I have been an insulin dependent diabetic for over 25 years. During that time only a handful of diabetic treatment technology gains have made a real difference to my health and quality of life. These advances include the home blood glucose testing, the insulin pump, and the production of quick-acting insulin analogs.
Now the continuous blood glucose monitor stands with these invaluable treatment tools for insulin dependent diabetics. Four weeks ago I started on a Dexcom Seven Plus CGM. The results already produced have delivered BG improvements better than I hoped for and the promise of impressive future gains seem clearly within my grasp.
Up until a few years ago my A1c numbers hovered around 6.5%. But then my A1c started to rise and got as high as 8.3%. While I had gained some weight and my exercise regimine faltered I still watched my blood glucose closely, sometimes testing as much as 20 times per day. I knew that my weight gain (about 15 pounds) and less than daily exercise contributed to my diminished control, I still felt that something else was going on.
I went through several periods that I meticulously counted carbs and kept a daily chart of carbs, insulin, exercise and BGs. That added attention did help. Over the last year I have been able to drop my A1c from 8.3% to 7.2%. While I appreciated the improvement in my A1c, I wouldn’t be happy until my numbers returned to under 7%.
From my perspective as an insulin dependent diabetic the stories about continuous blood glucose monitor development seemed tantalizingly just out of reach. I think I started reading about the CGM in the mid 1990s. A consumer-ready product always appeared to be two years away - just over the horizon.
When the first generation of CGMs arrived however, the insurance industry was slow to give it a green light. It was just this spring that I learned that a few other diabetics at my work had applied for CGM coverage successfully. I started the process last July and finally received the 7+ on September 4.
The Dexcom 7+ has exceeded all of my expectations. My last A1c of 7.2% translates to about an average BG of 177. In the last 28 days my average BG as measured by the Dex is 135 - that is equivalent to an A1c of 6.0%!
I’m having my blood drawn tomorrow for an A1c as I prepare for my visit with my endocrinologist next week. It seems promising that my A1c will drop below 7% but I’m truly excited about the next A1c, three months from now, measuring in the low 6% range.
As a single person that lives alone, I must face all that diabetes hands out by myself - especially the night-time lows. The Dex has successfully woken me up several times during the last four weeks to warn me of both lows and highs.
It seems to have virtually eliminated waking up in the morning only to discover a BG in the 50s and realize that it has probably been there for several hours. As you all know, an undiscovered overnight low usually rebounds with four to eight hours in the 200-300 range. I often delayed eating in those situations until the middle of the afternoon so I could keep my BGs below 200.
During the day I am able to head off any impending lows by popping a couple of glucose tabs. I can also respond more quickly with corrective doses of insulin to reel in a developing high. By the way, the ability of todays insulin pumps to calculate a corrective dose while considering the “insulin on board” is also an amazing tool. (I can remember countless times in past years attempting to calculate the right corrective dose while I’m busy with life’s other demands and my brain sluggish with elevated BGs.)
Last, but not least, CGM appears to be able to head off the major disaster of slipping below BGs of 55 and then becoming unaware of your condition. Anyone who has had insulin dependent diabetes for any length of time has their “story” to tell. Its a hellish nightmare that no one wants to repeat. You feel lucky to survive and not to injure anyone else
CGM technology is a major breakthrough in diabetes treatment technology. I look forward to an endless string of good A1cs. More importantly, I’m starting to feel the return of an energy that high and variable BGs robbed me.
For anyone who is considering this technology, I encourage them to give it a try. Like the finger-stick meters, insulin pumps, and fast-acting insulin analogs that preceeded it, CGMs are a keeper. Going forward, I will not face life without one!