Reading this post by Amy Tenderich about data logging in diabetes and why (by itself) it’s not the holy grail, made me wonder how does everyone here feel about this:
-Do you log your diabetes numbers?
-Do you do it online/keep a little booklet for it/both?
-Do you find it overwhelming?
-What do current diabetes logging systems good for?
-What are current diabetes logging systems lacking?
-Any other thoughts?
In an ironic twist of fate, I’ll lead off the discussion:
I’m the co-founder of MYLEstone Health, and we make Glucose Buddy.
Logging diabetes numbers is not the holy grail, in fact, far from it.
As a Type 1 diabetic, I do log, and it helps me recognize trends every day. It’s not the fact that I can review past logs, but it’s more that I’m taking the time to think about my numbers and see my reactions to food and medication variables.
Is it overwhelming? Absolutely.
Could it be frivolous if not done consistently? Absolutely.
I compare it to going to the gym;
If you go for 5 minutes once a week, you’re not going to see any results.
If you go 1 hour a day, 5 days a week, you’ll see substantial results…
however, if you have a trainer you could see the same results in half the time.
Unfortunately, finding a worthy diabetes educator/doctor is more difficult than going to your local gym and asking them to assign you a personal trainer.
Glucose Buddy, as it stands now, would never claim that it was the Holy Grail. What we’re doing at MYLEstone is expanding Glucose Buddy’s capabilities to include other things such as Education, Entertainment, Logging, Social Networking, etc. with the hope that somewhere within Glucose Buddy a diabetic will be able to better their life.
However, I’d also like to share that I’ve received hundreds of Emails and have had hundreds of conversations with diabetics that have told me that Glucose Buddy, as itself, is THEIR holy grail. This further displays the notion that what works for some simply doesn’t work for others.
When I was using the Ultra Smart I logged my exercise, my bg, my carb intake… This was so my endo and CDE could find patterns and gave me somewhat better control, now that I’m Ping’d my pump records everything except my exercise… Which according to my CDE is not a big thing as long as I know what days I excercise. I donload my pump to ezManager and set it up on a file drop for my CDE and endo so they can look at it at their leisure. Seems to work. Now the reporting for ezManager… Lacks a bunch but that can be a whole subject by itself !
I rarely tested at all, let alone logged, until I started pumping. If it wasn’t for the pump keeping track of things for me, I might still not be. The amount of information req’d to really be successful is daunting, esp when you look at the logging of that information for literally decades. Right now it seems that a pump/meter combo seems to offer the best tools
I was terrible at keeping a written log. I rely on my meter and my pump to keep track of my BG, my carb intake and my insulin intake. My doctor and my CDE do a pretty thorough job of reviewing the numbers with me, but I wouldn’t think of faxing them in or emailing them to get an opinion - I know they don’t have time for that. Besides, they’d be looking at the numbers in a vacuum.
I do wonder often why I keep these numbers, since I look at them rarely and when I do it’s a major chore to figure out what they all mean. I see the overall trends (e.g., bg tending to rise before lunch, frequent lows before dinner, frequent bed time highs) and adjust accordingly - i.e. by the seat of my pants. I’m going to examine the KEAS project Amy mentioned. I’d like to see some real time explanation of wtf these numbers add up to.
Terry
I passionately HATE logging, and if I found a tool that made it easy (i.e., nearly effortless) I might be more willing to do it, but I quit regular logging about 9 years ago, since after 12 (at that time) years of Type 1 diabetes, I didn’t really see any advantages to doing it. I had been told by doctors, CDEs, etc to log to find patterns, but I keep such an irregular schedule that it doesn’t really help, and even when I tried living a very scheduled life, my health care team didn’t seem to have much helpful input about patterns from the information I provided.
But again, that was 9 years ago. A lot has changed since then in terms of the tools available to us to make this work, but I still hate writing down every blood sugar, insulin dose, exercise session, bite of food consumed with carb counts, and every other tiny factor that can affect my blood sugar. I’d love to hear about anyone else’s success with a logging tool, or any recommendations they have. I wore a pump for more than 12 years and took it off last year, so while I used to have a record of doses and glucose readings from the devices that issued/took them, now I only have the BG readings. Any logging I ever do happens the good old fashioned way-- writing it down in a notebook. I don’t use the pre-printed logbooks because I’ve also never found one of those that suits my needs (I know, I’m way too fussy). But that logging tends to last about three days at the longest.
