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Tuesday, July 6, 2010

The More You Know . . . about a CGM

So I'm half-way done with my first Dexcom sensor.  I have learned so much in the past few days about my diabetes and how food affects my numbers.  I couldn't pin-point one particular nugget of knowledge to focus on for a blog post, so I'd thought I'd go bulleting with all my knowledge nuggets: 



  • My Novolog takes about 30-45 minutes to actually start affecting my BG.  The first 2 days I noticed that I was spiking to 250 almost 300 mg/dL when I bolus at the same time as I start eating.  So, this weekend I started testing, bolusing, and waiting 30 minutes before eating.  This is really easy to do on the weekend because I can enjoy a cup of coffee while I'm waiting on my insulin to kick in.  But I had to start a new routine this morning before work to give it the same amount of time.  I have begun testing and bolusing before my shower, then after my shower and getting dressed I will eat--giving my insulin at least 30 minutes.  I feel like this change alone will affect my A1c the most. 
  • It takes more than 15 grams of carbs and more than 15 minutes to bring me up from a low.  My current low alarm setting is set at the default of 80 mg/dL.  I like this setting because I feel safer catching the lows before they get too bad.  I understand the 15/15 rule is the same for any person experiencing hypoglycemia.  However, when insulin is involved (type 1 or type 2), you're fighting more than just a lack of sugar in the blood.  It's a lack of sugar combined with sugar-fighting insulin on board.  I'm noticing it takes like 30 grams of carbs and 20 minutes before I start to feel normal again.  Everytime I do the standard 15/15 rule (which states, "After 15 minutes, if your BG is still not normal, take 15 g more of carbs."), I always end up taking more. 
  • My nighttime numbers are crap.  I've only had one evening where I stayed in range around 140 mg/dL the whole night.  Otherwise, I ususally start out going to bed with a low alarm, correct, and end up high around 3:00 AM (which does not a happy Holly make).  I'm thinking some basal tweaking is in order, but I'm waiting the full week to get a better idea.  
  • Speaking of nighttimes, I am not very good at getting up when an alarm goes off.  Everyone hears it--my husband, both dogs, and the cats scatter, but I have already developed the bad habit of grabbing the receiver, hitting "C" for cancel, and going back to sleep.  The ultimate goal is to get my basals down to perfection so these alarms don't happen, but until then I need to get up and correct for the alarms.  Last night, I snoozed 3 high alarms before finally getting up--meaning I was high for 3 hours before finally getting up, not good.  
  • I need to also do some more tweaking for bolusing for high fat/high carb meals like lasagna and mexican (which I had for the past 2 nights).  My standard bolusing is to do a dual bolus 40/60 ratio with a 2-hour square bolus.  This usually puts me back at normal 2 hours later, but Constance has shown me that I continue to drop for another 2 hours.  So, I need to extend my square bolus for longer or just do a square bolus throughout the whole duration.  
  • Finally, this little device and all its fixin's, is expensive!  See the following:  
 Good thing because . . . 

it's over $1600 out of pocket.  Thanks, insurance!  

This also means between my pump (including tube, reservoir, and insulin), Constance and her sensor, and my phone, I'm easily walking around with close to $10K just on my hips!  Bionic woman, indeed!  Plus, with all these attachments, I feel like I need a toolbelt just to walk around. 

6 comments:

  1. Thank you so much for posting about your CGM! I am a Type 1 pumper (mine is named Borgy) and I've been considering a CGM. I was curious about the total cost and the general logistics and reading about your experiences so far has been very helpful to my decision making process!

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  2. Isn't it amazing the information a CGM can show us!!! I swear, it's the main reason I have such a good A1C right now. If only the out of pocket portion wasn't so high, huh?

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  3. You're welcome, Fiona! That's what this whole bloggy experience is all about--sharing information and connecting. Good luck on your CGM decision. I can only say that my experience so far has been worth it. =)

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  4. @Karen: Oh, it feels overwhelming the wealth of information I've received in the last week. I'm hoping this lowers my A1c even more and, most of all, helps me gain STABILITY!!! This bouncing from 300 to 30 crap is for the birds.

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  5. Awesome! I'm so glad that its working out!

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  6. I've been contemplating CGM for a while. Seeing your early reactions are pushing me more in that direction. Thanks!

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DISCLAIMER: I am not a doctor, nurse, certified diabetes educator (CDE) or any medical professional of any kind. (But I did stay at a Holiday Inn Express!) Therefore, please do not use any of my postings as medical fact. I am simply a blogger expressing my highs and lows (pun intended) with diabetes. For changes in your medication, exercise regiment, or diet please consult a qualified physician.

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My name is Holly and I live in north Alabama with my hubby, two cats, and a dog.