Thinking of CGM

[kkkk]

Looks great Duneplodder - I think I need to set my alarm back to 4.4 rather than 4 I also had the high on 13 for a bit, but have pulled that down to 11 (mainly as I don't like bolusing in-between meals unless I have to as it causes too many problems with active insulin and overlaps etc - I'll wait for pump fine tuning for that). My first sensor died last night - it was telling me I was hypo when I was 8 and then I was apparently just the word HIGH all night (which wasn't the case either). It did 12 days and I haven't worn it today as I would like a bit of time to re-watch the DVD and pop the next one in, already it has massively boosted my confidence and confirmed that I was mostly doing ok - I have found that I have really had a play and sort out of my doses and food (like back to the wholegrain stuff and porridge for brekkie, then working out what I need to adjust to avoid having to snack mid-morning - just taking one at a time and doing it gradually but CGM is an immense tool for seeing the fuller picture of what is going on and properly learning how insulin, food and exercise all come into play for your own body (plus the highlight - waking up for night time lows - I am sooooo enjoying my sleep with them on)

 

[DunePlodder]

I have the high on 11.1 which was the default, I think.
I've had a couple of busy days, graduation ceremony (no not me) Thursday, funeral (not me either) Friday, which with travelling as well, are the sort of situations where I would struggle with my BGs. A quick glance at the Dexcom made all the difference.

I was intending to write a thoughtful analysis of these first few days, but I all I do is keep thinking "Wow...wow...!"

 

[kkkk]

I am quite similar….and I should have watched this before I started - it is over an hour, but really interesting all about CGM and the pros and cons and how to use it effectively and look at the data (I just wish the videoer could have had the slide show a bit more in focus too )

 

[DunePlodder]

I am quite similar….and I should have watched this before I started - it is over an hour, but really interesting all about CGM and the pros and cons and how to use it effectively and look at the data (I just wish the videoer could have had the slide show a bit more in focus too )

Just watched it. Very useful thank you.

 

[DunePlodder]

Thought you might be interested in a Glucose Trend graph of the first few days:

As you can see muffins have a very dramatic effect! (I injected just after I'd eaten it). One of many things I've learned..

 

[kkkk]

Oooo very nice…probably some of the orange juice in the bucks fizz too

I found that breakfast was one of my worst spiky meals (though jacket potatoes - which in fairness I did know were not ideal - weren't great last night either - must remember to eat lots of veg and the meat before I tuck into mashed type potatoes ) back to breakfast - special k…weetabix….all of them I was spiking quickly after, but I have discovered that porridge with just a teaspoon of brown sugar is perfect - I didn't realise that it was ok to have sugar on porridge as I hated the taste with sweetener, and without cgm I wouldn't have worked that out! Also seeing sugar rises in the real has made me more vigilant about eating whole grain and lower GI stuff with meals to get less peaks.

For me a hideous hypo day….had a couple of ones where you treat, still feel rough, treat again 10 mins later…and then treat again, and say "stuff it I'll have a biscuit now, I am fed up of being low" and even that hasn't elevated my sugar that much which was what I was expecting once I hit the biscuits (I thought I had it all sorted and it had been playing really nicely this week - keeps me on my toes!)

 

[MarkusLondon]

I thought the same as you 6-7 years ago. Why use an insulin pump. However, using a pump is nothing i regret. You'll never think about it once put in your pocket. Using Animas Vibe CGM and am happy with it. Great advantage to always be aware of your approximate blood sugar. It will most likely improve your HBA1C.

 

[DunePlodder]

kkkk
I've had days like that where you eat ridiculous amounts and it just doesn't seem to have any effect. Inexplicable, but they do happen.
I'm experimenting with injecting my insulin earlier than I would have done previously. Ok as long as you are not low & in control of when the food is ready. This evening I injected about 35 minutes before I ate - so far so good.
So much to learn..

Markus
I must admit I have easily got used to having the sensor in, even in bed which I was a bit concerned about. I can certainly see that the fine control a pump gives would make quite a difference. For now though I'll be getting to know the CGM.

 

[kkkk]

I've noticed that too DunePlodder - I am a 15-20 min before if I am not too low and that does seem to even out some of the spikes a bit and make it more wave like

 

[DunePlodder]

Might be of interest that I've just confirmed that the transmitter & receiver are covered by my household insurance under "unspecified possessions" which covers up to £2000 in my particular policy.

