Continuous Glucose Monitoring - my second week

My first week with my CGM was very much in awe of it - my second week was about using the information to reign in my diabetes management.

People get anywhere between seven to fourteen days out of a continuous glucose sensor. I was lucky enough to get reach over 14 days.

In my second week, I started to look at the data in detail and find trends. I downloaded the data from my insulin pump to the Animas software programme, Diasend. With this software I can create reports that tell me what my average blood glucose readings were at each time of the day for any time period I choose.

In particular, I wanted to address my night time basal insulin rates and the fact that it bounced up and down like a rubber ball from 10:30pm til 4am. I selected my date as Monday through to Friday. From the report created, it looked like my evening basal rates were too low and my dawn phenomenon cover was too high.

I made the adjustments and have had a couple of hypos, so I still need to tweak my rates. However, my one and only sensor, because I had it on trial, had bitten the dust and I now feel like I'm flying blind.

I really miss having the extra information to make daily decisions about my insulin dose. The CGM not only gives you an indication of what your blood sugar is, it also indicates, with an arrow, in which direction it is heading. Or a double arrow if it's going there quickly!

This information is soooo useful especially at bedtime. A blood sugar reading of 6.8 mmol/L(122 mg/dl)and holding is much better than 6.8 and dropping.

I hope to apply to the HSE long term illness scheme for funding for a CGM but with holidays and a family wedding it will be, at least, September before I knuckle down to that. 

Are you a bad diabetic?

Take a deep breath everybody! I can just picture the steam coming from all of your ears, but let me tell you that in this instance, where I was asked this question, the only purpose it would serve would be to accelerate global warming!

I have never been asked this question before in all of my 22 years living with type 1 diabetes and it really caught me off guard.

Firstly, the person who asked had a number of alcoholic beverages taken so any worthwhile, educational response from me was going to be a complete waste of time! So frustrating!!

Secondly, this person was a very young, public health nurse! ($%^@*#%!!!) A little more frustrating.

How did I respond? Well! I first made faces as if I had swallowed a wasp while my brain tried to figure out how to respond. I think I may have scared her and she would have run away if she wasn't trapped on a bus with me.

I was trying to figure out if she meant if I was a bad diabetic because I didn't manage my diabetes well? Or bad because I had the "worst" kind of diabetes?

So after I made my faces, I said "I don't understand the question?" She probably thought I was the dope:-) Then, she asked if I was a insulin dependant diabetic? Now we're starting to make sense... just not enough for me to invest my time with her on this occasion.

At some point, I will sit down with this child and explain some diabetes etiquette and a few other pieces of information about diabetes.

For now, I will give her the benefit of the doubt and assume that she knows a little more about diabetes that alcohol would allow her to express.

Keep calm, they're only words!

My CGMS Awesomeness! My First week.

Disclaimer: I am not a scientist, nor do I have anything close to a medical degree. The views and opinions expressed are my own interpretation of the information and training I have received with my diabetes over 20+ years.


What is a CGMS?

CGMS is Continuous Glucose Monitoring Sensor. It consists of a sensor pod, which contains a very thin needle-like component inserted under the skin. It's about an inch long, the width of two strands of hair and just as flexible. The sensor reads how much glucose there is in the liquid between the cells called interstitial fluid. And it take this reading every few minutes.

This is the glucose sensor with
the transmitter attached.

The CGM has a transmitter attached to the sensor pod which sends the data from the sensor to the receiver. In my case, the receiver is built into my Animas Vibe insulin pump.

A finger pricker blood glucose test on a Blood Glucose Meter measures the amount of glucose in a drop of blood.

It has taken a decade (or two) for the technology in a CGM sensor to match the accuracy of a Blood Glucose meter but in my opinion it was worth the wait.

The Awesomeness!

I can press one button on my pump and have an indication of where my blood sugar is.

