constant glucose monitoring

[susan j]

Hi I am having real problems with hyperglycemia, I am a consequential diabetic using glargine x2 a day and novo rapid when eating and currently constantly correcting! I believe my lack of control is due to steroids that I have been taking for the past 2 months. Testing my BM at least 10 times per day and sticking to a food plan diary is helping but the results are still not great. (unexpected high BM readings) I am desperately trying to get my sugar levels back under control. Could anyone recommend a constant glucose monitoring system that I believe may help me. I have never used such a device but feel it would be helpful with my current issues. If you use or have successfully used a CGM please recommend. . (the steroids are for life so its not a short term fix ) Thanks in advance

 

[novorapidboi26]

What is a consequential diabetic? No heard that before

I have heard that steroids can increase your insulin requirement, specifically your basal requirements..........

So it might be worth doing some testing with the view to increasing your glargine doses..........

How do you feel a CGM could help you...........?

My understanding is that it could show you your BG profile throughout the day, show you patterns overnight..........allow you to adjust your insulin doses........but in the long term I cant see it doing much.........

Whats your thoughts...........?

I haven't personally used a CGM myself so thoughts from real users would be good....

 

[susan j]

What is a consequential diabetic? No heard that before

I have heard that steroids can increase your insulin requirement, specifically your basal requirements..........

So it might be worth doing some testing with the view to increasing your glargine doses..........

How do you feel a CGM could help you...........?

My understanding is that it could show you your BG profile throughout the day, show you patterns overnight..........allow you to adjust your insulin doses........but in the long term I cant see it doing much.........

Whats your thoughts...........?

I haven't personally used a CGM myself so thoughts from real users would be good....

Thanks for the response.
I had my whole pancreas removed over 10 years ago which made me an instant diabetic, I got the term consequential from my surgeon..
i am struggling with constantly high BMs however I am also having a hypo around 5pm daily..
I have increased my basal and am still upping it daily. I am taking over twice the amount of novorapid I used to and still have high levels most of the time...
this morning 15.4 not good...
I feel a CGM would show me the responses and response times that the novo rapid takes to act etc. I am testing with test strips soooo often and I think I am always wondering ok the reading is x is that steady or going up or down... I would like to see the whole picture 'eat food, take insulin... see the results over the next couple of hours... I feel that if i have this information I can adjust accordingly with better understanding of reactions. Anyone using a CGM I would value your input. thanks

 

[novorapidboi26]

I agree, a CGM would be really good to get the whole picture, but in the mean time you can still get good info just from testing..........

I think you need to ascertain your basal needs first though, carb free testing should tell you whats going on..........if you can pin this down more accurately, you will likely have a smaller, more accurate novorapid dose to deal with the carbs your taking.....

what basal insulin are you on if you don't mind me asking.........twice a day yeah?

 

[susan j]

I agree, a CGM would be really good to get the whole picture, but in the mean time you can still get good info just from testing..........

I think you need to ascertain your basal needs first though, carb free testing should tell you whats going on..........if you can pin this down more accurately, you will likely have a smaller, more accurate novorapid dose to deal with the carbs your taking.....

what basal insulin are you on if you don't mind me asking.........twice a day yeah?

I am on Lantus -solostar optiset - I was taking 30 units at 10pm daily now I'm taking 18 units at 10pm and 18 units at 10am. When you say carb free testing this is something in my 11 years as a diabetic I have never done. I'm guessing you eat no carbs? take no novorapid? This sounds interesting. Can you advise further please?

 

[Ambersilva]

I am on Lantus -solostar optiset - I was taking 30 units at 10pm daily now I'm taking 18 units at 10pm and 18 units at 10am. When you say carb free testing this is something in my 11 years as a diabetic I have never done. I'm guessing you eat no carbs? take no novorapid? This sounds interesting. Can you advise further please?

