Welcome SPS! Oh my goodness, where should I start. I’ve only had my Dexcom for a little over a week, and would never choose to be without it again. Number one for me is safety - the bottom limit on the dex is 70. I can sleep MUCH more easily knowing that it will ‘beep’ me awake if I drop below 70.(I do check all extreme dex readings with a fingerstick). I have my top limit set to 120 (you can set it as high as you want) so I can catch highs on the way, instead of already there. It has 5 arrows: straight, up, double up, down and double down. If I’m high and see a down arrow, I don’t correct, I wait. Low and a up, same scenario. It takes a reading every 5 minutes, and shows a graph for 3, 6, 12 or 24 hours.
I’ve learned so much about how my body reacts to various foods in the short time I’ve had it. I never knew I had a peak an hour after breakfast because I didn’t test until 2 hours after. Something to work on. I can download to the dex software and see average BG for times of day, so if I see a pattern I can adjust my basal accordingly.
That’s just a start - I’m sure others will contibute more!
Hi SPS and welcome. As jrt suggested I think a CGM may be a big help to your daughter. As for patient experience, evidence and data to help you get a CGM I would suggest a couple of things. First your daughters age and the tremendous impact a CGM can have on her quality of life. The other big advantage to CGMs is hypo unawareneness. I would try to cite specific examples, BG values and such to “prove” your daughter has hypo unawareness and needs a CGM. A testimony from a teacher or someone else who knows your daughter well and has seen a hypo may also help. The third point would be nighttime hypos. If she has ever had a hypo at night or may have a hypo at night then a CGM can be a big asset to your daughter. I know this qualifies for probably all diabetics, but I think this is also a very reasonable argument for a CGM.
I also wonder how active your daughter is in her own care. She may know everything that you or the medical profession can teach her, but if not I would recommend you consider diabetes education. Around that age I re-took all the diabetic classes and while quite booring it was empowering.
Also if my BGs are varying too much I like to start over. I mean to reduce as many variables as possible to find out what might be a problem. Have you done fasting to check your basal rates recently? Will your daughter eat similar meals at similar times to check her I:C ratios?
Hi SPS, I’ve been happily using a Dexcom CGM for one year now and would strongly advise getting one of these if possible. But you want to know how to go about qualifying. The most important thing you need to demonstrate is any history of hypoglycemic unawareness in your daughter: especially if she has experienced episodes of severe low blood glucose that she has been unable to recognize herself & treat so as to prevent loss of consciousness. Sounds from her history that you should be able to document this. Another important reason for needing CGM is if blood glucose drops dangerously while asleep, so any instances of that which you can document would be of help. Look around this site more and you will certainly find more stories of how patients qualified for CGM. The erratic glucose levels that you describe should also help, so it should just be a matter of keeping a log of these to convince the MD and, with luck, the insurance company. Good Luck!
I will print out her readings as evidence - she had lots of lows last weekend over-night with no hypo awareness. I have asked the school (yesterday) to write a letter Re; disruption to her education when hypo - she also gets headaches when BS are over 10.
We check the basal rates probably once a month, the day time ones are normally good - it’s just when she gets variables like the sun deciding to come out, or using more energy than norm in PE or running round the playground and her emotions are a big problem with school tests etc…she is a bit of a worrier.
We did hourly basal checking through the night last Sat/Sun and we had to do a temp basal rate as she kept going low. Then Monday night her levels started at 7.9 midnight, 7.9 at 1 am, 7.9 2am reducing to 5.9 on waking so they stayed pretty steady (just made a little adjustment to the basal), So not sure what Sat/Sun was all about??
Insulin/carb ratio seems spot on. Yes I think Diabetes Education would be very helpful for her. They haven’t offered anything specifically for her. I will bring this up at the next clinic visit.
These people are correct. I live in the US.
Specifically, keep great records for at least 2 months. If you use glucagon, what blood sugars were, and noting that she did not feel low at the time your blood sugar is 60 mg/dl (3.3 mmol/l) or lower, for instance. That was all they wanted here in CA for my HMO.
Mine isn’t covered by insurance, b/c they said my bg was too well under control, and I didn’t have hypounawareness, but as long as I can afford it, I will keep it. Best money I have ever spent, I think.
