We had our endo visit yesterday, upon arrival as usual they requested our Omnipod to download the data from it. I asked if they wanted the Dexcom as well, which they did not. I have been thinking about this since, and wanted to know what others experience is with this. We are extremely reliant upon our Dexcom and often only check BG's when low (or if indicated by CGM that he is dropping), or if he is high and in need of a correction, and of course when calibrations are requested. My thoughts are that if the information is downloaded from the Dexcom, far more information would be available and assist with making changes and recommendations.
I agree completely! I went to my endo about 2 weeks ago and they said they did not have the software available to download the G4 only the 7+. I was so irritated by this...why have they not reached out to Dex to get what they need for their patients and why has Dex not come in to them, I know the reps would be all about getting them software as this would lead to more scrips and therefore more sales. I do not write down my numbers it's really bad I know but I just can't be bothered, this will give you all sorts of pretty graphs and information and yet you can't or won't look at it, you just fuss at me for not keeping a logbook.
Unfortunately, you will have to advocate for EVERYTHING you want for him. I am lucky, my endo really "gets it"...he helps me run half marathons and cycle up to 100 miles. He wants me to do these things...while managing my numbers as well. He downloads info from my pump and dexcom. Then we look at it all, and compare to my own handwritten logs, WHICH NO TECHNOLOGY can replace. He will start looking at a group of high numbers, thinking we need to change a pump setting, and my logs will show I was getting my sugars up in preparation for exercise. So, having personal notes/logs always trumps what the technology says. Therefore, if you are keeping really good logs, the Dexcom info may not be so necessary. But I feel the more info you have, the better plans can be made. You can do several things. You can simply download the last few days of info from the dex and take it with you, or you can find another endo who will download it for you at visits. It sounds like you rely on info from the dex daily, so why wouldn't you want his doctor to rely on it to make decisions? Best of luck to you.
we havent written down numbers in forever, aside from what is done at school (his aid records all BG's and notes what the CGM trend is). Maybe I should, but so much of our life is absorbed by diabetes, it is kind of nice having technology do some of the work for us.
They should get software to download G4 if already available.
I personally think it unconscionable for a doctor not to include Dexcom data. You should ask that they download it. If they give you the excuse that they are unable to, contact your local Dexcom rep and get them on the case. I would also look for another endo. That may seem extreme, but here's my analogy: If your son broke his arm and you took him for an xray and took that xray to the doctor who was going to set the bone and he or she said, no I don't need it I'll just look at his arm, you would leave. The Dexcom provides the greatest picture of your son's daily diabetes.
My doctor started me on the Dex7, switched me to the G4 when they came out and when I go for my visits, they used to read it. Then toward the end of last year, they said that they didn't have the computer program anymore to read it. This is a hospital and I don't understand it. So now, I go in and make a copy of the report myself and take it to the doctor. We study that chart much more than them reading my Blood tester and they have never run my insulin pump. So it might be a better option. The Dexcom report is SO important. Good luck! Make your own copies - I have learned several things from just running it myself.
In the past when I would go to the Joslin clinic they would ask for my glucometer. Now that I have the Dexcom, I do not intend to bring my glucometer to the clinic with me. I have checked with my CDE to make sure they have the appropriate cable and software because the last time I went, my CDE attempted but did not have the right approvals for the new software and therefore could not download the data from the receiver.
My thought is that while some endos and clinics embrace the newer technology, many more do not. Given the brevity of appointments, maybe the information overload would not allow time for other things that the doctor or clinic thinks is more important ?
My CDE and I go over the Dexcom data and diet and ratios, the endo is more for the physical side of things, do I have feeling in my feet, how are my eyes, any serious hypos,how do I look feel ? I'm ok with my CDE actually working with me on insulin doses and since she recommended the Dexcom in the first place, she is happy to see the results.
That's inexcusable. Do they know that they can download the software in a few minutes? Insist on it. Bring them the cables and the unit if necessary.
If they still drag their heels, then print out the Dex report and bring it in.
