So I am a type 1 diagnosed about 5 years ago. One of my worst habits is forgetting to test my sugar. It is not so much forgetting, as it is knowing that my sugar is in range, so if I am busy (which is often) I just dont test and match my insulin dose to my carb counting as usual under the assumption that my sugar is within range. Just to clarify here, from diagnosis I have been EXTREMELY sensitive to my blood sugar. I can tell someone what my sugar is before I even test it, and I have only been wrong twice in 5 years, not kidding. I know this is very careless, and I want to rid myself of this bad habit. SO, I have been wondering about CGM, do only people with pumps have them or can a person who does multiple daily injections have one too? As far a paying for it I am Canadian so it is all covered. I was told once by a doctor that every time you test with CGM you have to double check it with a manual finger prick aswell, my thought on this was than what is the point of it, is this true?
It’s not that you have to double check “every time”, you have to calibrate the CGM periodically (3x/ day w/ the MiniMed that I have, I don’t recall what the Dexcom requires…) by entering #s from your glucose meter. It’s not 100% accurate but can be very close and very useful to discern trends and spot trends in your BG that may not be apparent from occasional BG reading. Also, a CGM tests every few minutes so your fingers would probably wear out after a couple of weeks of 200 or so tests/ day.
CGM is good, but not great. I wouldn’t bolus based on my dexcom. The only times I do a fingerstick is when the dex asks for it(2x a day), before I bolus, or if I suspect that it’s off by more than about 20%.
It is, however, fabulous for it’s high/low warnings (especially during the night for me), and the downloaded data makes it really easy to see trends over time.
I do fingersticks all the time though, mostly to double check the thing and also if I am exercising or stuff like that. I usually time the calibrations for when I wake up and when I’m coming home from work, a lot of times when I am going running anyway but I got used to it pretty quickly. Every now and then it’ll work out that the timing is annoying and I’ll work around it but it works better than I thought it would.
The CGM is just another tool. It is generally recommended for people who have lots of low blood glucose readings. Most CGM users are also pumpers, because the readings are transmitted to the pump. I am on my second CGM (Mini Med) and have found it a great tool, especially since I am unaware of low BGs, the CGM will alert me.
Also, it is not a substitute for finger sticks. As said above, the CGM must be calibrated. Mine requires one every 12 hours, but I usually calibrate 4 times–each meal and before bed. The differences between the CGM and real finger stick results can be great. Generally, a CGM is about 30 minutes behind the real BG, because it does not read blood, but other stuff I cannot spell. Also, if BGs are really out of whack (very high or very low) the CGM readings can be off 50, 60 70 or more. I still fingerstick at least 6-10 times per day.
It sounds to me like you just need to get into a routine and test BGs regularly. It just takes the adjustment to get into the habit. In the long run, it will pay off. I doubt you will “know” what your BG is without testing forever. As we age, the D changes, so establishing good habits now will pay off in the end.
As many others have said, you need to calibrate the CGM. The sensor measures the (glucose?) level in the interstitial fluid, which is basically somewhere between the blood vessels and the surface of your skin. Much like it takes time for the injected insulin to make its way into the bloodstream, it takes time for glucose to make its way out of the bloodstream into the interstitial fluid, hence the reason for the delay.
The guidance I’ve been given with the CGM is not to act (eat or take insulin) based on the CGM reading alone. If you’re busy doing something and just want to know “how am I doing?”, by all means, check the number on there (and the indicator telling you whether your BG is rising, falling, or steady) and if it’s good, go about your business. But if you’re high, test before taking insulin. If you’re low, you should test before eating in theory, but sometimes I’ve gone right for the glucose tabs in certain places where testing is not feasible or convenient.
You’re right, that IS a bad habit.
CGM’s aren’t really reliable for telling you where your BG is but are great for telling you where it’s going. All CGM makers tell us not to make a decision about bolusing without confirming BG with a fingerstick. So it won’t necessarily reduce the number of sticks but it could encourage you to take one when you need it. (or it could have the opposite effect.)
One way or another it would be a good idea to get over the habit of guessing and into the habit of knowing your BG.
Terry
The other thing that suprised me about the CGM was how much it improved my data collection which, in turn, seems to have led to slightly better numbers. I hate logging anything and the CGM gives you many more data points.
I have a pump and a CGM. I don’t know if you need to have a pump to use it, but I was also told that I have to double check the CGM reading with a finger stick as well before giving myself a basal, etc. It does seem like double work to me. Do some research, ask your doc, see what others have to say.