So I don’t use a CGM and never have (I did do a one week trial of one a couple years ago). I am still injecting with a syringe and testing BG with finger sticks and I’ve been doing so for a long time. I do test my BG a lot, and I’m curious how often those of you who have CGM’s actually check them for a reading. So on average how many times a day do you actually look at your CGM or watch or whatever you use to track your CGM results with?
Then how many times a day does your CGM give you actionable results? In other words, how many times do you use the results of your CGM to make a correction to your insulin or food intake, not counting normal meals?
Also, are you comfortable with the number of times you check, or do you think you do it too little (losing some important results), too much (it feels obsessive) or just right?
My son says he checks every 10-30 minutes when he is wearing his watch, without his watch he checks twice an hour, unless he is doing sports, then it is more like every 1/2 inning.\
Note: He sugar surfs often, so he reports taking action 10+ times a day for small adjustments, almost none of them from alarms. Most are just viewing the trend and dosing a little to keep an increase from breaking out of his desired boundaries. Or taking a small carb dose (i.e. 2 carbs) to land a drop.
At night, we take action 4/5 nights from alarms.
I’m the same as @Chris. I check my CGM every 15-30 minutes unless there is some reason I can’t do so. And according to my pump download, I give an average of 10 boluses a day. Some of those are for meals, and in addition to micro-boluses I also do some micro-carb corrections. So about 10 times a day acting on the CGM data (most not for alarms) seems about right to me.
Depending on how my basals are doing, at night I take no actions or (on bad nights) might get two or three alarms and have to make two or three corrections.
I do the same as @Chris’s son. I am also a sugar surfer. I inject my basal with a syringe and use Afrezza as my bolus so it is very similar to taking injections as you are.
Times per day I take action, I can’t really say. I take action whenever I have a high or low trend, so the most I can say is “often”. The big advantage is that I can see if I am going to go high or low before it occurs and correct before it happens.
I am comfortable with the number of times I check because it is always a natural movement for me. I can see my watch while I am working (I type a lot) so seeing the trends doesn’t take effort. I also display my glucose reading on my phone homepage, so any time I pick up my phone for a call/text/email/etc., I automatically see it.
I credit the CGM (and my insulin choices) for dropping my A1C to an average of 6%+/- since starting with it.
This depends a bit on how busy I am. When I am out with friends or doing something social, I might check every hour or so. When I’m at work, I check every 30 minutes or so. When my blood sugar is trending up or down, I may correct for that and then check more often until I can see the results of that correction. How often I check my Dex varies quite a bit day-to-day.
I am comfortable with correcting/dosing based solely upon my Dexcom reading. I generally test my blood around 2 times a day. If my readings are ever off from my Dex (not due to the expected lag), then I test & calibrate more often until things are once again lining up. During these times, I would dose based on my meter, not my Dex.
I don’t think I check it too often or too little. It’s been much, much easier for me to have good control while using a Dexcom. I can’t really stress how much easier the Dexcom makes my life. If I check it a little more often than I tested my blood before, then it’s only because it’s so easy to do. No concerns over obsession here.
For Liam, we look all day and it plays a huge role in our lives. Knowing where he is BG wise, and where (and how fast) he’s headed is critical to us.
The better question for us would be when are you NOT looking at your CGM.
When I first got a CGM, I was OBSESSIVE about checking. That phase passed quickly, and now I too check every 10-30 minutes depending on what is happening. Like many here I Sugar Surf (though at times I realize I still a novice surfer). When I have a almost “no-hitter” day I check infrequently. When I have instability in my bgs I check all the time. I use my Phone to check frequently, and use my pump to check before bolusing. Like @Katers87 I do trust the numbers enough to bolus from it unless it is first thing in the am.