My guess is that the endo is still thinking about the pre-Dexcom world, in which the average CGM didn't perform well enough to be comparable to the gold standard, which is still fingersticks. Let you doc know that the G4 is certainly close enough to work with, and it certainly adds actionable information in combination with fingerstick results, *which it records and includes in its data.*
It's so person dependent. I went to the endo this morning, and they have the ability to download the Dex (the rep told me) but the nurse didn't want to do it. I also had printed out the logs and she still didn't want to see them. All she wanted to see were the pump logs (and whatever they had to download it was broken). I told her the Dex gives a better picture but she just wanted to see the pump. Note this is a pediatric endo and Dex is not approved for kids (although you can get it) so it's probably not a normal thing for them and just a routine thing more than anything. The nurses were holding the G4 like it was an alien technology. As it is accepted more, I expect this to change. With these records on my pump and CGM, I'm not going to write anything down anymore - total waste of time IMO.
A lot of places cannot just download new software just because they want to, especially if they are a large hospital and outpatient clinic system. A lot of medical software is incompatible with Windows 7 or if it is compatible installing requires a coordinateted set of appointments with the office staff, the vendors, and someone in IT who has administrative privileges. It’s a bit of a nightmare actually when something new rolls out and installing software like this may be way down on the list depending on what other IT needs and priorities there are in the system. It’s not as simple as you might think.
That's a good point. HIPAA privacy and security regulations means installation is more complicated than for private users, so there will need to be planning and some time will pass before it's up and running.
My endo doesn't have any software and my CDE doesn't download my devices. I bring them printouts:
- Dexcom Studio Daily Trends Report for the last three weeks, one week per report (same as the Data Manager 3 Glucose Modal Day)
- The endo also likes the patterns report which has the Daily Trends graphs plus patterns and stats
- Copilot Logbook Report for the last 3 weeks in descending date order (I use version 4.2.0.1669 US which uses a larger font than the older version I was using. I can now print on letter sized paper rather than legal sized paper and read the report without a magnifiying glass.
- The OmniPod PDM Settings Report, page three only (the information from the PDM Settings tab)
- My paper logs for my CDE. She gave me a great paper log that has one sheet per day. It has space for glucose readings, boluses, exercise, and plenty of room for listing exactly what I ate. If anyone is interested, I can email you a copy (in Excel 2003 format)
I would be interested in that- for when my son is at school. So far we have made due with a notepad, but it gets pretty messy-
Thanks everyone for replying. I may send some reports to themes they can see and compare how much more information can be obtained from the dexcom.
Given the mix of software required by endos to support each meter, pump and CGM, why don't you download it at home, and upload it to an all-in-one service like ManageBGL.com where you can also analyse it pre-visit, and print out the reports you need too?
I agree that software can't replace decent logs. My endo used to only look at my morning pre- and post-prandial BGLs using a modal day report, which does not take take into account ratios, timing differences, different meal sizes etc. A modal day report needs to show the carb ratio and correction ratio for it to be truly useful.
My endo has me print out 1 or 2 charts and bring them in. Her office computers are very underpowered and outdated they cannot handle all the data downloads from all her patients. She has a company that supplies and maintains them and they are really basic older models they need updated computers. Lately I have brought my own laptop with all my data.She does not use most of the data.
Our endo does the download, I agree it seems that for us dex is the more meaningful now that we only do calibrations, and then put in a high blood sugar for a correction, we don't have MOST of our numbers on the pod!!
Sounds like you need a new endo!! Doctors have to keep up!! Things are moving fast but gees! inability to get your dex data is malpracice as far as I'm concerned... I cant wait till it's all web based and not so operating system specific, for one.
I am working on a software application for my medical practice that ya'll might be interested in, it will PULL dexcom data through a qualcom interface called 2net, then push into an iphone ap I'm developing, such that you'll have a health dashboard to monitor to help improve your behavior on a daily basis... I'd love to have some early feedback from dmoms and t1 adults and anyone else on tu that wants to get healthier!
amen