Wow! First day with Dexcom CGM and it's been interesting. Talk about behavior modification. As I was eating lunch I watched my BG spike over 200 so I stopped eating. My pump settings suggested not to correct because of the IOB so I waited a while, then corrected with the suggested amount, went on a walk and watched 2 arrows show up as I dropped from 200 to 180 to150 all the way to 60!
I can see how these arrows could make you overcorrect and go kind of nuts! Any advice? How high do you spike after meals? How has the CGM changed how you eat and treat your BG readings?
Oh yeah, on my first 1-week trial I was wearing the battery down with all my graph checking I spike way too high after meals for many reasons (girl hormones), and Dex helps me catch a high before it’s out of control. But…when it’s off, it’s 30-60 points off and I end up overcorrecting. It helps to be able to give small units of insulin if needed, I don’t pump so I go down to .5 or even less if I can manage (I’m on MDI).
Good luck! It’s a great learning experience!
Courtney - you will learn a lot about how your body responds to exercise, diet, stress and many other things. But please remember that the CGM is not a glucometer - it indicates trends, and that can be very helpful. Always check your blood glucose with a meter to learn where you really are before you make significant adjustments to your insulin. The CGM is only a tool - it is not a replacement for your meter or common sense. This is really an important thing to remember - the CGM can be off substantially at times, and you do need to be aware of that. In time, you will learn what the changes mean and you will recognize patterns that help you understand what is going on, and adjust things accordingly. In the meantime - enjoy the ride!
Actually, I’ve been checking more than my normal 10+ times a day because I don’t trust the CGM yet! So far it’s been amazingly accurate.
I guess the main thing I’m seeing is how high I spike because I normally test 1.5-2 hours after a meal and I’m normally at a good number by then. I’m just shocked to see the numbers spike so high! It makes me not want to eat anything!!
The CGM has made me start taking my humalog insulin a good 20 minutes before I start eating to prevent the super high BG spike I see when I drink something as simple as a glass of Sugar Free Instant Breakfast. I’ve also noticed the CGM makes me eat a lot healthier, I’m more likely to not order french fries with a burger and not eat as much pizza – which is both good and bad.
I agree with just about everything shared with you. My thoughts:
- When you dose your insulin, it is to cover the meal and have you to your target in about 3 hours.
- Well prescribed insulin to carb ratios may change over the day and with other physiological parameters (emotions, hormones, pain, illness).
- ALWAYS do a finger stick to dose insulin. Put the value in your Dex.
- Watch what happens and make paper and pencil notes as well as mental notes. I ate the same exact family restaurant meal three different days in a week and my curve when straight up once, a gentle climb another and stayed flat the third. All were target in three hours.
Ditto what Lane and Jay said. Upon starting a CGM I realized that bolusing 30 minutes before eating made a big difference, and I had to resist the temptation to overcorrect before the insulin peaked at 3-4 hours. Once you have the trend arrows and the data (albeit with a 20-minute lag) it is hard to keep from overreacting. On a few occasions I bolused before the insulin peaked and I didn’t bother to test my bg, so I didn’t realize that my bg was already on the way down.
That is why the pump is so important when compared to Multiple Daily injections…the pump shows the IOB, where with shots i was just guessing how much IOB…the big thing i like was the not having the highs due to the fact that i take my inuslin about 12-15 minutes sooner than eating the food, …LOVE THE DEX, JUST WISH THE SENSORS WERE FREE
I use to spike pretty bad after meals as well, but not anymore. Take it slow. You are going to get a lot of valuable info now about how your body responds to food, exercise, insulin, stress and many other things. I learned that small corrections work well. Once you learn your body responses, you will be a master at controlling your diabetes. Take it slow and remember it takes a little longer for sugar to show up in the interstitial fluid than it does in blood. That is why your readings between the two are so different. Don,t sweat it to much, you’ll get it!
I have noticed mine spiking up to 250 after meals and it takes 3-4 hours to slowly drop down to 120 ish… is it normal to take this long?? I don’t feel like it took this long before I was using dex.
I don’t trust my dex yet… numbers have been off… and even when I don’t eat for hours, my numbers start rising with single or double arrows… anyone else experience this? This even happened after a correction…
I noticed I spiked a lot at night and had a few lows at night as well…I discovered what I had to chaffed the portions of my favorite foods so I don’t spike too high. For instance no more meduim caramel latter from dunkins. A small is better for me.I learned not to eat at fast food often or even getting a smaller sized sub than my usual so I have a learned a lot so far