dexcom g5 advice

[justadad]

Hi,

I am a father of a 10 y.o. boy who was recently diagnosed with type 1.
Still trying to figure out many things, especially why his BG tends to be low during the night, or early in the morning.
It is too early to see his endocrinologist, as they've scheduled our visit late February.
I am now trying to see what options I have to monitor his BG better during the night. I believe my insurance can pay for a Dexcom G5, and I would appreciate if any parents would recommend the g5. I welcome any hints, tips, explanations, anything that you feel you can share.
And just a couple of specific questions:
- Can the g5 work with an insulin pump?
- Do you know if the g5 can be shipped abroad? I am not a UK resident.

 

[azure]

Hi @justadad I believe @mcpound uses the Dexcom, and @Ellie's mum possibly too.

Does your son already have a pump? If not, the Animas Vibe pump supports Dexcom (but G4).

The lows during the night are most likely due to a basal insulin issue. Are they at regular times? What basal does he take and when?

(I don't use Dexcom so can't answer your other question)

 

[justadad]

Hi @azure and thanks for your post. No pump yet, but hopefully one day soon. I am still unsure how the pump and the cgms integrate, if they do integrate at all.
I suppose that his lows are due to his levemir dose. At ten years of age he weighs 32kg and takes 4 units of novorapid around 8 in the morning, 5 units of novorapid between 1-2 pm, 5 units of novorapid between 7-8 in the evening and 7 units of levemir at bedtime, or between 10.30 - 11.00 pm. He eats just after he gets his dose of novorapid and usually has a snack before bedtime. Yesterday he skipped bedtime snack, and he reached the lows. Has been rather low throughout the day, with 3.2, at 3 a.m. 3.6 in the morning before breakfast, 4.2 at lunch, dropping at 3.0 couple of hours after lunch, after a generous size of lentil soup and some lamb. He had some chocolate to bring his sugars up a bit.
I think this must be his levemir dose being too strong,

 

[azure]

@justadad I've never used Levemir but I know many people split the dose and have it morning and evening. This allows for adjustments to one dose at a time, and can give better coverage.

Is he on fixed doses of Novorapid then? Does he also have fixed amounts of carbs that he has to eat for each meal?

Regarding pumps, I have an Animas Vibe but don't have the associated Dexcom CGM (because I'd have to pay for it and can't currently afford it) but if I did have it, my pump screen would show my CGM info too.

 

[Ellie's mum]

Hi. Sorry I can't give any advice, we use the libre

 

[justadad]

@justadad I've never used Levemir but I know many people split the dose and have it morning and evening. This allows for adjustments to one dose at a time, and can give better coverage.

Is he on fixed doses of Novorapid then? Does he also have fixed amounts of carbs that he has to eat for each meal?

Regarding pumps, I have an Animas Vibe but don't have the associated Dexcom CGM (because I'd have to pay for it and can't currently afford it) but if I did have it, my pump screen would show my CGM info too.

Yes, he is on fixed doses of insulin, but no fixed diet. By no means I can consider his a low carb diet, just careful on the sugar side. We need to learn how to adjust his carbs, I guess one of those smart kitchen scales might work.
Anyways his bg was 9 this evening. Took the usual 9 units before meal. We will see how it goes.

 

[justadad]

Hi. Sorry I can't give any advice, we use the libre

Thanx for the reply. The libre does not have the functionality to send real time data, though, right?

 

[justadad]

@justadad I've never used Levemir but I know many people split the dose and have it morning and evening. This allows for adjustments to one dose at a time, and can give better coverage.

Is he on fixed doses of Novorapid then? Does he also have fixed amounts of carbs that he has to eat for each meal?

Regarding pumps, I have an Animas Vibe but don't have the associated Dexcom CGM (because I'd have to pay for it and can't currently afford it) but if I did have it, my pump screen would show my CGM info too.

Thanx for that, but the animas vibe works well with dexcom g4, no?

 

[azure]

Yes, he is on fixed doses of insulin, but no fixed diet. By no means I can consider his a low carb diet, just careful on the sugar side. We need to learn how to adjust his carbs, I guess one of those smart kitchen scales might work.
Anyways his bg was 9 this evening. Took the usual 9 units before meal. We will see how it goes.

Ok, well that may be a big part of the problem. There's nothing wrong with fixed doses but they require fixed amounts of carbs to get good blood sugar. If his carb amount varies from meal to meal, then his blood sugars will be up and down.

I strongly suggest learning carb counting and adjusting insulin to match what he eats. That's what a pancreas does. It makes all the difference. You mentioned his low after lunch above, but that could easily be because he didn't have enough carbs for the insulin dose he took. Insulin and carbs are intimately connected. If you want a great book, I recommend Think Like A Pancreas.

For carb counting, there's an online course here:

https://www.bertieonline.org.uk

He doesn't have to eat a low carb diet to get good control. As long as he doesn't eat excessive carbs, he should be able to get good control with the appropriate use of insulin. Sorry to go on about carbs and insulin, but it frustrates me enormously when people aren't shown how to carb count. It's not uncommon now sadly. It makes it so hard for people and Makes no sense to me.

Anyway.....yes, the Animas Vibe pump supports Dexcom G4. This video explains it a lot better than I can:

 

[justadad]

Ok, well that may be a big part of the problem. There's nothing wrong with fixed doses but they require fixed amounts of carbs to get good blood sugar. If his carb amount varies from meal to meal, then his blood sugars will be up and down.

I strongly suggest learning carb counting and adjusting insulin to match what he eats. That's what a pancreas does. It makes all the difference. You mentioned his low after lunch above, but that could easily be because he didn't have enough carbs for the insulin dose he took. Insulin and carbs are intimately connected. If you want a great book, I recommend Think Like A Pancreas.

For carb counting, there's an online course here:

https://www.bertieonline.org.uk

He doesn't have to eat a low carb diet to get good control. As long as he doesn't eat excessive carbs, he should be able to get good control with the appropriate use of insulin. Sorry to go on about carbs and insulin, but it frustrates me enormously when people aren't shown how to carb count. It's not uncommon now sadly. It makes it so hard for people and Makes no sense to me.

Anyway.....yes, the Animas Vibe pump supports Dexcom G4. This video explains it a lot better than I can:

Thanx a million, you are very supportive. Just spoke to his endo who suggested lowering his levemir. Also mentioned the possibility of a remission.
I will still look for the book you mentioned, I think I already saw it listed on amazon.
And the carb count. Oh, the things one learns in just ten days...
Thanx again!

 

[Ellie's mum]

Thanx for the reply. The libre does not have the functionality to send real time data, though, right?

No but it is very good at showing what bloods have been up to in between checks and overnight. It's very easy to insert. My daughter has been using it since July and refuses to give it up. It had greatly reduced the amount of times she pricks her fingers