I’m confused as to what exactly you want the Dex to do? What parameters would you like to set that you can’t now? Would the rate of change alerts help?
My response wasn’t meant to give specifics about my situation or yours rather a way to let you know you’re not the only Type 2 out there. Like you said everybody’s different. Over the years I’ve found that sometimes what one person comes up with to manage sugars is something that never would have occurred to me in a million years. Hence the sharing. If it helps great. If not that’s ok too.
About the other questions no I’ve not had dramatic swings in A1c like yours but my highest readings of the day are in the am. The pump has actually been the primary thing that’s effectively controlled them for a long time now. I tend to go by blood sugars rather than A1c to determine changes I need to make.
I didn’t mean to imply that metformin is a bad or ineffective drug in general sorry I wasn’t more clear. I’m glad it’s working for you always was. I actually started metformin when it was first released in the United States. I don’t know long ago that was probably 16 or 17 years now. (I’ve had diabetes for 24 or 25 years now something like that. ) It’s only recently that it seems to be ineffective for me. But it did help partially for many many years.
DianaS:
Thamk yo kindly for respomse. I am old warhorse who shold know better.
Oops - wrong - only human.
I made mistake afew years back and did not follow p amd solve why daily nmbers were
all over the place. Well , stroke and 3 years later I am back on better path solving the problems.
As indicated, pills and solutions do not last and at some point out of steam. No argument.
Your comments were extremely helpful amd germaine, I was jst not sure what to make of hence my response.
A1c allows me to evalate my monitoring and check its consistency - that is all. I do not relie ony any one measrement but a compendim of factors to get a whole field best schmoo and best swag
of what is happening.
Comments on pump most helpfl as my Doctor has been leaning on that based pon extensive data I submit.
Regarding Data logging and charts, your comments got me off derrier to download and look at data.
I have been spoiled by the Nova Max software package that allows one to specify insulin type and software averages and calclates impact time. The Color charts are incredible and allow a faster
visual analysis of data.
Otherwise, there is mch to recommend the Seven plus and its data collection provide.
Thnak you for detailed comments and your experiences that are so key critical.
Glad you found it helpful. I wasn’t offended. I think everyone was trying to be helpful as ultimately it’s how you use the data to figure out food, activity, and meds etc that will determine how helpful the Dexcom is. It’s also a learning curve in that you now have data every 5 minutes but even our fastest treatments take hours to take effect. So it’s all a guessing game anyway.
Again I’m not totally sure what it is you were hoping the Dex would do that it already isn’t capable of. What settings do you use now? Are you using fall and rise rate alarms? What would you change if you could? If we knew that maybe the group could come up with ideas that would help. Or if this is all a mute point now and customer support answered your questions that’s good too.
DianaS:
Thinking about it, my response is as follows:
I do not get any alarm indications on falling conditions, even with alerts and alarms set.
I want a separate user settable interrupt that I can set on BG and not one limited at 100.
I need and want a user settable alarm at 140 or level of my choosing . High alarm and rates work fine, low level alarm is useless to me and locked out at 100 max. I need to alarm on conditions I watch and control for. Not having an interrupt at my BG interest level means I have to manually visually watch all activity since the unit can be 15 mintes or more delayed The unit does not give me the alarms on falling conditions helpfull to me.
As previosly indicated , my Doctor does not want me going under 100. Alarming at that number gives me NO TIME to stop fall. I was told others had also asked for wider settings on the low level alarm trip point as I asked for. If not due to spec and other issues; give me one separate user alarm I can set to my needs so as to precatch a nasty condition early since they are not forcasting any errors on alookahead to overcome interstitial delay.
So far Customer service has not solved my issues and I can wait till the next release.
Jim did you try some alternate site yet?
As a somewhat big-bellied guy (if I my make that assumption), the “per-FDA labeling” frontal abs location might not work as well, for you, as some possible locations.
Excellent point. I am big gy as well. I had seen some discussion on another vendor eqipment and a site where they
had offered other sites.
I love the smoothing on the data and the removal of fast wild swings otherwise I need to have a site where te lag between DEXCOM tracking and my body gets reduced or an earlier alarm I can set to trap change faster but have the security that I will get timely warning alarm before barn burns down so I can whip in and deal with.
On weekend, I spent time watching trends as I exercised and starting early glucose tablets to slow speed of drop
and fond:
walk dog 1/4mile arond condo park - 6 glcose tablets hold the line at 160.
