Maintaining Normal Glucose Levels

Type 1 and LADA
#1

“The nondiabetic ordinarily maintains blood sugar immaculately within a narrow range—usually between 80 and 100 mg/dl (milligrams per deciliter), with most people hovering near 85 mg/dl. There are times when that range can briefly stretch up or down—as high as 160 mg/dl and as low as 65—but generally, for the nondiabetic, such swings are rare.” Dr. Richard Bernstein M.D., F.A.C.E., F.A.C.N., C.W.S., FACCWS.

What is the longest period of time you have been able to maintain non-diabetic glucose levels of 80-120mg/dl (120 mg/dl is up for debate, I guess)?

#2

I guess this thread is for CGMers only. Non-CGMers have no way of knowing. Once in a blue moon I have 24 hours within 70-120 mg/dl. I can easily monitor this range because my alarms are set at these level. I definitely never had 2 such exceptional days in a row.

#3

Sorry. I cannot help nagging at non-CGMers. Maybe I get one person to wonder and try it out. My CGM took the sting out of my diabetes. If more diabetics get a CGM the economics will improve, there will be an incentive for CGM manufactures to improve the technology and eventually CGMs will become as common as pumps. I remember my resistance when my doctor forced me to switch from urine strips to pricking my fingers. Soon after I could not imagine going back to urine strips. I feel the same way about wearing the extra doohickey thingamabober. I cannot imagine going back to bg strips.

#4

Dave, obviously you are one of the not so few people who are frustrated with the MM CGMS.

I use the DexCom 7+. Let me go through your “wants” list:

A. The DexCom 7+ is accurate enough for me so that I typically prick my fingers only for calibration (twice a day).

B. I don’t feel the sensor at all.

C. The alarms are so loud that I use vibrate during the day.

D. Range is not perfect. The receiver gets only about 90% of all transmissions during the night. Even if I was told that the 7+ does not work at all at night I would not give it up.

Other issues:

A. There is a considerable lag going up. With the 7+ there is no or almost no lag going down. For me the low alarms are the important ones. I can prevent disorientation by popping a glucose tablet. There is not much I can do about highs because fast-acting insulin is not fast-acting. I can only reflect on what went wrong and try to avoid the same problem in the future. That being said I bet that I catch a high earlier than a non-CGMer.

B. I understand the hesitation to pay out-of-pocket. If my insurance would cut me off I would go out of my way to come up with money. I guess I am CGM junkie. I had 2 sensors which I had to pull before the 7 days were over. Most sensors are very accurate beyond 7 days. I agree that the technology is finicky. I just get so much out it that I do whatever it takes to keep it running.

#5

18 hours :slight_smile: And that did indeed include lots of food.

#6

Dave, I agree that there is no rush. Maybe next year the combo of your dreams will become available. I am also looking at the 7+ as a device to hold me over until something better comes along.

In regard to learning late about 200: I have learned so much about what certain foods do to me that I rarely go over 160 whereas before I would be above 200 on a regular basis. Thus the problem of learning late about 200 does not exist for me because my bg does not go that high anymore. My problem has been reduced to learning a little late about 160 instead of not knowing that I am above 200.

#7

Between 80 and 120?? - definitely less than 24 hours (like Dave said). Maybe 18 hours like Sarah said. Maybe even once or twice a full 24. Never longer. And I’m a veteran like many here, inching toward my 20th year as a type 1. That would be a range of 40 mg/dL and a standard deviation of close to 10ish, no? Sigh…but a girl can dream.

Now if you increased that to between 65 and 160 (those broader extremes), I would say that many days of my pregnancy have seen that, but I’ve had to keep a very tight leash on everything just to keep it that narrow. I still see a number above 160 at least once per day, despite tweaks to basals/ratios/etc and a (love-it-so-much) Navigator CGM.

#8

I must correct myself and line up behind Dave and Melissa: definitely less than 24 hours. I flipped through the last couple of months and this is the best day that I could dig up:

#9

Great stats, helmut. Here is a recent one of mine where I would say I almost made it the whole day.

#10

I think about 12 hours? With my MM CGMS. I don’t think I could have done it without it.

#11

Not long enough… I’m still diabetiic.

What a big bummer it all iss. On another note congrat is you can keep those levels thereee :slight_smile:

#12

Before joining TuDiabetes, I had spent my entire diabetic life (ages 10-28) thinking that these two truths were fact:

a) the kind of control my doctors asked of me was absolutely and statistically impossible (which made me feel beat down and hopeless)

and

b) everybody else who is a diabetic must be able to do this, otherwise they wouldn’t ask it of me (which made me feel isolated and defective)

Joining here and sharing with you guys helped me see that we’re all fighting the same battle, we’re all succeeding/progressing/babystepping as best we can, and normal control on a daily basis is an elusive and unrealistic expectation. But, like I said, we keep working.

