CGM problems

I haven’t been sleeping well due to my CGM alarms waking me up throughout the night. Lack of sleep is making me irritable and emotional. Does anyone have this problem? I guess I am just hoping I’m not alone!

I guess my first question is whether the CGM alarms occur because your BG (Blood Glucose) actually is out of range or if the sensor is not tracking well? I tend to view the different scenarios, well, differently.

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Which one do you have?

The cgm by minimed

Are you referring to threshold alarms, rising/fallng alarms, or both? Do you confirm with fingerstck(s)?

Both, I sometimes confirm with finger sticks.
I guess I am just very tired physically and emotionally. I have multiple sclerosis, too, so I have a really bad day if I don’t get enough sleep.

My BG is out of range.

If that’s the case, and your CGM alerts are confirmed by a fingerstick, the next step would be to try to adjust your overnight basal rate on your pump to see if you can’t get your BG more stabilized. Your carb intake at dinner time might be a factor as well. Generally the lower the carbs, the easier it is to manage. I find overnight BG is the hardest because you’re not awake to check on things until your alarm goes off, so even though theoretically I can have those french fries or piece of pie if I bolus for it correctly, in practice it makes things a lot simpler if I don’t. But the main thing is to try to see what the pattern is, eliminate as many variables as you can, and adjust your basal rate accordingly. Often more easily said than done, of course. :slightly_smiling:

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So? It would seem you need to try to take some steps to get your BG to stay in your target range more consistently. Especially overnight when you need to sleep. Perhaps?

Do you know if your out of range BG is a result of a bolus being off or if you perhaps your basal rates need tweaking?

While you note that your BG is moving out of range and causing alarm fatigue, I would suggest that BG variability is a major factor here. Of course you can adjust basal rates and insulin to carb ratios, perhaps you need to consider what you eat and how that food affects your BG variability. Lowering your BG variability will have many benefits for you. My prime tactic to limit variability is a carb limit with my diet. Good luck!

It could be that your alarms are set too high (or low) for you during the night. You might need to relax your alarm settings for overnight, so that only critical alarms will trigger and wake you. There is a lot of information on getting the most from CGM usage in Gary Scheiner’s book Practical CGM. I recommend reading it.

I have had a similar experience especially while on the Minimed CGM. With all the alarms going off and me not hearing them it irritated my wife who had to wake me. I came to the conclusion I was not going to die from a low BG but from a pillow over my face by my wife. Seriously, I have finally switched to a Dexcom CGM that I have found is easier for me to keep calibrated which has reduced the number of alarms and has given me the confidence and information to do more tweaking of my basal and meal insulin doses that were causing my lows. Good Luck!

Thanks for all the information, I really appreciate it! I’m heading to my endo this morning to see what can be done.

You don’t say which Minimed. I had similar problems but I found that the new Enlite Sensor DOES work with the Pradigm 723 (I use it only as a CGM, not as a pump) .
After several months of using this, here is what works for me;
I insert the Enlite, strictly according to the procedure in the instructions, except for the site selection. I can’t keep the darned thing in my abdomen so I put it in either my backside, or upper arm.
I run it for 3 days, as it is limited by the meter, not the sensor. Then I restart it as a NEW sensor. after teh 6th day, I remove and charge the transmitter, restarting it as NEW, then another restart, as NEW, on day 9.
The readings are not accurate, just like all of these CGM’s, but it is the trends I am interested in.
SO far, so good. The alarms usually do mean that I am going out of range and I appreciate the warning ahead of time, despite the inconvenience.

Using the Paradigm Revel 723 + Enlite as a CGM only is an unexpected approach. I have always thought that if you had no interest in using the pump side of Medtronic’s combo, then you’d probably be better off with Dexcom.

How did you happen to stumble into your current CGM setup?

For whatever it’s worth, I use the same same combo of Paradigm 723 + Enlite, except I started out using just the pump and then added the CGM sensors later on. Out of curiosity, does Medtronic have a prescription from your doctor for Enlites filed in your account? You need that in order to be able to get a failed/bad Enlite replaced when you call their HelpLine.

Sorry for the long delay.
At the time, when my Endo was suggesting pumps, I was travelling a lot, for business, in the US, Canada and overseas. Often, I would be in quite remote locations so I asked how would I handle a pump failure in such a location. The answers always defaulted to “oh, you need to carry an emergency supply of pens/ syringes etc etc…”, so I figured that a CGM would be ok as it is a support type device, and I could live without it if it failed. The Dr, screwed up and prescribed a pump so, when it arrived, I noticed that it had the CGM function and I just left the little red plastic plug in the insulin vial port; and it’s been there ever since.
Since then, I have sailed about 13,000 nautical miles, including ocean crossings, and am still alive. I also found the Walmart Glucose meter to be a great tool. simple, but functional, and cheap to operate. I am not so decrepit that I can’t input the readings into the CGM so it all works quite well.
Hope that helps in your search for good BG control, with simplicity.
And yes, I have a prescription with Medtronics, but, since Medicare denies coverage, I pay cash, and get about 40% discount.

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I had a very interesting experience with my G6 the other day. All of a sudden, my iPhone popped up a “transmitter battery critically low” alert. And my transmitter was only 2 weeks old. I tried everything in my repertoire to fix the problem, but the alert kept recurring. The phone app finally said I had to pair a new transmitter. And I noticed that the transmitter ID wasn’t the one I was using.

So I called DexCom tech support. After about 30 minutes of questions and troubleshooting, they agreed to send me a new transmitter. But I was told it would take 7-10 business days to arrive. I asked what I was to do in the meantime. The answer was to use a meter.

After I hung up, I killed the DexCom app, to try to shut up the alarms. That didn’t work. So I deleted the app. Finally, at about 3 AM, I just took my phone out of the bedroom to the other end of the house. I could still hear the alarms. So I spent about an hour more troubleshooting. Finally I had the “ah-ha” moment.

I had not deleted the iPhone G5 app. It was that app that was alarming, not the G6. I deleted the G5 app, re-added the G6 app, and all’s right with the world. And I have a spare transmitter in my inventory.