parent. No, I'm an adult living with type 1 diabetes.
And from that perspective, despite all the benefits of this device I see, it's just not for me. I see more cons and downsides to it than benefits and that's why I can't say it's worth the extraordinarily high cost (originally to the mind-blowing tune of $3,000!) that Medtronic is charging.
Really, it doesn't offer me much more peace of mind than my current continuous glucose monitor (CGM) does.
This wasn't my original stance, though. It's actually quite the opposite of what I envisioned thinking about the MySentry when I first decided to use it.
Several months ago after attending the Medtronic Diabetes Advocates Forum, I decided to take the company up on their offer of a three-month trial run of the Paradigm723 Revel insulin pump and the MySentry device. Approved by the FDA in January after about four years of talk and anxious waiting by the Diabetes Community, the MySentry is essentially like a CGM-connected alarm clock that has a monitor displaying real-time CGM sensor data. Through an "outpost" gadget that can be placed up to 50 feet away, it shows predictive alarms for both BG extremes and is marketed as providing some peace for nighttime sleeping without worry of dangerous low blood sugars, "just a glance away."
My trial run started in mid-June.
Personally, I thought it might draw me out from a deep sleep and alert me to encroaching low blood sugars -- that it could change my life in that sense by giving me another layer of security while sleeping.
My Loving and Supporting Spouse wasn't convinced, though. She disagreed and dubbed it basically just a "glorified alarm clock" version of the CGM that I already have and use. Although it may make a noise that's louder and more noticeable than the little oval-shaped Dexcom or even the Medtronic CGM-pump Paradigm combo that I'd used before, she thought it'd be too easy to silence and ultimately wouldn't stop me from hitting "snooze" and ignoring it.
She just wasn't convinced that this thing was Big for those of us married adult PWDs who sleep in the same bed with partners and already have each other as a layer of security in case of sneaky lows.
As it turns out, and I hope she reads this line: My wife was right, and I was wrong.
The practical Cons outweigh the Pros, we believe.
- Yes, the alarms are loud enough. They wake you up when all you want to be doing is sleeping and dreaming, and unlike the not-loud-enough alarms of the small portable CGMs that you can place under a pillow to quiet, the MySentry is un-ignorable; it motivates you to wake up and look at it.
- Thanks to the alert sound, the MySentry did catch some low blood sugars that might have had a negative impact on my night-time and early morning sleep routine. And it may have led to my wife being forced to kick into gear to grab some juice for me.
- With its user-friendly screen, the MySentry is easy to read and understand when you look over at it bleary-eyed in the night-time sleepy hours.
- Yes, the MySentry caught some lows. But there was an even larger number of alerts and annoyances that came when the device couldn't see past the existing CGM sensor inaccuracy and tried to scare me into thinking I was low, when really I wasn't. This is a fault of the core CGM technology of course, but at least with that device I don't have to worry about it alerting the whole dang house that something is wrong when it isn't. (It's a little ironic I'm dissing a device for doing what I wanted it to do in the first place...)
- The MySentry does have volume control and a dimmer function, but the thing is still too darn bright in a dark room at night! Peace of mind to let you sleep? Um, that's assuming you're not being kept awake by the bright beacon light next to your head. (As if glancing at that kind of electronic device light from smartphones isn't already sleep-disrupting enough...) Yes, you can put a washcloth or towel over it and even face it down on the nightstand... but that just seems to defeat the whole purpose of the device. I guess the alarm will still blare and wake me up if there's an impending hypo, and I can just lift the cloth to see the screen as needed... but I shouldn't have to do that. It'd be great if there was some option to completely blackout the screen between alarms for smoother night-time snoozing.
- There's no off switch. So, when you walk out of the room for awhile and forget to silence it — and you don't want to take the outpost along — the MySentry screams for you to return. Oh, and even if you try to unplug it into silence, it still wails out as if you're too stupid to realize you had unplugged it from the wall. I get that this is some sort of safety feature, but seriously?! Please, Medtronic: Don't insult my intelligence and assume I can't use my brain to logically and safely use an off switch. The "privacy screen" option you offer is nice so that we can conceal the BG results if we want to, but it's not adequate if we want to escape this device entirely based on our own free will. I really don't think unplugging it is good enough, and I swear I still hear it wailing even when unplugged...