Walk Costco parking lot and store twice - once in morning and once in afternoon. BS starts at 185 to 190
and I let fall to 160 on my handheld and start adding glcose tablets. I used 13 tablets each time during interval to hold glcose line at 160 flat. ( dexcom at 168 and handheld at 144 on some of readings. - not accuracy issue, just how far my body steps out below sampling rate - interstitual delays.)
I am thinling my arm or maybe my finger.
As always thank you for excellent comments and suggestions.
Working with my Dexcom I was delighted to see the trendline and cetainly working with the slope of trend
line is helpfull balancing, insulin and glucose. One certainly cannot easily do that with handheld data without extensive averaging and filtering…
So yes there are good aspects of the Dexcom 7. I just want a user alarm Dexcom does not need to log or track and simply report alarm on a BG value on rising or falling or both. that would better help me manage my diabetes.
My goal is simple, I need machine that when things are quiet, stomach glucose output up and insulin cross loaded, I am happy to have machin watch that part and only report exception that need my intense involvment
My sincere thanks to all whom responded and offered their experience, comments and suggestion.
While I was concerned about my experiences with the Dexcom and still have some concerns, I was equally thankfull for the sggestions on diabetes.
IAs I am not on pump and a weird hybrid of humolog, metformin , starlix and lantus there is mch room for hypoglycemic moments whne heavy exercise coupled in.
Hmolog was not issue, starlix trned out to be generating too much insulin and cutting lunch and dinner
starlix in 1/2 cut back the insulin pressure greatly. Evening lantus is only now applied when the slope
of bg curve on dexcom flat or close to so a sto ensre not overloading. Dinner lants varies greatly depending on residals - last meal.
Finally, my body can still jump out in front of Dexcom on my rising glucose and on my falling glucose. Big systems still move faster than small ones. This also helps to explain a writer on the main CGM page grumbling at her unit and its numbers seemed all over. Simply the slow respomse of interstitial fluid and any other software delay. This as I said is not accuracy issue but simply speed of response. Explaining in terms of accuracy per centage while helpful for looking for place to hide is not real story. As long as I took this lag/lead issue into account and careflly made decisions on the handheld data during these fast moving incidents, this was held under control.
Lastly, I really could use a user settable alarm to alarm me on my BG level of concern - settable in rising or falling or both for which Dexcom does not need to log or track and be wrapped around the specification axle and regulatory issues.
One issue that really tics me off is the specification - how many angels on the head of a pin:types arguing and supporting the 20 per cent nmber when one is watching falling glucose numbers under 120
and trying to cut that off. Most drops I catch, some go straight to liver crash. I had case last night that took off and hammered my sugar up to 211. Thank god I was in window when metformin up to strength or I would have been at 278 to 311…
Anyways kind thanks for the comments, suggestions and ideas presented by all.
I’m glad it’s sort of working out for you even if it’s not what you want. I don’t have any suggestions as what you’re wanting is outside of Dex’s preset parameters and is way different than what I need. Even if all you can do is keep an eye on the screen it’s still more than you’d have with fingersticks alone.
Good luck hope you end up liking your Dexcom.
DianaS:
My view is shaped by my experiences as well as cost benefit concerns. I do not worry so much about the capitol cost - one time charge of the base eqiupment but the recurring charges. I have had stroke and am on disability and glad I have medicare plus supplement. Neither cover this good machine .
The recurring costs appear to be dexcom probes plus the finger prick handheld test strips.
So far I do get covereage on 4 strips a day from medicare if you are insulin. I can by these strips generally on cash for $ 26.00 per 50 strips.
Now , as best as I can tell reading much traffic on this, some type 1 say they need to test at least 10 strips a day. My number says 25 before Dexcom and now hopeflly I can get that down to 10 to 12 a day. The fact that my body jmps in front and back faster than machine can follow forces extra strip testing by me just to calibrate and ensure I do not misread machine. Na dyes I watch the trends more closely bt I do need to ensure where things are, Two strips a day just aint it.
So now I have this new trick machine that does provide some excellent data and capabilities and does not eliminate prick testing to a very small amount. My gess on stripo costs would be 12 - 4 (drug plan) = 8 per day I need to buy = 31*8 /50 = 5 tubs at $ 26 = $ 130.