I hated logging on paper but I did it and never used it. Now I have diabetes pilot on my palm pilot and it helps me track BGs, exercise, it has a food database so I can keep track of how many calories, carbs, fiber, protien etc. I am getting. I use the information and make changes accordingly. I also have an insulin pump and CGMS that can also be downloaded and the info used so that i can make changes to achieve better glycemic control. It is not a waste of my time because It to help me. If the info isn’t used or someone doesn’t understand how to put it to use, then it is a waste of time and energy and isn’t helpful at all.
I’m a T2 and love the wavesense app for the iphone. I did write down my results prior to using the app but this is so much easier. I log to see how I am doing and am able to compare it with my nutrition for that day/meal. I use the bodybugg program for that. This allows me to adjust my diet and carb intake so that I can better control my BG. For instance I have found that carbs (more than 10-15g) are bad for me for breakfast and if I do have some carbs I need to balance it with a certain amount of protein. Since my log is on my phone I am also sure to have it with me when I see my Dr. I would absolutely love it if the new upcoming bluetooth wavesense meter would sync with the computer as well as the iphone.
I think this is one of those areas that is a personal decision and you get out of it what you put into it. Before I started using it to help figure out what I can and can not eat it was just a bunch of numbers I wrote down because my Dr wanted to see them at my appts.
I find it to be a pain in the butt. lol, but I try to do it most of the time.
I keep them in a “diabetes diary” from www.coheso.com
They are pretty cool.
I think I have a problem with logging as much as knowing how much of the food I ate and calculating the carbs. By the time I’ve done all that, I feel too lazy to write all the info down lol.
I lwrite down my numbers, the carbs I ate and the amount of insulin I used on good old fashioned paper, because for me it is the fastest way. I use whatever logbook my endo has available at the time, as long as it has enough space. During the week I keep a very regular schedule, so this is easy for me. The logbook is extremely helpful for me, because I adjust my dosages a lot short term. A few days of stress and bad eating for example will make me more insulin resistant for a few days, before everything goes back to normal. Without the log book I’d have a lot more roller coaster days.
I have a bit a different take on the whole issue of “logging.” I “log” my BS and write down notable variations in my meals, medication and other factors. I keep a small book for this matter and use it to annotate my downloaded meter readings. I analyse the readings in an excel spreadsheet to understand my standard deviation, analyze the effect of medication changes and perform my own little “human experiments.” I find that I can often point to personal achievements that I would not be able to see if I did not log.
For exercise this has turned out to be critical for me. I also maintain detailed logs for exercising. I write down every weight lifted and how many times. Pages and pages of this stuff. I have spreadsheets of stuff over months and years with my progress (or non progress). But let me tell you, if you do an activity like exercise and you cannot see improvement, it becomes frustrating. In many cases, you won’t be able to “see” your improvement unless you make these observations and write them down. To me, if I go in the gym and lift a weight one more time than I did before, then that get’s marked as a Personal Record (PR). These little accomplishments make a big difference in my attitude and how I look forward to going to the gym.
Yes, I log.
I use a 4x6" 50 page notebook in my purse, a one page per month columned dealie on Word printed out so I can write on it, and an Excel spreadsheet (added to about every week)…
Never overwhelming. Love numbers. Tweak numbers.
I believe in analyzing, seeing causes, interpreting, rooting out problems and enjoying.
Each type of logging is for a different reason: in the notebook I save time by having the grams available from favorite foods on previous pages. It’s a page a day so serves for 100 days. I write down the time, preeating results, exact food being eaten, total gms, and units - and that’s when I give insulin. I write down shopping, exercise, and number grams taken. Correction doses are in there.
The columned page is for viewing patterns for times of day and scanning down days at suppertime, for example,. It lets me see tests that are creeping up. It puts together the number grams and units in close approximation at the six times of day I might put food in my mouth.
The Excel is for seeing at intervals how the averages and standard deviation are moving through the month. It also figures daily sensitivity and ratios for feedback.
I like my system: with the 3 parts, it has made me take time to look at the data from different vantage points. I was called “brittle”. I think tweaking over time removes brittleness as one resets targets. I’ve tried apps; I used the Dexcom’s system & profited from it (compared its data with the foods in my notebook). We need to try different methods, experiment with them. I think using more than one method makes you have to take time for comparisons, for analysis. And time for analysis is a key. ( My A1c is in the 5s consistently; standard deviation between 5 and 12 consistently; no lows; average 96).
