Dexcom Question---How often do you use your meter?

I tried the Dexcom for a month I think. It was inaccurate and too painful for me so I just went back to finger sticks alone. It was constantly beeping to tell me that I was low or high etc. when I wasn't. It stressed me out. I never trusted it to take insulin or sugar, so I think I was testing more with it due to all the warnings, but I tend to test a lot anyway. If they ever approve the one which uses light and which doesn't require having a sensor inside you etc. I will definitely be interested, depending on accuracy. I think you really do need to do a lot of finger sticks to be sure what is really going on with your bg, especially if you are hypo unaware. There are some lucky people who have more accurate results & who can tolerate a sensor. Someone said they only do 3 sticks per day with it. I think your doctor is worried about possible errors with lows.

While I never had the Dexcom, I had the Medtronic CGM, I just didnt get much out of it. It kinda annoyed me. I think a lot of people do love their CGM, and maybe if I was just newly diagnosed NOW I might have a different opinion of it, but with close to 30 years I've survived by testing and I'd much rather have my pump, and do finger sticks than the CGM. The device kinda annoyed me, but I have managed to get my BG levels pretty stable, and I don't really have sudden wild swings, maybe something else that would make me reconsider. My endo asked if I was using the CGM, and I'm like no I tried it and it annoyed me, he was in agreement based on my blood glucose levels I don't REALLY need it. But that's me, I think for a lot of people it does provide an added sense of security and comfort, but I too would not rely on it entirely for dosing my insulin.

I think that the CGM also makes diabetes less work. It's sort of ironic in that it's always tempting to see what's going on but it gives you the number *and* the rate of change. If the number isn't perfectly on, particularly if it's changing, it's pretty easy to scroll back and guess about where it is. I noticed almost immediately how much less time I spent wondering what my BG was doing when I got a CGM. They don't really market this but I think they ought to.

I've been using my Dexcom for about a year and a half now and would be lost if I had to give it up. While the accuracy amazes me sometimes, I've seen enough random craziness that I would never dose insulin solely based on my cgm. I still test 10 to 12 times per day, even if I'm stable and in range, just to make sure. It's all about peace of mind for me.

The main thing I love about my Dex is the ability to see what's happening between those finger sticks and overnight - plus the security of the alarms. Those graphs are so valuable for setting basals.

While I can see that a teenager would not be crazy about fingersticks, as a Dexcom user and a parent, it would terrify me to think that my child was dosing insulin based off the cgm. Most teens eat diets that are significantly carb heavy, meaning fairly large insulin doses - unless their carb counting is spot on... carb counting mistakes and big insulin doses, along with corrections based on cgms... scares me. JMHO as a mother. Many of the people here eat relatively low carb diets and/or have stable bg levels most of the time - I would speculate that most teenagers don't fall into those categories because of their age and hormonal changes.

If my teenager didn't like the cgm and wasn't hypo unaware, I'd just skip the cgm and use fingersticks, instead of dosing from cgm.

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IĀ“ve only had a CGM for 3 months (Dex G4) and find myself using it the same way as Laddie describes.

To answer your Q:
On a regular basis I find I test less. When something is off - the meter or the CGM - I test at same rate as before I got the CGM.

I always trust the CGM for dosing decisions. I only do the twice daily calibrations, no extra checks unless I suspect a problem. The real value is knowing the trend rate, which is just infeasible if you're doing meter checks 20 times per day or less. If you can get him to wear the CGM by doing fewer checks, that's a definite win. There is always the chance of being inaccurate, but that is true of the CGM, traditional meter, and any other device. That's where you use strategies like understanding typical daily patterns, interpreting sensations of highs and lows, and considering unusual factors like changes in exercise or illness. In those situations, do the occasional extra check if your intuition says the CGM may be off. Don't sacrifice the good in pursuit of the perfect.

me too, sometimes I test more because CGM is saying dropping, I'm low, low or high high and I'm not if I test on my meter. NEVER do a correction or take insulin while using your CGM for a guide. Many times the CGM is spot on if I'm steady but it can also say I'm dropping to the 40's when I'm in the 80s. It serves the purpose of providing data and trends, especially middle of the night and shows spikes etc after meals.

i've done some over correcting too many times with the CGM because it's given me low, low, low's when my meter hasn't, it makes me kinda freak out like 'am i really dropping this low'. But, when I change out my sensor and it's recalabrating and now working 'yet'..i feel like I'm kind of becoming 'dependent' on it, feel reassuring in a weird way too.

i'm kinda starting to hate wearing this Dex G4 too, especially on my stomach (very little real estate) and with a pump starting tomorrow. ugh. I put it on my arm yesterday, although I have very little fat....it doesn't bother me at all on my arm but it did take a full day of messed by CGM numbers to get it to work better.

I noticed a tremendous increase in accuracy when I upgraded my G4 software. Their statistical algorithms are often the deciding factor in accuracy.