My wife's opinion is succinct: She says, "It serves no purpose for us."
One morning, I made the comment after glancing at the MySentry: "Boy, that is really nice to look at in seeing your results overnight."
Her response: "It shows you the same thing as the pump-CGM screen does, except it's bigger and in color."
Yep, so very true. Maybe this was a confirmation of the longtime belief that Medtronic's insulin pump-CGM display could be more 21st century, like any smartphone screen is these days. (Hint, hint!)
What about the fact that it allows her to "see how my day went overnight" as far as blood sugar numbers? Um, if she wants to know, she asks and I tell her or show her my CGM. But typically, this doesn't dominate our discussions and when it's worth chatting about, I bring it up. We communicate openly and easily on these issues; that's just how our marriage works. If people have trouble communicating about diabetes, I'm not sure the PWD in the partnership would want to show off their number graphs anyway.
Being that I work from home now, I lost track of the times that I was going about my business in the home office when suddenly the MySentry in the other room started blaring an alert that it wasn't able to find the pump connection and I'd forgotten to silence the alert after getting out of bed that morning. Yes, I can use the outpost but I'd rather not plug and unplug this wall device every time I move rooms. This also presented problems at night, since I often go to bed later than my wife and the MySentry would annoy her if it wasn't silenced when I was out of the room. Again, there's no reason to tote the outpost around since the whole reason I was using this was for night-time blood sugar tracking.
And then there's just all the other cons that can be found, like the cost (WTF, Medtronic?) and CGM accuracy issues that we just can't — or shouldn't — overlook.
This MySentry trial run actually taught me something else about my preferences on CGM use: I don't like it most of the time. Especially when it comes to the Medtronic CGM, which has what many of us not-so-fondly refer to as "the harpoon," a shell-shaped sensor that's not too comfortable to insert or wear. I didn't use the MySentry for the full 90 days because, honestly, I couldn't stomach being connected that long consistently to the Med-T CGM. I needed breaks from it.
We've been hearing about the new and improved Enlite sensor that Medtronic has on the horizon for a long time. It's supposed to be smaller, more accurate and comfortable. But they just submitted it for FDA approval in June (!), so it's got a long way to go before coming to market.
The bottom line is that the current system that uses both the existing CGM sensor and MySentry device just isn't good enough. If the CGM sensor is off, which happens way too often, then the MySentry showing you the BG results does you no good. You're not low, despite what the alarm clock says. But the MySentry screams at you until you have to get up and do a fingerstick check of your sugars anyway — forcing you to do the very thing you were hoping the device would help you avoid in the first place. That's not peace of mind, in my opinion.
Yes, maybe things will be better down the road. I'm sure they will. But this is the here and now, and at this moment the MySentry is simply as strong or weak as the current CGM sensor allowed in these United States. After all, it's just a viewer for a flawed system in its current form.
Medtronic, I'd really like you to lower the cost and fine-tune the override functions the MySentry offers. I can't take seriously claims that it's a "safety function" that you can't turn it off or have some "black out option" for those who want it. We PWDs manage our diabetes day in and day out, and so I don't think it's too much to ask that you acknowledge that we can and will use a device responsibly based on our own preferences.
Sure, I have been using a 723 Paradigm Revel pump that connects with the MySentry. I own and typically use a 722, which doesn't have the predictive alarms but would be easy enough to upgrade to a newer version if I really wanted to. But I don't. The old pump and my Dex CGM that have been gathering dust for a few months will soon be back connected and I'm happy enough with what works.
Not everyone probably agrees with this review, I'm sure, as we can see from other reviews out there in the diabetes online universe. This is just one couple's opinion, not to say anything about the parents or single adult PWDs who might see all kinds of benefits that we just don't. And maybe other married adult PWDs see the pros outweighing the cons, too... again, we just don't. I'd rather rely on my little oval Dexcom and my wife's keen CGM-like senses that alert me to low blood sugars during the night. I just have more confidence in that. And it's less cumbersome.
To us, the MySentry isn't a big win. But bravo to the company for making this available for those who do want it and are willing to pay.
Disclosure: Medtronic provided me with a 723 Revel pump, the MySentry system, and all the pump supplies and CGM sensors that I needed during my trial run. They didn't ask us to write anything, but likely assumed we would, as that's how we roll.