Monthly cost is now $ 307 + 130 = $ 438 a month for having Dexcom.
I am also hopeful that eliminating any insulin excess pressure from Humolog/starlix combo reduces testing for lows on handheld. . So far that is looking better since slicing the starlix in 1/2.
AM I happy, not sure. Certainly I am getting better data and capability and I had hoped my handheld would have paid a smaller role. Three forward - two back.
SO far all I can do is hope that the technology development cycle follows similar in PC business where performance goes up and price down every year.
The other frustration is that I used to design and build,and program hardware and run teams who did. In those days I would have whipped out my emlator gear and made the qick chnages I need to meet my needs, Post stroke - forget it.
Folks:
Further testing and looking at data ( and yes I entered hand held test points - small or large numbers thru day. I suddenly realized looking at data , three missed lows in three days and resulting crashes to 278 and no real indication on Dexcom 7 that something was amiss except till after crash and then unit tells me - great.
-
In two different days I have seen pictres on Dexcom saying alls well and finger tips off by a mile. All I get is the FDA 20 % arguments. Fact remains pitures on machine are lower and wrong versus fingertips data. no wonder i could not stop crash.
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After scrounging web, I found a web site whereby dexcom users were adament that stomach /gut were useless and while arms and upper butt worked well and that numbers on gut were hopeless and unreliable. I agree. I lost 3 weeks running on black hole.
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I swapped over to arm last night and now numbers closer and highs more accurate. So far issue I arn into now is it gets up there and similar readings hang around longer and need to enter new handheld rdgs to get back down and synced better in. How many - more than morning evening 2. done both and no real improvement.
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When I hand tested my readings up to 38 a day - every 1/2 hour, I got to know where my BG was, hot spots and I stopped crashes except where I missed a time testing window.
With this machine I have no trust on that data I get is the nvarnished truth amd I have had a crash every day for last 3 days and cannot find any data on Dexcom showing where low - crash occurred.
I have done my damdest to make this work; but training and support from Dexcom have been a full zero and are blocking success here on a product , I really want to work well.
I am quickly getting to point where this product is not for me and I need to return.
- Customer support at Dexcom - not helpfull to me. I asked for another 30 days of warranty return and still do not have answer even after barage of letters faxed and playing lawyer.
With experience your having, I’d return it without further ado. Given all you have tried and all the advice given by all, it is very unlikely you can get it to be a worthwhile tool. Arm sites might improve performance for lows but I doubt it will prove satisfactory.
Don:
Thank you…
I wish i had tried the arm three weeks ago. Difference is light and day difference.
most curious was the site i found where folks were adiment that gut site was useless.
not perfect but far better tracking and response. I have spent a ton on strips following this unit last night and today to see better response.
tracking lows and liver dumps is nasty business and less understood in field and other well meaning folks.
i found article on web that talks about this and the 20 per cent accuracy:
Although the apparent value of immediate measurement of blood glucose might seem to be higher for hypoglycemia than hyperglycemia, meters have been less useful. The primary problems are precision and ratio of false positive and negative results. An imprecision of ±15% is less of a problem for high glucose levels than low. There is little difference in the management of a glucose of 200 mg/dl compared with 260 (i.e., a “true” glucose of 230±15%), but a ±15% error margin at a low glucose concentration brings greater ambiguity with regards to glucose management.
Don:
Further comment and thanks to every one’s patience. Dexcom is infinitely better and better response on upper arm location. One aspect of the Dexcom is most interesting in that they are running a parallel relative universe to one’s fixed world and it is relative. When you add the BG entries, one is anchoring their world to yours.
All is fine until the liver dump occurrs and disrupts everything especially taking finger stabs on ones finger and attempting to decide OK what is right value.
After dump fingers can be all over place and 60 to 100 points apart.
That nonsense stops when you walk and pump enough blood to flush out the loose glucose and all fingers on both hands stablize to a reading of 5 to 10 points apart. My dump occurred at 4:00 pm and my BG was finally crammed up to HI - 511 and slid back to 257. Liver does not neatly mix glucose for even mix but dumps that out and lets heart pump around the body to mix up.
The worst part of this mess is that you can get readings on your handheld that are huge compared to the stabalized average. Not wrong, but you really do not want those instantenous readings mcking up your bg averages. "transport - unmixed glucose readings from liver/gut are a nuisance till mixed up and averaged out.
