- Messages
- 110
- Type of diabetes
- Type 1
- Treatment type
- Insulin
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- Lazy Doctors and Endos
This is a bit of a rant, hopefully you find some useful info in it.
I've been running my complex CGM setup for over a month now, so far it's been an interesting experiment with great results.
I thought I'd share my setup and thoughts and hopefully give you some management ideas and incentive to go CGM.
BG: I've had T1 for 43 years, I'm on MDI with Lantus/Novorapid and reduced carbs.
My GL (glucose level) target is 3.8 - 7.5, here are my current CGM stats with around 40 days of data:-
- readings (in range 8956/high 224/low 276) (94%,2%,2%)
- average GL 5.35
- estimated hba1c: 31 (5%)
My last official hba1c (before starting CGM) was 36.
Dropping by 5 points is a lot at these levels, I think this is purely done by early action on upward trends.
Early action also helps when going low, I don't think I've gone below mid 3s since starting CGM.
My CGM components:-
- Dexcom sensors/transmitter
- wixel bridge (receives signal from transmitter, sends data to phone by bluetooth )
- xDrip android app (receives signal from bridge, full glucose trend UI and settings, replays data to Pebble and nightscout )
- Pebble watch with xDrip watchface (shows current GL and alerts )
- nightscout (CGM in the cloud)
Running day to day:-
- GL alerts
I have GL alert sound and vibration turned off. I rely on alert notifications being sent from xDrip to my Pebble watch, the watch discreetly vibrates and shows current GL.
This is the real advantage of CGM. Early, discreet alerts that prompt me to take action. They run 24/7 and alert me to any movement without disturbing those around me.
Going low I have alerts at 4.5, 4.1, 3.8 & 3.1, going high I have alerts at 6, 6.5, 7, 8, 9.
- Night time running
My phone shows my nightscout web site while charging on my bedside table.
My Pebble watch alerts me to movement without waking my wife, I can easily see my GL trends on nightscout, no more finger pricks in the middle of the night.
I hide my basal pen so I get the right one to give small nudges in the middle of the night.
- Calibration
I've turned calibration alerts off. I do a single calibration once a day when my trend line is dead flat (usually when I wake up in the morning), I will delay calibration if trend isn't flat.
I use the average BGL from both left and right hand, surprisingly they are often quiet different (left always seems to be higher than right??).
I found that my CGM reading are more accurate from a single cal on a flat trend rather than multiple cals on moving trends.
- Bolusing/corrections
Yet another variable in bolus calculation, current GL trend!!! definitely worth +-0.5 unit.
I generally just correct/bolus from CGM reading, I do BGLs if CGM says I'm low/high and I'm not feeling it.
A few thoughts on CGM:-
My use of CGM has been enlightening, from seeing overnight trends for the first time, learning about timing between bolus to food intake, GL effects of protein..., it's all one big learning curve which is still continuing.
I think CGM is the biggest advance in T1 management since insulin. CGM compared to BGM is the same as having a full time video compared to a few point in time photos. I suspect CGM will be the norm in 5 years, especially as costs come down and governments get on board.
To get the most out of CGM, you need to be fully self sufficient and confident in your own ability manage your T1, adjust and calculate your insulin levels and food intake on the fly, without time to get confirmation from your T1 team. I can see that people who are not fully confident or engaged in their self management may become overwhelmed with all the data and struggle to convert the information into positive results.
The early/multiple alerts available from CGM allows you to action changing GLs at the earliest possible time. This leaves FGM(Libre) as a reviewing tool rather than a real time management tool. Well worth the extra couple of $ for a CGM.
I've been running my complex CGM setup for over a month now, so far it's been an interesting experiment with great results.
I thought I'd share my setup and thoughts and hopefully give you some management ideas and incentive to go CGM.
BG: I've had T1 for 43 years, I'm on MDI with Lantus/Novorapid and reduced carbs.
My GL (glucose level) target is 3.8 - 7.5, here are my current CGM stats with around 40 days of data:-
- readings (in range 8956/high 224/low 276) (94%,2%,2%)
- average GL 5.35
- estimated hba1c: 31 (5%)
My last official hba1c (before starting CGM) was 36.
Dropping by 5 points is a lot at these levels, I think this is purely done by early action on upward trends.
Early action also helps when going low, I don't think I've gone below mid 3s since starting CGM.
My CGM components:-
- Dexcom sensors/transmitter
- wixel bridge (receives signal from transmitter, sends data to phone by bluetooth )
- xDrip android app (receives signal from bridge, full glucose trend UI and settings, replays data to Pebble and nightscout )
- Pebble watch with xDrip watchface (shows current GL and alerts )
- nightscout (CGM in the cloud)
Running day to day:-
- GL alerts
I have GL alert sound and vibration turned off. I rely on alert notifications being sent from xDrip to my Pebble watch, the watch discreetly vibrates and shows current GL.
This is the real advantage of CGM. Early, discreet alerts that prompt me to take action. They run 24/7 and alert me to any movement without disturbing those around me.
Going low I have alerts at 4.5, 4.1, 3.8 & 3.1, going high I have alerts at 6, 6.5, 7, 8, 9.
- Night time running
My phone shows my nightscout web site while charging on my bedside table.
My Pebble watch alerts me to movement without waking my wife, I can easily see my GL trends on nightscout, no more finger pricks in the middle of the night.
I hide my basal pen so I get the right one to give small nudges in the middle of the night.
- Calibration
I've turned calibration alerts off. I do a single calibration once a day when my trend line is dead flat (usually when I wake up in the morning), I will delay calibration if trend isn't flat.
I use the average BGL from both left and right hand, surprisingly they are often quiet different (left always seems to be higher than right??).
I found that my CGM reading are more accurate from a single cal on a flat trend rather than multiple cals on moving trends.
- Bolusing/corrections
Yet another variable in bolus calculation, current GL trend!!! definitely worth +-0.5 unit.
I generally just correct/bolus from CGM reading, I do BGLs if CGM says I'm low/high and I'm not feeling it.
A few thoughts on CGM:-
My use of CGM has been enlightening, from seeing overnight trends for the first time, learning about timing between bolus to food intake, GL effects of protein..., it's all one big learning curve which is still continuing.
I think CGM is the biggest advance in T1 management since insulin. CGM compared to BGM is the same as having a full time video compared to a few point in time photos. I suspect CGM will be the norm in 5 years, especially as costs come down and governments get on board.
To get the most out of CGM, you need to be fully self sufficient and confident in your own ability manage your T1, adjust and calculate your insulin levels and food intake on the fly, without time to get confirmation from your T1 team. I can see that people who are not fully confident or engaged in their self management may become overwhelmed with all the data and struggle to convert the information into positive results.
The early/multiple alerts available from CGM allows you to action changing GLs at the earliest possible time. This leaves FGM(Libre) as a reviewing tool rather than a real time management tool. Well worth the extra couple of $ for a CGM.