#13

Another one here with “less than 24 hours” as an answer to your question, Danny. I try, though, as I’m hoping for a pregnancy soon and that is the range I’d be required to be in throughout the pregnancy. I can say it’s not easy! I have a CGM (minimed), but it frustrates me to no end because it’s usually off by a good 50-100 points. I am intrigued by the Dexcom now after reading this post and wonder if I should look into a trial…guess it couldn’t hurt.

#14

I’m 6 months pregnant and have been using the Navigator CGMS for about a year. It’s beautifully accurate, even after restarting the sensors and wearing them for longer. It has given me so much peace of mind.

Even pregnant, with my 5.6% A1c, I want to let you know that you shouldn’t expect to be in that perfectly delicious range all the time and not to beat yourself up too badly. I shoot for under 140 mg/dL at an hour after meals, under 120 at 2 hours, and a fasting glucose of 70-90, but life gets in the way! I see a number over 200 a couple times a week and top 160 at least once daily. What’s important to me (and why the CGM is crucial) is that I correct aggressively and try to get the number back down as quickly as possible. We have to give ourselves permission to be diabetics doing the best we can.

#15

Thanks for the tips, Melissa. It’s always more comforting to hear that from someone who actually experiences highs and lows, rather than a doc who doesn’t. I love my endo and ob, but neither really “gets” it. You know what I mean?

Have you only used the navigator as your CGMS? I wonder if anyone has switched from the minimed to the Navigator or Dexcom and had better experiences. I should probably post this question over on the CGMS board!

#16

I demo’ed the Minimed and Dexcom before choosing the Navigator. In talking to people on TuD, I’d say that everyone who switches to Dex or Nav from MM has a better experience.

I found the MM to be an evil harpoon. It was so inaccurate and painful (in my back right hip) that I left a tear-soaked voicemail on my CDE’s phone, telling her there was no way I’d consider CGM.

Then a few months later, I agreed to try the Dex for 7 days. I liked it. It was more accurate than the MM after the first day of wear and much more comfortable (wore it in my lower abdomen). I couldn’t feel it. What I didn’t like was the lack of features on the receiver (graphs, statistics, events, etc) and the short range of the device. If I wasn’t wearing the receiver, it lost my signal. I couldn’t even get the 10 feet they claimed for it.

I started the Nav about four months after that and have nothing negative to say. I can leave the receiver in my classroom and walk two classrooms over to talk to a colleague and it will continue to read the data. I can have the receiver in my purse in the kitchen and go out to the mailbox and not lose data or have to reconnect. The accuracy is spot on after the ten hour warm-up period and throughout the wear, and it’s easy to insert/use/etc. I love being able to mute the alarms, flip through screens of records about my standard deviation, lows, etc. I love that it has a built in meter for calibration so I don’t have to carry a meter. And I like that it uses the same strips and software that my Omnipod PDM uses.

#17

By 3:30 a.m. if she is at a stable number, she will vacillate around 30 points (if basals are spot on and they are changing) until she wakes up. If she sleeps late on the weekend, she will have a nice long stretch of stable numbers. Unfortunately, on school days, she has to get up and eat at 7am. But the nondiabetic range of 80 thru 100, never. If she is 80 I will give her some juice to bring her up to 100. I would consider 90 through 120 overnight ideal.

#18

Wow-Melissa…you took the words right out of my mouth.

I just joined this site this week. I’ve not posted much, but I’ve read a LOT and have learned even more. I think that you hit it on the head by saying that those truths made you feel beat down, hopeless, isolated, and defective…boy is that true.

I commited to turning my haphazard eating/dosing around, found a new endo, and am trying to proove to her that I can be compliant to get a pump. (Her words…:slight_smile: ) My management was careless, at best, due to the things you just said. And I own my own stupidity about it all…but it sure nice to know that, well, I don’t have to add shame to the pile anymore. :slight_smile:

#19

Type 2 here.

If I stick to eating clean foods meaning no rice, breads or pasta I can stay within the 80-120 easily. What takes alot of effort on my part is not cheating on my meals every once in awhile. To answer your question I went almost two months last time without seeing anything above 110. I could have went longer but Sushi was calling my name LOL.

What I don’t get is "There are times when that range can briefly stretch up or down—as high as 160 mg/dl and as low as 65"
How long is briefly? 30 minutes? an hour? two?

#20

Thanks for the info. I think it’s time I contact my endo and CDE and ask about doing a trial run with the Nav and Dex. I agree with your comments about the MM…my biggest gripe was the huge inaccuracy. I knew going into it that the numbers would never match my meter, but I expected it to be close!! Otherwise, what’s the point?

I’m a teacher, too!!!