ICD and CGM - Is it safe

Similar experience this end when sensor placed on left arm near to pacemaker

by Gemita - 2024-06-27 14:15:56

Breezy, my husband has a pacemaker and a CGM (continuous glucose monitor).  I tried to place the sensor disk on his left arm near to his pacemaker initially but it didn’t work, so I had to remove it and to start a new sensor on his right arm.  It mostly works well on this side.  

I rang Abbott Customer Service here in the UK and they replaced the faulty sensor without delay.  They told me that they are currently working on this issue and hoping in the near future to issue guidelines on its use with an implantable cardiac device.

I attach my original post to the Club in case it is of help.  The link should be copied and pasted into your main browser to open:-

https://www.pacemakerclub.com/message/43869/anyone-with-diabetes-and-using-abbott-freestyle-libre-2-continuous-glucose-monitor

I keep all the iPhone App alarms turned off.  I am monitoring all the time with my iPhone, so see no need to use the alarm.  I know what I have to do to keep my husband's glucose levels within range and I am sure you do too.  Our Freestyle Libre info is shared with our health professionals in any event and I am in frequent touch with them should I need to make insulin adjustments.  

I have also spoken to the pacemaker clinic and they have confirmed that no unusual interference/events have occurred since using the Freestyle sensor and they do not expect any difficulties with its use.  

There are many of us with pacemakers and glucose sensors out there who rarely have problems. For legal reasons the manufacturers have to confirm that it has not been tested for use with a pacemaker, but that doesn't mean that it cannot be used "safely" with a pacemaker.  We have been using the Freestyle sensor for quite a while now and glucose levels are accurate when compared with HbA1c periodic blood test results.

CGMs

by piglet22 - 2024-06-28 07:59:06

Firstly, I don't have one, but being pre-diabetic type 2, I do keep an eye on levels at least once a month by finger prick.

I run at between 6 and 7 millimoles glucose per litre of blood. I don't know what your device reads in units of, but 67 is way off the mark.

These continuous monitors have a hard job to do. I don't know the detailed way they work, but there is going to be some pretty complex and delicate processes going on, especially if it's non-invasive. There might be issues with sweat, skin colour etc.

Companies like Abbott Laboratories offer a range of medical devices, and it would be reasonable to expect that any interactions between a CGM and a pacemaker/ICD would be well known and documented. Freestyle is also a well-known devices/sensor company.

CGMs use something like Bluetooth to communicate. Some pacemakers and ICDs the same, but not all.

My Medtronics PM doesn't have Bluetooth so no possibility of data being corrupted. Bluetooth data is highly encrypted, but I would be wary of very close contact between any critical device and something else transmitting on the same frequency (2.4-GHz).

Having a CGM and a pacemaker or ICD is quite an achievement.

On balance, I would say the risks are small and acceptable. Fliers like 67 if we are on the millimole scale, would definitely knock my confidence in the CGM rather than the ICD. I’m sure it’s a one off and much research would have been done to make sure it’s reliable and accurate.

Quite rightly, I would not want to experiment either. I can see some advantage, where possible, to have devices from the same company in the hope that departments talk to each other.

Good luck

Need for CGM with Type 2 Diabetes

by Old male - 2024-06-29 22:52:42

Have lived with Type 2 diabetes for last 26 years and take oral medications.  I can imagine why one with Type 1 diabetes might want to closely monitor.  Is this device now recommended for Type 2 also or just for the curious?

Old Male

by Gemita - 2024-06-30 05:05:20

My husband has type 2 diabetes which is proving difficult to manage because of his complex health problems.  Our diabetic specialist nurse recommended that we get a prescription for a continuous glucose monitor (thanks to our National Health Service this was approved) which would give her more information about his sudden highs and lows before, during and after meals.  The monitor allows her to "safely" increase his insulin levels which he is needing several times a day.  Through the monitor which is linked to her clinic, she is able to see daily trends and to watch us more closely.  It also saves me from having to do so many finger pricks which were starting to cause pain.

I would say it is useful/recommended for both type 1 and type 2, although it is mainly recommended for those who have to do frequent blood glucose checks to remain safe or for those patients whose insulin levels are volatile/difficult to control unless insulin is given frequently.  

Guidelines for prescribing the continuous glucose monitor will be different depending where we live.  Frequent checks in the UK is usually more than around 6 times a day to qualify I was told, or based on symptoms like spikes/falls in glucose levels that may be difficult to control requiring higher levels of monitoring/more in the way of daily insulin injections.  

I attach a link from Diabetes UK for guidance for UK members but might be helpful Old Male to answer your questions:

https://www.diabetes.org.uk/guide-to-diabetes/diabetes-technology/cgm-flash-pump-who-qualifies-on-nhs

Old Male

by piglet22 - 2024-06-30 08:29:11

Personally, I think we all need to monitor our own health more closely and not rely on infrequent visits to GPs or more often than not, a healthcare assistant or a paramedic.

Surgery visits can be stressful enough and can certainly push up blood pressure.

Where home monitoring scores is that it's more like real life and enables you to see or not how different things affect you.

I'm a firm believer in BP, heartrate, blood glucose, oxygen and temperature readings and recording.

Maybe it's because I'm a scientist and live by data. Without data, it's just guesswork.