My sensor is now on day 8. So far so good.

 

[neels]

Hi,
I read in this topic that some of you have asked about the funding of CGM's. I am no expert on this, but I know about 3 years back, a type 1 Diabetic wanted a CGM and so purchased it out of his own pocket. He then wrote a very strong cased letter to the hospital who fund our pumps, and he actually got his CGM funded by the hospital.
I am now thinking I would like to do the same. I am most likely going to approach my Diabetic care team at the hospital and see what they say. If they say no, then I will remind them that it was done previously to one of their own patients in this hospital and take it from there.
Hope that may help some of you who are already thinking along these lines - and that it is actually possible!

 

[kkkk]

I am going to see if I can have some funding for it, I have been looking at my CGM graphs and I am pretty sure that my HBA1c will lower, and I am having less hypos with it. I am not sure how true it is but it has been suggested to me that I need to be on a pump too, so that I can prove that the pump doesn't resolve all my problems and the CGM is still of benefit….so I am waiting for that too. It is soooo hard because I know how much difference having CGM has meant to my control, but I've only had it a little over a month, and I am keen and all that - I am hoping to be able to demonstrate to my hospital and trust the difference it has made to my life at my next appointment and hopefully that will start carving the way for others too - I know when I went in to speak to the nurses they hadn't seen anyone on injections and a CGM, and told me how good my control was, had I been sorting stuff out as a result of CGM (absolutely - it is soooo much easier to see the patterns!). I know there are a few people out there on long term loans and with funding, mostly kids - or it is mostly their parents that talk about it - so it is possible, but I know they had to fight to get it, and you need your diabetes team on board and fighting for it with you. I think that will be my next step, but I am try to compile evidence from my data and bits, and might have to wait until I am on a pump before I get that far.

 

[DunePlodder]

Interesting. My plan is to wait until my annual check up (June/July) and discuss funding then.Hopefully this will show an improvement in my HbA1c, and there have definitely been fewer hypos (nothing below 3.6 in this first three weeks). I live alone so the overnight low blood sugar alarms are invaluable.

 

[kkkk]

I LOVE the overnight alarms (I know that some people get woken up when they aren't so low sometimes….but you know I am more than happy to be woken up on the occasional wrong bit of data - so far no problems and I've been wearing all the sensors longer). My next appointment is a pump clinic and with the main consultant I used to see, my last appointment with the diabetic nurses was so much better than I envisaged and they were encouraging and supporting and interested so I am really hopeful that I can get closer to something that really works well for me and my diabetes. I know I can get the vibe (animas) funded and that comes with the receiver in it so that is one less cost! Just don't want to get my hopes up too high as I know it will be a bit of a fight but the more of my team on side then I think the more likely I am to get there.

Also I am just well chuffed as I had a fairly flat day yesterday (well it looks flat ish in the 3 hour and 6 hour window, but is a zig zag in the 24 hour window….but I don't think I went much over 8 or dropped below 4…which really doesn't happen often for me …and I ate Chinese takeaway in that!) - so I am going for 2 days in a row now see if I can create a record It is to make up for a day when despite giving myself loads of extra insulin I wasn't really able to get my sugar to stay much below 8 and seemed to hover around the 10 mark all day (then I realised I needed to change my basal again!)

 

[DunePlodder]

Also I am just well chuffed as I had a fairly flat day yesterday (well it looks flat ish in the 3 hour and 6 hour window, but is a zig zag in the 24 hour window….but I don't think I went much over 8 or dropped below 4…which really doesn't happen often for me …and I ate Chinese takeaway in that!) - so I am going for 2 days in a row now see if I can create a record It is to make up for a day when despite giving myself loads of extra insulin I wasn't really able to get my sugar to stay much below 8 and seemed to hover around the 10 mark all day (then I realised I needed to change my basal again!)

Nice work! I think that's one of the unexpected things about CGM it's so encouraging when you can see good results. Even bad ones make you think. I've got a new enthusiasm for making changes & feel safer when I try things.

As I said in another thread I've had a fairly flat couple of days. Unfortunately I'm a bit worried that it's the sensor failing. 3 weeks up today & I can't decide whether to change it or not..

I've reduced my basal since getting the Dexcom. I also have crazy days like that still - and the other way round.

Good luck with the 2 days in a row - you can do it!

