Hi Guys, I came across this post as I recently got the MiaoMiao + Spike to use with my Libre (which I have been using on it’s own for 2yrs). But the question I wanted to ask is how much is too much to check your levels with the CGM and by check I mean look down at your watch or app? My DE already thinks I scan too much with just the libre and that it’s not exactly great to check so much etc. as she does’t want me to think about diabetes 24/7.
A bit of background: I’ve been T1D for 20yrs MDI until 2 months ago I started my first pump (T-slimx2) and had a horrible time with it - no trusting etc. and increased anxiety, so I am now back on MDI. Any insights you guys have with the Libre+MiaoMiao+Spike would be greatly appreciated! Thanks
Many of us check our CGMs and meters a lot. We use the Dexcom G5, and probably check it 30 times or more per day (in some situations more than others). On top of that, we use on average 10-12 glucose meter strips per day.
Naturally, this is a very personal thing I think. We sugarsurf and make many adjustments along the day.
I can’t think of any situation where I’d feel we are checking our CGM too much Of course, YDMV.
[EDIT] Btw, I split your post into a new thread as it seems to be its own topic.
I know i dont think about diabetes 24/7, i have to sleep sometime. But i do check my cgm and fgm alot throughout the day and also fingerprick on average every 2 hours. Mabey thats alot but i try and run tight numbers, 90 - 110. But like to stay around 70 - 100. I use an enlite gcm, and libre fgm but dont totaly trust either. Both work fine during stable bg’s but lag abit. As long as you are not stressing over having to check, i feel no harm no foul. How else are you going to know where your at. Not all of us can be the bg whisper and always be correct.
And welcome also.
I keep a pretty close eye on my CGM and probably glance at it upwards of every 20 minutes if I’m not busy. Mostly out of curiosity, and sometimes to check in on how a treatment decision is playing out. I’m checking for information, and I do not feel anxiety over getting or not getting that information.
I would say it’s a very personal thing, and maybe ask yourself why you are checking often and how it’s making you feel. If you’re checking often because you just want the information, that’s probably fine. I’d say the only time that checking “too much” might be bad is if you’re feeling really stressed or anxious about it throughout your day, and getting overwhelmed by too much information
I think as you have access to more information you naturally check it more often than before. With that said, having had access to CGM data for a couple of years, we now check it less frequently. Honestly, if our Endo asked how many times we check the data, I wouldn’t bother answering, because that isn’t the most pressing issue to us. The real question in my mind is how often we take action. And based on our usage, it is definitely every hour at a minimum. Is that too much?
I probably check the CGM and IOB 20 to 50 times a day. Mostly in clusters when I’m making an adjustment with glucose or insulin and watching for a response. I can see how someone could become obsessive about it, but for me it’s kind of like “How often do you check your mirrors while driving?” For me, checking the CGM doesn’t have anything to do with anxiety, it’s all about keeping track of where I’m headed so I can steer in a good direction. Can’t steer if my eyes are closed.
I’m not sure if it’s “too much” but our son’s care plan asks the teachers to check his numbers every 15 minutes, more if there’s a sharp change.
And when I look at my iPhone statistics I have about 160 pickups a day where the first app I look at is Dexcom Follow. My husband gets the same notifications, so presumably looks at least half that amount. And we get SugarMate calls if he’s below 80. Add to that that I have NightScout running on my work computer in the background all the time.
So I’d say for us, there is no such thing as too much. Even with this frequency of looking, there are often times we miss trends if my son is away from his phone or my phone happens to be in another room and I haven’t checked for awhile.
I don’t think there’s ever “too much” unless one is pathologically neurotic about it. I’ll ignore mine for hours on end when I’m focused on my work (when I ignore everything else too), but if I’m tackling a problem high or low I’ll keep an eye on it much more frequently. When things are relatively stable, I might look at it once every two or three hours or so just to see how things are going.
This is likely because my G4 receiver lives in my pocket. If I had the data on a watch or my computer screen, I’d probably be looking a million times a day.
Lots of great advice above! I would also add that your DE isn’t you. And, I suppose if it is turning into a nervous tick, that might be something to address with a counselor or therapist. But if we are actually discussing checking your BG using your sensor, I don’t really understand how there could be too much. Sometimes, it’s a lot – sometimes, it’s not very much.
That seems like such a strange advice to come from a medical practitioner. Not looking at your diabetes doesn’t make you any less diabetic.
To me, it should really be up to you! Not to your doctor, not to your diabetic educator, not to anybody else. You are in charge of you. And it sounds like you’re trying to take the best care of yourself possible!
Are you more comfortable back on MDI? When you switched to the pump, was that something you wanted to do or was it something you feel you needed in order to fix a specific bg problem you were having on MDI?
I ask because I attempted podding in 2008, two years into my T1D diagnosis. My doctor’s office did all of the “right” things to get me transitioned, but it was awful and I was not getting the help I needed to truly learn pumping and thrive on a pump. I went back to MDI until 2014. I tried podding again in 2014 to solve problems that were not being solved with my MDI regimen. I had also tried new MDI regimens to no avail.
All of that is to say…when I was trying pumping, going back to MDI, trying different strategies on MDI with poor support, and going back to pumping…obviously my tools weren’t working great for my bg management and there were issues to solve…which meant LOTS of testing to stay at least safe, if not ideal. My endo told me to slow down on testing…my CDE told me to slow down on testing…but, their opinion on that just HIGHLIGHTED how much they did not understand that we had this huge elephant in the room (mostly tanking overnight lows) and they weren’t helping me solve it, but they wanted me to test less so I could “relax.”
