So I got my latest A1C which coincided with my 3 month anniversary with the Minimed CGM, my A1c dropped to 6.2; the lowest it’s been since diagnosis (and I did update my TuAnalyze number). I know that this is a direct result of the constant surveillance afforded by the device. The interesting thing is that I still have room for improvement.
During this time I had an extended bout of highs caused by ineffective (due to age) insulin, that took me about a week to figure out. Also, I had days where I spent greater than 80% in compliance with my BG range and days where I spent less than 50%.
I experienced wildly different readings from the CGM and my meter, dealt with “bad sensors”, bleeding from insertions, etc. The biggest thing is that I was able to dial in my overnight basals to keep me within compliance all night long, virtually every night as a direct result of using the CGM.
But, at the end of the day, I’m chalking the past three months up as a huge success. I’m guessing that going forward I should be able to achieve real life a1c’s below 6 without much more effort, just continued strict control and no extended time in hypo. Reasonable?
Awesome Bob! Great to read your success story!
How are your numbers after eating? Do you go high 1 hour after eating? This is what I am struggling with and I think that it is keeping me from having an A1c under 6.5. I bolus early and try to match the timing of the insulin. The only way to avoid these seems to be low carb for me. Are you eating low carb?
Kristin - I actually don’t eat any grain based carbs in my diet. I eat any and all meat, lots of veggies, moderate fruit, nuts (almonds mainly), nut butters and fats (avocados, full fat plain yogurt, coconut milk). I don’t generally spike after meals - once in a while.
My biggest issue is with my basals. When I set up my pump my endo put me on 4 different basals evenly distributed over 24 hours and they all ended up relatively the same. What I found with the CGM is that my body works better with 6 different basal rates, not evenly spread out through-out the day. I have a desk job combined with intense physical activity early in the morning, at lunch, and usually after dinner - so my insulin sensitivity varies. My basals range from .55/hr down to .25/hr
The other thing that has a huge impact on me is switching to a dual wave/square wave bolus instead of dumping all the insulin in my system at once. I just “read the book” and am a little annoyed that we never covered this when I went through pump training. It has really helped smooth my numbers post meal.
6.2 is excellent! Be careful and saff if you are aiming for lower with insulin therapy.
Dual Wave bolusing rocks! I didn’t know about it until I had been using my pump for a few years. It really makes a difference (along with square when needed).
Am sooo glad u posted about having 5 different basals. MM actually discouraged this idea but I have 5 also & MAYBE am finally “getting the hang of it” w/CGM…can’t tell you how disappointed I am w/the no support after the sale (except for 800#. which I have used tons of times. Also thankfully someone on this site suggested getting 4th Ed of Pumping Insulin (I had 3rd)
I just read Think Like a Pancreas, based on a recommendation from another thread, and it was a really great refresher/primer.
You’re right about post-sales support, the amount of communication pre-sale was incredible - then nothing. I really like my endo, but I understand the guy is double booked all day and has, at most, 15 minutes of office visit time to work with me - same for my DE. I spent the first 10 years post-diagnosis going to Joslin-Boston, but moved to a more convenient team once I really took active control of my health a few years ago.
I read an older edition of Pumping Insulin a few years ago - I’ll look for the new one.
I was definitely having way more hypos pre-CGM, much safer post CGM - even with finicky sensors.
Another big wake up for me was reading Loren Cordain’s Paleo Diet, Mark Sisson’s Mark’s Daily Apple blog and Robb Wolf’s Paleolithic Solution blog/podcast.
Dialing in my diet, understanding the technology attached to my body, and kicking the splenda/nutrasweet habit has helped. I don’t think a lot of people realize that sugar substitutes increase your craving for sweet things - once I dropped them from my diet (no more Diet Cokes or Splenda in my coffee) my sweet tooth went away for good.
Dual wave was a revelation for me as well.
I was so excited to read this post. I just submitted paperwork for Dex Seven. I’m struggling to get my A1c below 7. I’m not perfect, there’s always room for improvement…but I do pretty good. My worry has been “what if this doesn’t help all that much”. And I’ve wondered the nuts and bolts of HOW people use the device (or data from the device). Your post shed some light on this. I’m getting excited. Thanks for sharing and keep up the good work.
I was dx’d in 1958 at the age of 3. A lot of MDI. I felt like a pin cushion. I am now pumping for 2 1/2 years. I fine tuned my basal’s to 8 different ones per day. I usually sit at a desk most of the day. In November I become very active. I have another basal rate set up for that. I have always been an avid deer hunter since I was a kid. I live in New England. D has never stopped me from anything and it never will.
It’s really eye-opening when see your numbers over 24 hours. For example, I never really gave the dawn effect much thought, but I found out that I was getting a BG rise about an hour earlier in the morning than when I had my overnight basal switching to my morning basal. I was normally sleeping through this and would never have known without my CGM. I was also able to see the impact of my noon exercise sessions and how the benefit started to trail off at 3pm.
Overall, I feel that I have much finer control without a lot more effort, being able to look at 5 days of trends really allows you to dial in your treatment.
Oh, I’ve read a lot about the pain involved in inserting the sensor due to needle gauge. I just hold an ice cube in plastic wrap on the site for about 30-45 seconds before I insert and it sufficiently numbs the area so that I don’t feel a thing.