First A1C with Dexcom: thoughts and experiences

Today we had our first A1C measure since she started using the Dexcom CGM. (referring to my GF of 8 years TI since 9 years old) We had our best A1C reading ever at 6.8 She started using Afrezza 1 year ago now and her A1c has dropped from 7.8 before Afrezza to 7.4, 6.9, 7.0, 6.8 To be honest we had hoped for a greater improvement in her A1c since starting her CGM but it does mark her first reading with a full 1.0 drop since starting Afrezza, which is an exciting milestone.

We absolutely love Afrezza + Tresiba + CGM. We have learned so much about her body and how she reacts to different foods and situations. We have learned to time Afrezza dosing so much better with the CGM feedback. Fast carbs in fruits and sweets should be dosed immediately before eating while slower carbs, like pizza should be dosed at the end of the meal and require aggressive follow-up dosing. We also were able to visualize a post breakfast peak that she was having every day and we didn’t know it was happening. Wout the CGM she would measure BG before breakfast, dose during the meal and measure again before lunch. Her BG would be pretty much in the normal range by lunch but every day she had a >200 peak right after breakfast. She started dosing 8u instead of 4u before starting breakfast and she has all but eliminated that peak.

The CGM has also been invaluable in dialing in her basal as well. We can now see that she was trending down during the night because her basal was a little too high. For her it was also beneficial to switch from morning basal to evening basal dose. We would have never been able to make these corrections without the CGM.

The last point I would like to make about the CGM is it demonstrates conclusively for us, just how poorly the A1C measures your average BS over three months. I have posted many CGM traces on twitter of average and challenging days like Thanksgiving and its clear to us, seeing her readings day in and day out, that her average blood sugar was well below what the A1c indicates. Having said that we are still very excited by her best A1C ever and we hope to continue to improve and learn how to control her B.S. with the great tools we now have available.

Good luck and good health to you all. Special thanks to those of you Sam in particular who motivated us to give the CGM a try.


wonderful news.

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Thanks Mike! Forgot to mention you as well! I believe you too recommended using the CGM. We love it.

Congratulations on the wonderful milestone! It definitely makes for a power trifecta… win-win-win!

Cheers to health!


I hope you’ll pardon me if I remain somewhat skeptical of your analysis, but I noticed some things about your past posts and tweets:

  1. You always refer to your “girlfriend” as “her” and “she,” but never call her by name. Most people with a loved one at least occasionally call them by their name when discussing them. I also notice that – apparently – “she,” herself, never has anything to say about afrezza or diabetes. It’s always you who makes the comments.

  2. I notice that you tweet very often about afrezza:

Indeed, you appear to have tweeted about next to nothing but afrezza since you opened your twitter account last August! Presidential elections come and go; major sporting events pass by; all kinds of interesting news in the world but every comment I looked at by you was about afrezza!

  1. By the same token you also post about Mannkind Corp. on “stocktwits”:

And again, it’s about nothing but Mannkind and afrezza! And not just an occasional message, but a relentless stream of messages sometimes 5-10 times a day!

These observations recalled to mind something Amy Tenderich pointed out in her own article, “Six Things to Know Before Starting Afrezza”:

“6) ePatients Beware – If you plan to blog, or in particular, Tweet about your experiences with Afrezza, beware investor trolls! They are mostly obvious with brand new Twitter accounts showing only an “egghead” profile pic, and a timeline that talks nothing but #Afrezza. Some are more subtle. But all are pretty ruthless in their attempts to control the message in the interest of influencing MannKind stock prices to their own advantage. I guarantee that unless you are saying 100% glowingly positive things about Afrezza all the time, you will be hounded and patronized.”

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I really couldn’t care what you think. Please ignore everything I have to say. Regarding Amy she blocked me when I asked her a legitimate question regarding her experience with afrezza because I was concerned about my girlfriends intention to start afrezza. I’m not a fan of hers as a result. If you have any legitimate questions about dexcom afrezza or tresiba please ask. Otherwise please refrain from corresponding with me.

Why was my post removed? I’m confused by this.

My response was deleted as well. Oh well. Very happy to hear you’re having such great results. It really sounds like dexcom is vastly improved since I last used the previous model. Cheers to a happier, and healthier new year and many more going forward.

Thanks Sam. We highly recommend the Dexcom to anyone using any type of insulin. The insights it provides are a valuable tool to understand how your body responds to foods, situations and time of day.

I just ordered the dexcom today after much teetering on the fence… I think I’ll probably just use it intermittently for self study for the time being… my insurance quoted me at $268 for the startup kit with “90 days” worth of sensors and they told me I actually would qualify for the $200 rebate so it’ll only be about $68 to get started


Wow - didn’t think you were ever going to join the dex-side @Sam19.

I hope we now get to see some nice flatliners posts.


We will just consider it an experiment for now… a large part of the consideration is how well the combo seems to pair with Afrezza… I don’t personally see near the appeal of continuous monitoring when paired with other insulins that work so much slower.

In the past when I used he dexcom 7 I was newly diagnosed and it actually just seemed to increase my anxiety over the whole situation… and it didn’t work very well for me, so hope for a better run this time.

Thanks @Vibes121 you talked me into it

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Outstanding! Look forward to hearing how well it works for you. Magaly used a previous model CGM paired with the pump some years ago and hated it. Needle was long, set up unreliable and often needed repeating. Dexcom is easy and we have never failed with new set up (I always help her). Quick and easy. Awkward at first but can be done in two minutes now. Data sharing on smart phones also a plus. I can see her BG in real time 24/7 and often warn her when she it about to go high. Good luck! I hope it helps you! I agree that is a nice pairing with afrezza.

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I’ve been using mine for about 9 days now… it’s been a little less accurate than I’d hoped for and I’m not impresssd with its ability to maintain a Bluetooth connection to my phone but I see what you mean it goes hand in hand with Afrezza so much better than it did with novolog…

The benefits of an update every 5 minutes when you’re using a rapid insulin that fast are pretty remarkable. Honestly I don’t and didn’t perceive anywhere near that much benefit when I was just using an insulin that takes an hour to start working and 3-4 hours to be done… cgm with Afrezza is a winning combo. How easy is it to just set up upper alarm to 120 or 140 and take an appropriate dose based on what I had eaten when I start spiking across that level as notified by a beep on my phone… having to think about it is a thing of the past… it almost doesn’t even really matter how accurate he cgm really is at that moment because whether the number is correct or not the cgm can certainly detect an upward skyrocket and the Afrezza can certainly stop it in its tracks

From dexcom clarity report avg glucose 91, std dev 19, hypo risk n/a.
Range 60-140
0.5% time high
97.2% in range
2.3% low (believe all were false lows caused by laying on top of the sensor… I apparently have a habit of rolling over onto that side at about 3am and triggering false lows)

This thing won’t give me an estimated a1c because I haven’t been using it long enough but if this pattern held true and is accurate— it’d put it at 4.8ish


Nice work Sam! We have been happy with its accuracy. Make sure to wash underside of sensor with alcohol swab between applications. We have noticed a bit of inaccuracy with some locations at first bet it settles down with-in a day. She always uses abdominal site off to her side. We still love the immediate feedback!

I’ve found my accuracy much improved since I started doing the first 2 start-up calibrations 15 minutes apart Sam, if you aren’t doing that try it.