FUDiabetes

How differently do you manage BG when you stop using a CGM?

I am wondering how people change their BG management when they decide to go without a CGM for a while after using one?

@Chris’s son goes without his CGM from time to time for 4-5 days. I do too, but most times only for about a day. For me, I can’t manage my BG without CGM the same way as I manage it with one. So I have to change my techniques a lot with and without.

With a CGM, I am very aggressive with meal bolus and corrections. I would rather use more insulin than less. I don’t like being high. I also use high temp basals on peaks, and long suspends on lows. Because I wear a CGM, I can see when the trends change and change what I do then. For instance, if I go on a peak, I turn on a high temp basal and dose a lot. But, when I see the peak go down, right away I shut down my temp basal and sometimes I suspend.

Without a CGM, I dose less. I never anticipate a rise (I often do in a peak with a CGM), and I aim for a higher BG when I come back from a high, in more careful steps. I don’t use aggressive temp basals or suspends. The worse part is peaks without a CGM, because I can’t feel myself go high until I am about 200 (or more), so I waste time before dosing, and spend more time high.

But the result is that I must be at a higher average BG without a CGM, although I can’t really prove it without a CGM. If I did not have peaks it would be a lot easier to go without a CGM. Before I got into puberty, it was not that hard, really, but now it is a lot harder.

I would be really interested in reading how other people change their techniques when they go without a CGM after using one.

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I’ve read your question, really like it, and am mulling it over…

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Like you, I’m nowhere near as aggressive when I’m not using a CGM, whether that’s for a couple of days or a couple of weeks, because I can’t see any sudden or risky trend change. I accept that I’ll probably run a bit higher and I don’t get stressed about it. In an effort to prevent ending up too high or too low, I fingerstick more frequently, but not obsessively – pre/post-meal with a few spot checks in between (if I remember). If I’m concerned about any particular trend, I might fingerstick every half-hour or so. Overall I don’t mind not being on the CGM, although I prefer to be, but then it’s a relative newcomer in my diabetes toolbox.

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Since we sugar surf with Liam having that trending data is critical. Without the CGM we would be unable to manage as we usually do so our processes for everything would change.

  • Strict BG checks for eating and corrections
  • More things done “on schedule”
  • A lot more finger sticks.
  • A lot more time spent managing all the moving parts
  • A lot less sleep
  • A lot more frustration

Since Liam’s bgs can climb from 90 to 400 in 30 minutes sometimes being able to see the climb and react to them is vital for us.

I don’t want to think about him not having a CGM because I remember the early days before we had one and I don’t wish to relive those days again or stay awake all those nights again.

When he gets older and wants to experiment though, sure. I’ll support his decisions as he works to become more independent… After all this is his long term journey.

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I was going to write a poem or string together some images that show the transition that we take as caregivers for our kids with diabetes…but as I began stringing it together, I realized…it’s no different than how we raise our kids without diabetes.

  • 1st stage…we’re carrying the baby/toddler on our shoulders and taking care of all their needs and making all their decisions

  • 2nd stage…they are able to “walk beside us” and help in the decision-making process as we walk side by side

  • 3rd stage…you come to a fork in the road where the child is now an adult and making their own decisions. At this point, they go separate ways, but the caregiver is always there if needed.

As a parent, all we can hope for is that we made the right decisions in the first two stages because the 3rd stage the child has to do alone for the most part.

This is the same with raising a child without a medical condition so I scrapped that project.

Sounds like you’re entering stage 3! Part of being in stage 2 and definitely stage 3 is doing exactly what you’re doing here. Asking the tough questions, yearning to learn and grow so that you can manage diabetes in the very best manner possible. Very proud of you @Kaelan!

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As many have already said, I, too, would be less aggressive. Times when I have gone w/out the CGM, I really have not been very successful in controlling highs. I might go to 170 and not even realize it. I use a lot of the same techniques as already mentioned w/ temp basals, but those are much more difficult to do successfully w/out the CGM in a timely manner.

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I remember the days before CGM’s were available. I was much less aggressive with insulin and still had many serious lows. And my A1c’s were in the 7-8 range.

The CGM changed that dramatically. Having a trend line literally kept me out of the hospital, and I was finally able to safely achieve a sub 6 A1c.

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About the same for me. Started with medtronics sof sensors. Learned alot, but no big change in A1C until I switched to dexcom seven + lower carb.

Without cgm, would do lots more bg checks.

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@MM2 This was with the Dexcom STS3, so the only thing that was really accurate was the trend.

Before that I probably did 8-12 fingersticks/day, but could never get as good a trend as with the Dexcom.

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I think it was same timeframe as MM sof-set. Agree on trends. But was eye opening to see how high it went up after “approved” exchange plan foods. Prior to it, I only tested prior to next meal, so never saw the post meal peaks until cgms. Back then I followed doctors orders. Then I found TuD.

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