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When I first got my CGM I was specifically told (and itā€™s in the manual) that a CGM is not a replacement for blood glucose testing. The CGM is meant to be able to help you see patterns in your glucose level and be able to figure out what the foods you eat and activities you do and medications you take, etc are doing to your glucose levels. And also to know when you are rising, falling, or holding steady. A CGM is supposed to be used in addition to blood glucose testing, not to replace it. This is what I was taught and I agree with it, even though it is very easy and tempting to just go by the CGM readings. :smile:

Even with my very accurate CGM I still test at least 4 (usually more) times a day.

At the moment, Iā€™ve been carrying a newer G4 receiver (with Share) (newer software) and the Animas Vibe (which is stuck at the older software version). I have found very little accuracy difference between the two ā€“ and both quite accurately follow my meter - especially on the lower end of the range. If anything, the newer software seems to err on the low side (which I take as ā€œcautionā€) a bit more than the older version. On the very high end, there is the greatest difference between the CGM reading on both receivers and the meter.

In general, I do test with the meter before making dosing or correction decisions, but there are times when I do rely on the monitor. Last weekend, for instance,I was at a wedding and though my meter was with me, I relied on the monitor with no problems. The consistency of the Dexcom results has given me confidence to use it. Of course, the G5 is approved for clinical decisions in Europe, but I think the G4 is close enough in accuracy to satisfy me.

Iā€™ve been CGMā€™ing for about 7 years now. Love it. I still do 10-15 fingersticks a day based on what the trend arrows tell me. I confirm, check for the rate of change and dose accordingly (or use the temp basal). Most of the time my meter and my CGM agree. I just like to have as much data as possible. Maybe itā€™s cuz I was Dxā€™d before there were meters nad there is joy in knowing what is going on. I really donā€™t mind the fingersticks, I just have to remember to use real good hand cream at night to fight the calluses that make getting a sample tough.

Given that the fed requirement for meter accuracy is +/- 20% (did it change to 15 recently), I donā€™t see it as the magic ā€˜accurateā€™ BG reading. I do bolus off my cgm because 95% of the time itā€™s reading is lower than my meter. I have never, in my 15 yrs with a cgm, run into problems bolusing off cgm reading. But, ymmv and I am not recommending this for anyone else.

Iā€™ll admit that I did get into a little trouble once on the older Dexcom firmware. The CGM lagged behind on a high a bit too long, leading me to over-treat a bit. Ended up checking when it STILL didnā€™t come down, so I was ready for the big drop when it occurred.

In my experience, a properly calibrated Dexcom CGM is at least as accurate as a meter (except during the settle-in period with a new sensor), so I do not see any compelling reasons not to use CGM data to make dosing or correction decisions. Given the relative inaccuracies of both meters and CGM, I take any CGM or meter readings with a dose of skepticism, and check and re-check if I find necessary. Iā€™ve made any number of ā€˜mistakesā€™ in my T1D management, but I do not recall any that I could ascribe to CGM (or meter) inaccuracy. If I were to assign priorities in CGM technology developments I would rank faster settle-in time first, reduced delays and faster updates (e.g. 1 min as opposed to 5 min) second, and improved accuracy third. Of course, these are all just personal opinions, ymmv.

During periods when BGs are not changing rapidly (angle up/down, single or double arrow up/down) the Dex is plenty good to use to treat provided recent tracking aligned well. I still fā€™stick plenty but Iā€™m getting more and more comfortable using the Dex to treat. I will be cautious if Iā€™ve delivered some correction boluses and waiting for them to kick in.

I only used a can a previous generation can (Dexcom 7 plus) for a few months, several years agoā€¦ It was very glitchy and didnā€™t work well for me-- I actually ended up using my meter significantly more while using the Dexcom because I was always looking at he Dexcom going ā€œthat doesnā€™t look right, better double checkā€ and usually the meter just confirmed that the cgm was malfunctioning

Thank you to everyone who answered this. I just came from a new endo who made me feel awful. He said he would only allow me to test 3 times a day since I had a dexcom. Time to fire him.

@Bunny1 I still have a recent (and currently not quite accurate) Rx from my endo for 900 strips every 90 days. I used to get 1400 but that proved not to be needed now that I have a Dexcom. In the near future I may ask that the Rx be written yet again (long before it expires!) for an even lesser amount. Recently, Iā€™ve dropped strip usage to an average of 6 tests per day. I could make do with less, I think. I often skip calibrations for 1/2 a day beyond when the orange ā€œdripā€ shows up on the receiver. :slight_smile:

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Thanks @Dave44. This doctor in general made me feel crummy. Heā€™s not been helpful at all. I went through a really, really life-changing, stressful hard time, and all he could do was blame me for not having a good A1C (although all of my other labs were perfect- and Iā€™m working on my blood glucose). Although I stood up to him, I left and cried for hours. I will never go back. He reduced me to that scared little girl that I was when I was first diagnosed.

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