Hello Susan,

I have a Dexcom G4. It is very useful for showing trends and, in particular, what is happening when you are asleep. You still need to callibrate with readings from your meter twice a day supposedly to keep it accurate. However if the CGM is showing unexpected high or low readings it is best to confirm with a finger prick reading before making a correctiive action.

When you are eating what you consider to be a 'no carb' meal you may still need to inject Novorapid to cover the meal. For example I still need to inject about three units of quick acting insulin when I have a generous helping of fried bacon egg and mushrooms. Perhaps other Type 1s can get away without the QA insulin if they are very active and remembering that they have 24 hour insulin acting in the background all the time.

I inject approx 14 units of Lantus once a day. I did try splitting the dose but that method did not work for me.

 

[novorapidboi26]

I am on Lantus -solostar optiset - I was taking 30 units at 10pm daily now I'm taking 18 units at 10pm and 18 units at 10am. When you say carb free testing this is something in my 11 years as a diabetic I have never done. I'm guessing you eat no carbs? take no novorapid? This sounds interesting. Can you advise further please?

Carb free just refers to a period of basal testing, so yeah, you would pick a time to test.............easier starting with overnight, have no carbs 4-5 hours before the test, and therefore no novorapid............a test before bed and at waking should tell you whats happening overnight in terms of your Lantus dose.....if you feel up to it, you can set alarms so you can get more results overnight, every 2 hours for example.....

if your BG rise overnight this would suggest you need to increase your dose....and vice versa, if you go low, assume you need to decrease.........a repeat of the test is wise just to confirm, before you make any adjustments...

once your happy any adjustment you have made are correct and holding your BG steady, you can move on to the waking part of the day, have a carb free breakfast Monday, carb free Lunch Tuesday and a carb free Dinner Wednesday, see whats happening with your Lantus over those parts of the day...........you may find you rise over breakfast and drop from lunch, unfortunately you cant cater for each of those time of the days independently with only one injection, but you can make an educated decision on what you need to do to the dose...

Injecting for a no carb meal like eggs, bacon etc is sometimes required for some people, but for the majority of people this is not required, so I would assume you don't need any insulin for fats and proteins at this stage....your Lantus will deal with any of the glucose produced by those foods....

 

[Charles Robin]

You're probably already aware of this, but a CGM is a big financial commitment. They are not generally available on the NHS, and cost a number of thousand pounds a year to run. I'm hoping one day they will be much more readily available though. They are still relatively in their infancy, and with some luck the costs will come down to a level the NHS can stomach in years to come.

 

[gfmoore]

Yeah, it's a joke. I mean what do they use in these things, diamonds and rubies?

They are all in a similar price range, so I suspect cartel type action and especially in America (where I guess? most of them are made) they can get the insurance companies to cough up. I bet my mobile phone contains more electronics.

There is such a huge market for someone to come up with a non-invasive constant glucose monitor. I know there are several designs around and one under test somewhere in the UK (I forget where). Let's hope someone makes a breakthrough and then they'll make a mint. (Kickstarter anyone?)

Similar argument for test strips - it's a world wide rip off.

 

[Ambersilva]

Yeah, it's a joke. I mean what do they use in these things, diamonds and rubies?

When mine expires I must remember to take it to pieces to search for the diamonds. I'm not bothered about the rubies.

I am taking a break form wearing my CGM sensors at the moment. I have learnt a lot about how my body reacts to certain foods. My last sensor continued giving good readings for 67 days. I finally removed it when the results were well out compared to my meter readings.

 

[iHs]

Yeah, it's a joke. I mean what do they use in these things, diamonds and rubies?

They are all in a similar price range, so I suspect cartel type action and especially in America (where I guess? most of them are made) they can get the insurance companies to cough up. I bet my mobile phone contains more electronics.

There is such a huge market for someone to come up with a non-invasive constant glucose monitor. I know there are several designs around and one under test somewhere in the UK (I forget where). Let's hope someone makes a breakthrough and then they'll make a mint. (Kickstarter anyone?)

