I was about to do my second Calibration for the day around 10:30. My meter said 263 when the dex said 401. I decided to try again about 20 mins ago as I really needed to get some sleep as I remembered not to calibrate if its that much off. Well my meter said 263 and the dex still says 401 (it did dip to the 300s for a bit) so my question is should I skip this calibration and hope it will kink itself out or should I just go ahead and calibrate so I dont wait all night for it to sort itself out? I really can not go to sleep until I have some sort of answer.
Part of me say wait till morning and skip this calibration but then another part of me is go ahead and do it so it is in sync. So I have no idea what to really do!!!
I’m gonna go to sleep…I can’t keep my eyes open any longer. I’ll just calibrate in the morning and when I print out the reports, I’ll just tell my dr that there was a 100+ difference between meter and the dex but I still do look forward in reading the advice you guys can give.
Here’s my $0.02…I would do more than just two fingersticks a day if I were in your shoes. I would also enter the 263 value (assuming that was the second fingerstick at that level within a short time period). If the Dex couldn’t digest that value, then it would tell you to enter another fingerstick.
Last, this is OT a bit since it isn’t specifically Dexcom related, but I wouldn’t want to go to bed without treating a high BG level like you had. Whether it is 263, 363 or in fact 401, it still is too high and shouldn’t be ignored.
If this continues, maybe you need to replace your transmitter. It wouldn’t hurt to call dexcom’s tech support. Also, Any metal can effect Dexcom’s communications between the transmitter and the receiver. This would include loose change, belt buckles, some pajamas that have snap on buttons, etc., if your Dexcom receiver is too close to a cellphone (like in the same pocket/area), can cause an incorrect reading
the thing is I do not know how to treat a high. I’ve been at this since 2006 and no one bothered to teach me. This morning was a bit better with the calibration. I’ll enter my lunch time one so its a bit better and can catch up.
Please get in contact with a good CDE, or an endocrinologist. Knowing how to treat a high is crucial. It’s the main reason why a person is a diabetic in the first place!! (assuming your on insulin) If you don’t have a doctor that knows what he’s treating, it’s time to move on to a doctor that does. It is unacceptable for a patient to be almost 5 years in to his/her diabetes and not know how to correct a hi… FIRE THAT DOCTOR!!!
I do have a good DE and well my dr is good too but not pump happy yet. I can’t just find a new dr that easy. I do have state insurance (meaning I have commonwealth care which is managed care medicaid so finding a dr is not that easy). Plus the Joslin center is going to be the best for me to go to.
I’m late to this party but I would have calibrated even if they were reading so very far apart. If a single calibration didn’t bring it back in line I would have called the Dex help line. Maybe not at bedtime but certainly the next day. Unlike Minimed you also cannot overcalibrate the Dex. You wouldn’t lose anything by calibrating and you would possibly gain better accuracy while sleeping.
A correction is when you take extra fast acting insulin to bring your blood sugar back in range. Do you not have a sliding scale? You can ask your doctor about this when you see him.
Are you taking set doses of insulin? Carb Counting? Dosing insulin based on blood sugars and food intake is a big big part of pumping. The pump will do the calculations for you but understanding how it all works and getting some “practice” with MDI based on corrections and carb counting pre pump start will make your pump start go a lot better in my opinion.
It also may go a long ways towards getting your dr to sign off on the pump. I personally don’t like the idea that people with diabetes have to “prove themselves” before a doc will order a pump but that’s how some docs operate.
I’m glad you’re enjoying your Dex. I love mine. I would give up my pump before CGMS. Not that I want to give up pumping either.
YMMV: if i were to put in the 263 when dex was 401 ( which is as high as it will show BTY) ; it would give me false low readings ( somewhat based on the 140 pt difference) throughout the night. it would also most likely ask for at least one additional blood test within the next 15 minutes. ALSO get yourself a copy of both “Think like a pancreas” and “pumping insulin”. They will teach you how to correct lows, and how to adjust your insulin to help you maximize stable appropriate BG levels. This is a disease where the patient MUST be proactive, as it requires much closer followup than a medical professional will ever be paid to provide.
I am on humalog 75/25 mix as 4 shots a day was stressing me out so he put me on that. I know what correction is. I just never had to do it. When I first started off as a diabetic I was on a sliding scale. Then was off of a sliding scale then put on the mix. Now I want a pump to de-stress me some more. I’ve been carb counting since day once which Joslin doesnt seem to understand. I’ve been telling them I’ve been carb counting since I started going there in January of 09.
The reason why I dont want to go on the 4 shots a day is once again as I said many times is my job schedule is in the middle of lunch time and my break is 15 mins long and that is the time frame to wait to eat and my job isn’t going to budge on that or I lose hours which I can not afford to do.
ugh, I’ve said many times I already have both of those books! GRR! I really do need to switch to the pump due to work schedule and not wanting to do MDI again. I just dont want to keep doing it. Its time consuming for me, stresses me out, and really doesn’t help lower the numbers. Plus I am at a part time job where I HAVE THE TIME to switch over. If I get a perm job, forget it. I can’t take that time off or I will lose my job (it has happened before even though I have no proof of it but I do suspect it was a reason).
My dex straightened itself out this morning’s calibration and is now working normally.
I put in calibrations even if I am off by 100. I haven’t noticed subsequent false low readings, but I wasn’t looking for them. I suggest contacting Dexcom tech support during regular business hours (it’s no longer an emergency since you are now back in calibration) and ask them what to do if it happens again.