I’m terrible for logging… when i was first diagnosed i logged everything… i had whole notebooks filled with dates and a ton of numbers. However… when something went wrong with my A1C and my endo accused me of lying about my numbers and wouldn’t consider any other cause for the high A1C i quit logging because it didn’t seem to be worth the time and effort it took to do all that work if my endo was just going to disregard it. Now i have a new endo because i’m an adult but I still don’t log. I know i should start especially with the new technology and all but… haha anyway that’s my story
I stopped logging for years and I always felt the necessity and the sense of doing so. Once in a while I was motivated and then it was overwhelming because it did not fit into my life / work schedule. I always thought positive about logging with technical gadgets. But after loosing one month of data with my palm I was really upset. In addition to that I realized that the data was kept in an undocumented database format and there was no way to access it anymore.
So I started the project Glucosurfer with these thoughts: free of costs, usable in full anonymity, free data exchange via xml, usable via HTML and even WAP to support many mobile devices. I really prefer to use my mobile phone that has an affordable data flat for 8€. By using WAP the page can be quickly accessed even in areas where 3G is not available. With this choice I do my logging directly after the measurement or any other event worth to be documented. This way I can integrate the logging into my daily routine and it has helped me a lot to accept the little burden of logging. It is interesting to note that you will still make the same mistakes and you will still have months that you want to forget about. So I look back at the last month and see that I have made some serious mistakes. But instead of just claiming that I am the victim of D again. I can now analyse the situation because I have all this valuable data at hand. Why all these lows at night? Why I am less sensitive to Levemir? With some reasons and conclusions at hand I can start to think about modifications. This makes me the person in charge not my D and this is enough motivation for me.
I use the Glucose Buddy app on my ipod to log my food/activities/and site changes (Hey Matt, there’s an idea for a new section!), but leave the numbers in my meter or pump. Once a week I’ll upload the numbers to Carelink (which I truly do not like, as 1: it is on windows not mac, and 2: their reports I do not find very helpful…). I then export a csv with the sugar and insulin numbers from carelink, and upload THAT to web app a friend created, which pulls the relevant info I need and in a format my cde insists on (screen shot here…)
http://longesturinal.com/diabetes/DanDataOct19.pdf
(I know, lots of high carb meals lately, strange week…)
The glucose buddy food and activity info I then import onto that same website.
I agree with the other posts that it is the act of logging that is most useful, in that it forces me to keep check on my daily activites, but although it is very rare, I will go back now and then and look for food trends, etc… One major frustration is having to log the food and sugar/insulin numbers separately, and the fact the whole point of the digital data for me is to make it easier to log and send the info to the cde and doctor, but they often have trouble with the digital side of things, and I have end up faxing them printouts from the website anyway! grrr…
The most useful improvement for me would be to be able to consolidate the pump/meter data and the glucose buddy food data automatically, with more customizable reports. If Glucose Buddy could do what the web app does, and pull relevant information from the carelink csv, that would be a huge improvement for me…
-dan
My cgms pump keeps a month’s worth of numbers, and every now and then, I’ll download it to my computer to look at trends and make adjustments.
Can someone send me their Carelink CSV to mtendler@glucosebuddy.com?
Thanks.
When Caleb was diagnosed and shortly thereafter when he started pumping, I logged religiously and I logged everything. I have spreadsheets for basals, IC ratios, correction factors even separate spreadsheets on pizza, Chinese food, etc. As variables have become more predictable, however, I have pulled back. I find myself going back to the logs when we go through times of change. It’s also not uncommon for me to pull out a scratch piece of paper and map out his basals and BGs for the last couple of days and come up with adjustments.
What I find most important right now is to track specific dosing for the challenging foods that Caleb eats. I have a “note” set up in my phone which lists the food and the dosing I used last for that food and the result. I refer to that the next time and tweak as necessary.
Caleb recently started DexCom and I have yet to download that data since I’m a Mac and it’s not Mac friendly, but I hope to do that soon and see how that can help in managing his settings.
iv’e done it online = takes a while and kind of pointless!
i’ve written it down, i always forget i usually just logged my #'s and if something was off i would make a note of it!
my pump has it all(= and is the easiest!
Medtronic CareLink , as a sensor user , has helped both my Health Team and I to change some of the carb ratio’s , timing of insulin delivery , sensitivity ratio’s etc. .I do some manual data logging most the time ; it helps me to read some of the for me pertinant information , such as when did I do an infusion set , when did I start my " new " sensor " .
I don’t find " it " overwhelming …but do feel at times, that my life with diabetes consumes a lot of time around managing diabetes.On the other hand …it is paying off …27 years and no complications todate.