That’s not how it works. At least, it’s not how it works for me.
So, if you are pleased with your current management and swiping your Libre (or whatever you do with Libre) helps you, don’t worry about it. But if you are not pleased with your current management and you are swiping a lot to hold on for dear life (or something less dramatic than that), keep swiping and keep problem solving. FUD is great at helping with problem solving. But doctors thinking that testing or swiping a lot is mentally harmful are not always right. It can be wise advice for certain personality types, but this disease requires vigilance. Anyone who thinks otherwise either has the best self-care plan ever established or doesn’t truly understand how fast bg can change. At least that’s my experience with it.
I think the DE comment is probably one of those well meaning motherhood statements that get turned into an over simplified action item that never quite fits your individual needs.
Like - “Stay Hydrated” becomes “Drink 8 glasses of water a day”. Which completely ignores the fact that everyone has different needs for water and if you are running in the desert you need a lot more water. The goal is stay hydrated and the general guideline is 8 glasses of water, but for some reason people will make the goal “drink 8 glasses of water” and not worry about the staying hydrated part.
So I think in this case “Try to optimize the time spent managing your diabetes” turned into “Do not check your CGM all the time” which may turn into “ONLY CHECK YOUR CGM ONCE PER HOUR OR ELSE YOU ARE A BAD DIABETIC” Then your goal becomes not optimizing the time spent on your managment but instead all you worry about is managing how often you are looking at your CGM. Oh no - I looked at it 15 minutes ago and I ahve to wait 45 more minutes. Ok now only 15 more mintes left… ok I can look now… In other words you start watching the clock instead of your diabetes.
I have my CGM reading on my watch. I love it. I glance at it every time I check the time, and usually if I am feeling my blood sugars changing I will take a glace to see how it is trending. It is very unobtrusive to me. It helps me optimize the time spent managing my diabetes because if I give a correction before my blood sugars go too high, I spend less time managing trying to get them back down.
Thanks so much for your responses! And thanks for the welcome, I only just discovered this site.
I went on to a pump because I thought that was what I should do, as everyone was saying it will give you better control etc. my control has always been ‘good’ but I thought it might help with my sporting commitments and to help my morning dawn phenomenon - which it did. But since I started on the pump I never thought about my diabetes as much in my life, I think because it was constantly ‘there’ and attached to me. It’s definitely changed my way of thinking and I am trying to get back to the kind of thinking I had before the pump which was more relaxed.
I have had the libre for 2 years and I looked back at my scanning before the pump and it was still a lot but I guess no one told me it was ‘a lot’ and I was fine, but since being in constant contact with my DE with the transition to the pump she has highlighted it as an ‘issue’ - I do think she means the best but I guess she just doesn’t understand. I think the fact she has highlighted it as an issue has got me concerned I am checking too much now.
I am more conformable being back on MDI, but it does feel a bit old/clunky now since I have opened my eyes to the pump and how more precise the dosing is. I kind of feel like I’m missing out now being on one now, but maybe I’ll try again in the future.
p.s. Now I have the miaomiao attached I am not sure if this is a good or bad thing - I may be a bit too reactive with the trend arrows.
I started on Dexcom CGM first and then OmniPod pump about 3 months later about 4 years ago.
Yes, I, too, was very reactive with the trend arrows at first. I have to say, I was really stunned by the numbers I was seeing, so I think it was only natural to be reactive!! I had no idea I would rise and fall so drastically in between finger sticks! I still am reactive when it is going straight up! Hence, as others @Michel mentioned, I sugar surf, too. I tend to take the correction then watch the CGM trend to see if a temp basal reduction is required. Being able to use the temp basal on a pump is one of the features that cannot be done w/ MDI! Yes, it does require dedicated monitoring, but as a T1 for me, it is the only way to keep tight control. Of course, we all want to be stable, but if we aren’t then sugar surfing is the next best strategy
I check my CGM often (maybe every 5 minutes!) when I am not stable, for example after dinner, or after exercise. I use a watch w/ Dexcom so it is really easy to just glance at it while out and about, during exercise, etc. While working, my Mac displays the value in the menubar so I can easily just glance at it. So when I am stable and nothing is changing in the environment to make me unstable (eating, activity, stress, etc.), then I may not check for a few hours at a time, but as I said, I may glance at the menubar from time to time. If I see a big change then I’ll try to figure out what is causing it, do a finger stick on the meter, and then make an adjustment, such as set a temp basal on the pump, take a bolus correction, maybe eat something.
Sorry for the long answer! I’m just thinking it out as I write!
And @Mel in the event you don’t know where the term “Sugar Surfing” came from…
It is a book by Dr. Stephen Ponder whose premise is basically - diabetes management should be dynamic because your body is dynamic. My interpretation, it is looking for patterns on your CGM and giving correction boluses or correction carbs as required to keep in range. It is the opposite of a fixed bolus regime.
Oh - and how appropriate today’s blog title is “Glancing at a CGM screen is an empowering act.” so I hope you feel empowered
Then your goal becomes not optimizing the time spent on your managment but instead all you worry about is managing how often you are looking at your CGM. Oh no - I looked at it 15 minutes ago and I ahve to wait 45 more minutes. Ok now only 15 more mintes left… ok I can look now… 
In other words you start watching the clock instead of your diabetes.
