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Dexcom g4 readings not matching bg

Diamattic said:
No problem!

Reading your last post and now knowing that she is 2 and recently diagnosed you may be witnessing what is actually going on during the 'honeymoon' period. She likely still has some insulin being produced but in sporadic bursts at strange times. This would cause a lot of flux in her sugars and would probably result in very 'random' looking readings on a CGM due to the lag and frequency of change she is probably experiencing.

I would stick with it, and just fight through the 'random' times. Use it as your doc suggests, and do your best. Over time the honeymoon period should fade and things will become more linear and predictable. You're in a strange time right now with her diabetes.

As for symptoms - she is really young, and the symptoms of a low can be fairly subtle, she may just not know how to describe it yet. As adult the best I can do is 'I feel off' lol until they are into the low 3s then i just feel slightly faint, and have a mild tension headache at the top of my head... I would imagine this would be hard on a 2 year old to notice and describe.

Best of luck - things will get better!
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Thankyou, and yes its hard to no if shes hypo as she shows no signs at all ive tested her and shes been 2.8 and shown mo symptoms ots only when i test her that i find out, hence why i test a lot in the night and its a good job i do as shes always 3.1 or below in the night when i test her but it varies as to what time so i cant do it by time... but thankyou for that

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Hi @ Layah2013

When yr daughter goes to bed, how long after he eve meal bolus is that and also how high are the bg levels before bed? It might be ok to go to bed with higher bg esp as the level falls over night. Also, you say that the pump is on the lowest basal but you can do a TBR if you want to to reduce the basal a bit more or even set some of the basal rates to 0.000 about 3hrs in advance of the first low bg level. There's lots to find out about pumping but remember it's just an insulin delivering device and not something super dooper. Well.....not yet.
 
iHs said:
Hi @ Layah2013

When yr daughter goes to bed, how long after he eve meal bolus is that and also how high are the bg levels before bed? It might be ok to go to bed with higher bg esp as the level falls over night. Also, you say that the pump is on the lowest basal but you can do a TBR if you want to to reduce the basal a bit more or even set some of the basal rates to 0.000 about 3hrs in advance of the first low bg level. There's lots to find out about pumping but remember it's just an insulin delivering device and not something super dooper. Well.....not yet.
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When she goes to bed she is around 14.0 usually as she has her supper at 7pm and i test het around 11pm to give the supper time to be out her system.but i dont correct on that as her dsn said to leave at that so she goes to bed a little higher to see if that helps, but the other night she was 14.2 at midnight and by 1.30 am she was 3.2, she drops really fast, this is why i test through the night as it can happen at any time, and i will ask about her having 0.00 at certain times, i would just like it to get under control a bit more, im doing everything i can in regards to precise carb counting, she has regular set meal times i weigh all her food, its just a whole new life to get used to ..

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@Layah2013 do you have the fall rate alert set to on? If you go into alerts, then advanced, then select fall rate, turn it to on and select level 0.11mmol/L/min - that way if your daughter is dropping quickly (by 0.11 per minute or quicker) it will alarm.

As others have said, set the low alarm to 5 or 5.5, go into alerts, select low alert and tell it you want it to come up - that will move your red line up.
 
Also, if using Aviva teststrips, try pulling them out of the pot from the middle of the strip and not from the top as its easy to contaminate the area of the strip that takes the blood sample and could affect the bg level. With very high bg levels, always best to double check, make sure hands haven't been dried on a towel that have something soapy within the fibres.
 
catapillar said:
@Layah2013 do you have the fall rate alert set to on? If you go into alerts, then advanced, then select fall rate, turn it to on and select level 0.11mmol/L/min - that way if your daughter is dropping quickly (by 0.11 per minute or quicker) it will alarm.

As others have said, set the low alarm to 5 or 5.5, go into alerts, select low alert and tell it you want it to come up - that will move your red line up.
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Thankyou, i have now set it to 5.5, but it has just alerted me at 5.5 but when i tested her finger she was 2.9, so im still not managing to catch it before shes hypo, i guess its because she falls fast, as 1hour before this hypo she was 13.2.. which was after her tea which she had 20g of carbs and she ate it all so not sure why she went hypo..

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Layah2013 said:
Thankyou, i have now set it to 5.5, but it has just alerted me at 5.5 but when i tested her finger she was 2.9, so im still not managing to catch it before shes hypo, i guess its because she falls fast, as 1hour before this hypo she was 13.2.. which was after her tea which she had 20g of carbs and she ate it all so not sure why she went hypo..