 

[kkkk]

I reduced my basal quite a bit in the 1st week on CGM and that got rid of quite a few lows….however having a brief holiday which is why I think my basal has gone up as I am obviously very lazy I'll probably have to put it back again next week - but that is quite interesting in itself as I wouldn't normally touch my basal - but just have extra at my meal times….whereas it seems like a basal increase works much better for me overall. I'll have to test theory when I next have a holiday too.

 

[DunePlodder]

Having had my Dexcom G4 for a whole 3 weeks I now feel qualified to make a few comments.

It's not perfect, but I am very pleased with it.

It has given me peace of mind. Especially at night, but at all times. In just this length of time I have learned a lot. I have reduced my basal by about 10%. Getting your basal insulin right is very very important. Assuming I'm not low I now inject earlier - 20 to 30 minutes before I eat breakfast, lunch, or dinner. This definitely reduces the post meal spike, especially after breakfast. I wouldn't have the confidence to do this if I was doing normal testing.

I had no problem inserting the sensor on my abdomen, maybe I was lucky. I did have to shave the area before I began, something I hadn't thought of! I was concerned about sleeping with it but after the first night it hasn't worried me at all. Most of the time the figures are pretty close to my OneTouch Ultra meter. Many within 1 unit but I have seen as much as 3. It's difficult to judge - if levels are rising or falling then the fact that the lag of the Dexcom is around 10 minutes(ish) behind probably accounts for much of it. It has also made me think about the accuracy of the OneTouch meter. As I already knew, consecutive readings even from the same drop of blood can be quite a bit different. I try to calibrate when the graph is nice & level.

I think every type 1 diabetic should have access to one, at minimum for establishing their basal dosage. A week would do this & give an invaluable insight into what happens when you eat, exercise, & sleep.

Anyone caring for a child or adult with diabetes should/must have the option. The range is such that in most houses the carer could have the receiver by their bed giving peace of mind, not to mention more sleep!

Anyone who is pregnant/trying for a baby should surely have one.

The Dexcom receiver works well and is very easy to use. I would like it to do more but I can see that simplicity is very important. The receiver battery seems very good, after the original mains charge I have only charged during my download sessions with the pc.

Some wishes for the receiver:
Ability to scroll back at the same scale (e.g. 3 hour view)
Option to change the vertical scale of the graph - I would probably change it to 16 rather than 22.
Build quality - I'm not too convinced & I've read stories of buttons & the usb cover coming loose. It is only guaranteed for a year & at around £600 for a replacement I think it should be better. Hopefully I'm wrong and it will last for several years. The case provided is OKish but I'd like a better one.

Dexcom Studio
Great fun if you like graphs! Useful too
My PC has Windows Vista so it works for me, but not on Windows 8 or a Mac which isn't too good.
It would be nice to easily add comments to a graph. When the receiver is plugged in it would be good if the software downloaded at intervals giving a "live" graph. Perhaps a little widget or app to show this in the corner of the screen whilst you do other things.

I've now started week 4 with my original sensor. No itching or hint of infection. Have wondered if the results are less good as there seem to be fewer/gentler spikes on the graphs. Before restarting yesterday I intentionally ate a higher carb lunch & delayed injecting until I began eating. The graph went up to about 11 as I would expect.

I used Skintac and the original sensor tape was fine for the first week. Since then I've added numerous strips of hypa tape. May look at some alternatives I've read about. I shower each day & haven't done anything to protect the sensor & transmitter. I've yet to have a bath or go swimming.

So far so very good..

 

[searley]

It's good to see that people are getting 3 weeks plus from a sensor, as this makes running it much cheaper.

I was already 90% certain to get one.

The only thing that is delaying me now is that I've just had some major vet bills, but as soon as the insurance pays I will be in the phone ordering




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[DunePlodder]

Hi Searley,

I've just noticed that you are using Humulin S & Humulin I which is what I started on. How do you get on with them?
Have you tried/considered a basal/bolus combination or is there a problem? I'd have thought it would give you more flexibility.

Perhaps I've been lucky getting 3 weeks out of this sensor. I hope not because cost is a big factor for me too.

Hope the animal patient is doing OK.

 

[searley]

I'm actually now on Humalog and degludec(trisiba). Was on basal bolus even with Humulin i&s

Animal patient died, after £1500 worth of vet bills, still when the insurance pays I can get the dexcom


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