I was driving to visit my Mother who lives an hours and a half away - I tested before leaving and I was fine to drive but my CGM alarm went off about 45 minutes into the drive alerting me that my BS were less than 4.4. There were 4.1 and dropping and as the saying goes "don't drive under 5". I wouldn't have caught that low until I was well into it.

A couple of days into sensing, I figured out how to view the 6, 12 and 24 hour graphs. I was so surprised to see that my overnight blood glucose readings are not AT ALL like what I thought they were!

I have done basal rate testing occasionally but was never surprised at the results. I go to bed in range and wake up in range but according to the CGM data there is a LOT of bouncing in between! I had been catching the in range readings every two hours. But in between those two hours was an up-swing. I never would have suspect that.

Whoa!

My sisters hen night was two days into wearing the CGM. So with a couple of beers in my system (and only a couple), and a restaurant meal the predictable happened. My CGM alarmed every 30 minutes to remind me that my blood sugars were in the high teens. But it told me if they were still rising or if there were holding steady which meant that I had more information to address the highs (or high, as it was one long continuous high).

The Meeh!

So, I'd been wearing the CGM on my upper arm for a few days and apart from hitting off a couple of doors I had no huge problems. Just one minor issue, my arm where the sensor is placed is a little tender. So, if I get lucky enough, to be able to use this device again, I would explore other areas to place it.

The layers of tape trying to keep it secure are getting a bit itchy.

My one big concern, at this moment, is that the weather has gotten warmer (finally) and the CGM is visible if I wear a short sleeved t-shirt. I wore a light cardigan over my T the first day. The CGM makes my diabetes visible and I know it's going to be difficult to explain this device when I'm still learning about it myself. But I shall embrace this when I'm ready.


Overall, having the extra information from the CGM is great - I can't deny that. I would love to have one permanently. However, and this is an important however, I would never rely on it explicitly as what my blood sugar reading is. I still do my 8 finger pricker tests daily.

New NovoRapid Package

Anyone notice the change in the NovoRapid Insulin packaging?

When I go to my pharmacist, or chemist as we say here in Ireland, I always watch as they pack my one month supply into a bag. Sometimes I get it wrong and order the wrong thing or sometimes they get it wrong.

Recently, as Catherine was packing my bag I saw something "foreign" looking. Is that a 100ml vial of NovoRapid?, I asked. So we both examined the package and determined that it was. But why does it look different? Catherine asked me to open it and, sure enough, it was the same on the inside.

I was happy to toddle off home and stock up my fridge.

The photo on the right shows the difference between the old and the new. The old is the smaller box on the top. Both bottles are the same size. The new allows the vial to rattle around in there noisily.

The new box is easier to read, so maybe that's why the product has been repackaged? Either way, I'm thinking 'is it still going to fit in my compartment in the fridge?The answer is just about and that's what's important to me;-)

Reasons to be EXCITED!!!

This past week has been a little bit mental, what with children on mid term, a bit of a raffle going on, some wedding invitation making and a bathroom demolition (*%$#@@).

I really didn't think I would have time to write a blog. However, I just had to write a quickie for this. Thanks to Animas, I am starting my trial of a CGM with my Vibe tomorrow!!! It's been a year in the determination. 

I don't know if it will make a huge difference in my life but I will let you all know. I have been using the "wizard" features of my Vibe a lot more and this has smoothed out my numbers quite a bit.

The "wizard" features are "Our pumps can: > Calculate a bolus amount to cover the carbs in food (ezCarb) > Automatically calculate a correction dose of insulin based on the latest blood sugar reading and incorporate the insulin on board (ezBG)"  from http://animascorp.co.uk/animasvibe/animas-vibe-and-cgm-system

I am also looking forward to a very much needed holiday with my hubby's family in Minnesota, where I will get eaten alive by mosquitoes but will not have to worry about the weather.

AND, if that wasn't enough I have received my itinerary for the Diabetes Advocate's MasterLab conference.