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How long before her meal are you blousing and what is your daughter eating?
 
Layah2013 said:
And she has her bolus right before she eats her dinner and tea,

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Yes i do her blood sugar work out her carbs and within 5 mins shes eating it, before she had her tea earlier tho she was 17.5 so did a correction with that and then her meter asked for another test 1 hr later as it does wen she gets a high reading and the next reading 1hr after her tea was the 13 one no correction with that one and an hour later she was 2.6, so not sure if it was the correction that sent her hypo or not

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Layah2013 said:
Yes i do her blood sugar work out her carbs and within 5 mins shes eating it, before she had her tea earlier tho she was 17.5 so did a correction with that and then her meter asked for another test 1 hr later as it does wen she gets a high reading and the next reading 1hr after her tea was the 13 one no correction with that one and an hour later she was 2.6, so not sure if it was the correction that sent her hypo or not

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2.9 sorry

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Layah2013 said:
2.9 sorry

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It's a possibility that the corrections are stacking, causing the low bg.
Has the Insight got the IOB insulin on board function to it? I've found using the Vibe that if my bg is at my target or just above, the insulin calculation equals the bolus for food plus the bg correction and IOB but sometimes the calculation isn't always correct as the IOB isn't always deducted and instead the pump ignores the IOB and the bolus calculated causes a low bg, so sometimes I have to do a bit of adding and subtracting myself. I f bg was lower than bg target, then the IOB is deducted from the bolus and the insulin calculated is correct. If there is a surplus of IOB, then I eat some carb to use it up.
 
I would suspect you need to give her insulin at least 20 mins before she eats, things like coco pops are not very healthy for either a non diabetic or diabetic as laden with sugar.
 
A good low carb substitute to use is a bowl of sugar free jelly with no cream etc or fruit and then see how bg levels go. For getting the basal okish, this is better than coco pops.
 
Hi @Layah2013 I am so sorry you are having this battle, and I hope the feedback is helping.
As you have guessed, the CGM is not a replacement for BG testing, it is simply an aid, but it can be an incredible one! You need to look at is as log of where the BG has been, but more importantly, where it is going. If your daughter goes to bed high, then you can check it every couple of hours and see whether it is rising, dropping or steady. I'm afraid it does mean more broken sleep, but its a 2 second glance at the screen is all that's required. This way, if you see the downward trend, you can pre-empt the hypo, without relying on the alarm. Secondly, if the pump is on the minimum basal, I don't know if it is deemed "best practice", but can reduce it further by setting it to alternate between the minimum and 0 u/hr throughout the night. It sounds like you are giving too much bolus, too close to the food in the evening, so this might be worth investigating? I'd certainly consider a basal test, as that will help immensely.
 
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She doesnt have them every day she mostly has weetabix, rice crispies, cheerios, but does sometimes have them as do the other 3, non of them are over weight or unhealthy and are all very active so i dont mind the odd bowl of coco pops,

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iHs said:
A good low carb substitute to use is a bowl of sugar free jelly with no cream etc or fruit and then see how bg levels go. For getting the basal okish, this is better than coco pops.
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She doesnt like jelly or fruit or i would give her that, she doesnt have them everyday she mostly has weetabix or rice crispies or cheerios, she has always had these from starting solid foods as do the other 3, none are over weight or unhealthy they are all very active, her diatician said she can still eat the things she has before diabetes asling as shes having insulin for this and she told me not to restrict her foods, they all have a cooked meal everday with meat, potatoes, and plenty of veg, so get a varied diet at there ither meals, so i dont restric a bowl of cereal at supper,
CarbsRok said:
I would suspect you need to give her insulin at least 20 mins before she eats, things like coco pops are not very healthy for either a non diabetic or diabetic as laden with sugar.
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@ Layah2013

would yr daughter eat something just low protein based as a bedtime snack? This isn't forever, it's just to allow for the basal rates overnight to be set a bit better....that's all. At the moment you are going round in circles not getting anywhere by the sounds of things.
 
iHs said:
@ Layah2013

would yr daughter eat something just low protein based as a bedtime snack? This isn't forever, it's just to allow for the basal rates overnight to be set a bit better....that's all. At the moment you are going round in circles not getting anywhere by the sounds of things.
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What kind of protein based thing would you suggest, i will try her with anything if she will eat it, its just that her dsn said while shes having the night time hypos to make sure shes having carbs before bed to keep her bg up a bit, but i will give anything a try

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