In any event; I found I could trust better but managing BG entries and hand held in middle of crisis nasty. Dump occrred at 4:00 pm and fingers finally stabalized out around 9:00 pm. WHen all over the place; all one can do is take 8 readings and average out for best guess BG data point.
To get BG down and these have happened for me just before next meal. If pill/inslin not loaded I load. Have smaller meal that is tight low glycemic and skip all carbs. Save insulin to whack down that load. It usually takes me walking 1 to 2 miles to offload the excess glucose down to sub 200 and work down normally at end to 120 for bed.
I was having an issue with refill metformin which was new vendor. I had kept my breakfast metformin on some of last working fill and new stuff started at lunch. Dump’s have been occurng right when gut empties and metformin just up to full strength in blood. Strangely I could not see any drop ot or any reason for Liver dump (CGM was most helpful on this riot.) Guess was that either new Met is bad or timing of noon met pill up just s stomach was emptying and I will drop lnch pill to see if that fixes this.
Since you’re thinking about “20%”, in this post and some newer posts as well, I’ll offer some advice about this figure.
First of all, even with bG meters, TANSS! The EU-proposed “standard”, which many already-approved devices FAIL to meet, changes the rules for low bG: At less-than-normal bG levels, they allow an error of roughly 20 POINTS (even though, obviously, at “true” bG of 60 mg/dL, that would constitute an error of 33%).
Second, this is a sample measurement, and it thus follows the curve of a “Normal Distribution” around some midpoint (which is also erroneous). When you hear a support person say “20% accuracy”, they really should have said “a standard distribution, with 95% of readings within 20% of the value of a reference standard”. (Or, in the case of the proposed EU requirement, 95% of sub-normal measurements should be within 20 points – although it is of course expressed in mg/dL terms.)
That means 5% of your readings will be off by more, and some of those will be utterly WILD. (BTW, when I say 95%, I’m approximating the reference figure which corresponds to 3 Standard Deviations in the Normal Distribution.)
Got it? OK! Now- neither Minimed nor Dexcom makes any such claim. Anyone who says that they do is lying. Some of us enjoy high accuracy, but many of us don’t. YMMV!
rickst29 and folks following:
Thank you for excellent spin on the tu-tu and comments.
On cgm one can follow the relative changes and slope of changes but not fixed absolute values world of the hand helds, That belongs to them.
Get the dam sensor off the gut wall and over to the upper arm and or upper butt back. All else is a farce.
good motoring.
After last 3 days, I can say I have a piece of eqipment that is now working far better and instead of looking like piece of crap. Other website dexcom users are right: their complaint was very close/similar to mine and said get that dam gut sensor over to upper arms
to stop readings all over the map and not tracking handhelds,
I am now getting confidence on this item and lost 3 weeks on useless gut sensor locations - 3 different ones.
Wow, what a great turn of events. Lots of irony that Dexcom support cannot suggest arm sites due to being approved only on abdomen and it was really the online community that provided the answer!
Don:
My deepest and utmost thanks to the on line community and users for making success possible on a web of Issues. My special thanks goes to tu-diabetes and their website and users as well as Children with Diabetes and ladies on that site
and any other good sites I failed to mention for the excellent help, comments and suggestions.
Since stabalizing the Dexcom on a reliable site on my body, progress really has been made and I am starting to see the benefits of such technology as well as note the Dexcom has been performing well without any more hitches.
Since last thursday, the unit has enabled me to slow down and not overstimulate respond to issues and respond timely to body action trends. I have now been able to stop slamming the rails and banging my body out of the groove. This was not possible on handheld.
One item is the BG readings that Dexcom asks for and given my body’s nonsense, I take a total of 4 readings - 2 from each hand and averfage the lot and use that as BG entry and that really stabalizes the crap. The only time my finger readings are within one or 2 points is after hard walking.
For more fn , I have 3 meters; accu-chek, Nova max and Free-style and if I take 4 from each and average to a BG; I find the Dexcom and nicely tracks em all and throughout day things track very well.
SInce stabalizing Dexcom, I have switched over to meds and working with Doctor to fine tune and that has been most helpfull as well.
So…thank you one and all of the on-line community for your support that has been crucial to turning down the firefight and starting to reap excellent benefits of such technology.
The dramatic change I expected from such technology is now begn to appear and enable better glucose control and provide hidden unobservable data.