My experience has been that my endo does not know the in’s and out’s of my devices (CGM and pump). My (nurse) CDE is more knowledgable, but for the most reliable information I would go to the manufacturer. I also trust the people on this blog to provide practical advise which might not be officially approved by the FDA.
By following up now, you will be prepared the next time this happens. When I was still on MDI, I wasn’t prepared when I grabbed the wrong pen before bed and gave myself 16 units of humalog instead of levemir. I didn’t know what to do, so I went to the ER and was ignored for several hours. By the time they finally started treating me, I was down to 35 and needed glucose intravenously. Of course the tech missed the first time. The next day I called my endo, and he told me what to do so I wouldn’t have to go back to the ER if I ever made that mistake again (which I did once before I started pumping). Those Dunkin Donuts sure tasted yummy!
I am surprised that your doc is putting up roadblocks on your getting a pump. Mine had been encouraging me for years to get one. I didn’t want to because I felt if I couldn’t control my diabetes through MDI it meant I was a failure. Stupid me! Now I am pumping, I am in better control and much less stressed by the “D”. My life no longer revolves around and is no longer ruled by diabetes.
The Dexcom sensor generates a small amount of electricity in the sensor. The transmitter measures the current and sends the data to the receiver. As each sensor is calibrated, the receiver learns what the corresponding BG via finger stick equates to what sensor data. After about seven days, the receiver has it but then it is time to change the sensor (or restart it).
I calibrate with every insulin dose/meal and when I get a check after a meal, I punch that into the Dexcom as well. My spread (BG to CGM) stays about +/- 15-20% at all times after 48 hours with the sensor.
Biggest piece of advise, watch the peaks and valleys NOT THE NUMBERS themselves. Calibrate with each insulin dose and any time you do not feel like the number it is showing. The Dexcom must learn who you are and how sweet you are at the given time.
Remember, Dexcom is a TOOL, not a body feedback loop.
One other thing of note… Yesterday my sensor was reading higher than my sugars all day. I then noticed that the tape had become loose on one side. As soon as I changed the site, the sensor was reading correctly. Make sure the sensor isn’t starting to become “unstuck”.
My guess is it isn’t a problem with the equipment. Looking at your posts and pics your BG bounces all over the place. The Dex can’t get a good calibration when you are having those big swings.
If you are on a 74/25 mix, you would not do a correction bolus, as you would also be changing your long acting. I also think you have a misconception of the way a pump works. You will be needing A LOT OF PERSONAL TIME for at least the first month, and probably several months, to get the settings correct. It will also require FREQUENT Blood tests, to assure that you are not giving too much, or at the wrong time, until you have a feel for how the delivery through a pump will react with any given food, exercise, time of the month, etc. A pump gives control like a high performance race car… , (over-steer, and it will roll over) it will not “de-stress” you. I am very surprised that your insurance will pay for a CGMS if you are only taking 72/25 twice a day???
“Joslin probably doesn’t seem to understand” since you are on 75/25, and don’t want the hassle of MDI of only 4 times a day. What does the “carb counting” that you do accomplish for you? How could you compute a correction level for you, if not on a seperate short acting? and how could you calculate your I:C factor?
I already know I do not do correction bolus. I’ve used the 75/25 mix for over a year now. And I already know about the personal time hence why I am doing it while I have this part time job vs a full time job where I will not have that time.
I have commonwealth care which is managed care medicaid. If there is a good reason on the medical of necessity letter which there was they will cover it.
The I:C fa
I carb counted since 2006. I am only allowed 45-60 grams of carbs per meal and if I dont count them correctly, I over carb as I can eat a lot in one sitting. Computing the correction factor will be a bit of the challenge but the trainer will know what would be the best. Today my sugar level was at 265 and my dr wanted me to be at 225 for the two blood test he ordered. He figured I took 28 units this morning he calculated 4 units of humalog. Which did the trick to get me to 225 in one hour. So it is doable. The I:C factor can be calculated with what I was taking and when I was on the humalog/lantus i was on a slding scale. I am sure that we will find the perfect settings. I have read about I:C factor since June. I have way to much time on my hands to do TONS of research. The dex has helped me understand what is going on between meals and at night! My dr was finally able to see that roller coaster I was talking about. Because of the dex and my choices that I made with foods along with my finger sticks my A1C has gone down a bit at todays appt. Which makes me happy
Sometimes Dex just starts acting funny. Once it was moisture by the transmitter (I now dry the transmitter after a shower if I see it is not calibrated). Sometimes I can not figure it out. I had perfect readings Friday, Saturday, Sunday, until Last night.
After I had a Pomegranate and a bunch of Blueberries after a no carb dinner, I was wondering why I did not have a spike by 11:30 (my Bolus usually kicks in 30 minutes later. I am afraid to bolus much sooner), at 11:30 Dex still showed 120. So I started thinking, was it because Farb got injured and it upset me? So I checked and my meter showed 227. I Calibrated, and took some correction bolus, went to sleep. Wake up this morning and see all night my correction has not worked and I am still at 220!!!!! So, I check again and it is 140 on my Meter. I calibrate again, bolus for my 20 G Carb breakfast and come to work. Now Dex shows 233. But usually by the time I get to work, the bolus has taken care of my breakfast. So I check again, and the meter shows 96. Wow, that is a big difference. Dex asks me to test again, and I get 110 and calibrate again.
I have had this happen once or two times before, but it eventually corrects itself. One day I will figure out exactly what causes it.