Similar argument for test strips - it's a world wide rip off.

What's driving the cost of cgm to be so high is demand and lack of competition. Once more companies start to produce cgm, the increase in competition will start to make them cheaper. A bit like mobile phones and lcd tv.....

Sent from the Diabetes Forum App

 

[susan j]

Carb free just refers to a period of basal testing, so yeah, you would pick a time to test.............easier starting with overnight, have no carbs 4-5 hours before the test, and therefore no novorapid............a test before bed and at waking should tell you whats happening overnight in terms of your Lantus dose.....if you feel up to it, you can set alarms so you can get more results overnight, every 2 hours for example.....

if your BG rise overnight this would suggest you need to increase your dose....and vice versa, if you go low, assume you need to decrease.........a repeat of the test is wise just to confirm, before you make any adjustments...

once your happy any adjustment you have made are correct and holding your BG steady, you can move on to the waking part of the day, have a carb free breakfast Monday, carb free Lunch Tuesday and a carb free Dinner Wednesday, see whats happening with your Lantus over those parts of the day...........you may find you rise over breakfast and drop from lunch, unfortunately you cant cater for each of those time of the days independently with only one injection, but you can make an educated decision on what you need to do to the dose...

Injecting for a no carb meal like eggs, bacon etc is sometimes required for some people, but for the majority of people this is not required, so I would assume you don't need any insulin for fats and proteins at this stage....your Lantus will deal with any of the glucose produced by those foods....

Thanks for the advice, I have started already with a no carb lunch.. (lowest mid day BM results in months) currently 6.2 I will keep monitoring until Dinner this evening..

 

[susan j]

Hi

Yeah, it's a joke. I mean what do they use in these things, diamonds and rubies?

They are all in a similar price range, so I suspect cartel type action and especially in America (where I guess? most of them are made) they can get the insurance companies to cough up. I bet my mobile phone contains more electronics.

There is such a huge market for someone to come up with a non-invasive constant glucose monitor. I know there are several designs around and one under test somewhere in the UK (I forget where). Let's hope someone makes a breakthrough and then they'll make a mint. (Kickstarter anyone?)

Similar argument for test strips - it's a world wide rip off.

When mine expires I must remember to take it to pieces to search for the diamonds. I'm not bothered about the rubies.

I am taking a break form wearing my CGM sensors at the moment. I have learnt a lot about how my body reacts to certain foods. My last sensor continued giving good readings for 67 days. I finally removed it when the results were well out compared to my meter readings.

When mine expires I must remember to take it to pieces to search for the diamonds. I'm not bothered about the rubies.

I am taking a break form wearing my CGM sensors at the moment. I have learnt a lot about how my body reacts to certain foods. My last sensor continued giving good readings for 67 days. I finally removed it when the results were well out compared to my meter readings.

While your taking a break from using your CGM would you like to rent it out ..... Only joking but it would be a good thing if you could hire these machines short term...

 

[Ambersilva]

Hi

While your taking a break from using your CGM would you like to rent it out ..... Only joking but it would be a good thing if you could hire these machines short term...

Nope, because I know you wouldn't want to give it back!

 

[susan j]

Nope, because I know you wouldn't want to give it back!

Hi Amber that pretty much tells me what I need to know.. it must be beneficial and good aid as you don't want to part with it.
Can I ask how many days on average do you get from a sensor? I am assuming 67 was a rare thing.

 

[Ambersilva]

Hi Amber that pretty much tells me what I need to know.. it must be beneficial and good aid as you don't want to part with it.
Can I ask how many days on average do you get from a sensor? I am assuming 67 was a rare thing.

The first lasted 18 days
The second 34 days
The third 38 days but I accidently pulled it off
The fourth 67 days. I kept it on for 69 days and it was still giving results and showed trends but they were obviously not accurate as they differed substantially to my meter results.