I started with CGM while I was still using a syringe with vials of lantus and novolog. I’d say I generally checked the graph 30 or 40 times per day, and made lots of small corrections based on what the graph was doing. These days that approach is called Sugar Surfing because of Steve Ponder’s book with that title. I learned to check early and often because a small BG excursion is much simpler to fix than when I go way high or low. When my first receiver failed out of warranty there was a gap of almost a month before I was able to get the insurance pre-approvals, and being back on just 8 fingersticks per day was so much harder. I called it “flying blind” and it was kind of like you’re driving a car but you’re only allowed to look out the windshield for a brief glance once every 20 seconds. It can be managed, but you just don’t know how far out of range your BG is going.
i am now on a trial run of the Dexcom for one week. i have been on it before, but found it unhelpful because i had too much trouble with a lack of “realistate” to attach the sensor to my very lean body. i couldnt get 3 days out of 1 sensor and i was constantly on the phone with their tech support team trying to resolve problems, trouble-shooting, and requesting replacement sensors. (they were wonderful about all mentioned; awesome company)
also, i was obsessively checking my graph and the arrows; up, down, double up, double down. panic would set in. i couldnt take it anymore, so i went back to my old fashioned finger sticks.
well, its been about 3 years since i gave up on the dex, but here i am trying it again. so far, so good. it woke me up every couple of hours last night with “low” alarms, but it wasnt so bad. i just took a Gtab and went back to sleep.
after bfast this morning the dex read 137 BG. it seemed strange, so i did a finger stick and found out that my BG was actually 87. so, i re-calibrated the dex. so far, so good.
no obsessions yet, and i am wearing it on my left back of upper arm. very comfortable; dont even feel that its there. i used skin tack under it before putting it on, so i hope it stays stuck throughout my swimming. (one thing that the sensor Libre was not was waterproof; and, as you all would guess, i need waterproof )
will keep you all posted on how this experiment goes. if i decide to get it, i think i might wait until the G6 comes out and is approved by Medicare.
For safety I’m happy to have low alarms instead of dropping too low while asleep. Although being too low while asleep will lower the A1C, that’s not a good way.
Looking at last night’s CGM graph helps me see what’s needed to tweak my overnight basals, and then I’m not going low while asleep and also not being awakened to take glucose.
I’m happy to hear that you handled it so well. It shouldn’t be that far off, but if it is, it’s no big deal. We can either check it again later to see if it re-converges with the meter, or just fix it with a calibration like you did. In any case the CGM graph line tells us if we need more insulin or carbs or whether we can just watch and wait a while.
I find it’s better for me to calibrate before eating breakfast so there aren’t carbs and boluses pushing my BG around. (I don’t get a big “feet hitting the floor” spike in BG when I get up, my BG stays relatively stable until breakfast.) If you calibrate after breakfast, the BG is changing because of the digestion and meal bolus, and that can make the Dex read farther away from the meter (like maybe your BG is falling from the insulin, but the Dex is running behind and will need another 15 minutes to catch up.) Calibrating when the BG is changing and the Dex is lagging behind can cause the Dex to be wrong in the opposite direction. For example, if you are at 87 in your capillary blood but the Dex says 137 because the interstitial glucose has’t fallen yet, then forcing the Dex to read lower right now will mean that the Dex continues to fall below 87 as the interstitial glucose finally drops to match the capillary glucose, and then the Dex will be false alarming that you are way low.
If my sensor starts peeling at the edges I just re-glue the loose part. I use Mastisol on a q-tip for that, but I’ve heard that some people use SkinTac for re-gluing. And if it seems that the sensor starts peeling too soon, you can use an overtape of Opsite Flexifix. Just make a donut out of 4" wide tape: cut a big oval of tape with a smaller rectangular hole in the middle to let the transmitter stick out. The hole is because we’re not supposed to tape over the top of the transmitter.
Is this different in the US? The Canadian FreeStyle Libre site says: “Swim, shower or exercise — the FreeStyle Libre system is designed to be water-resistant and worn while bathing, showering, swimming5 or exercising.”
i did 2 trials on the LIBRE. at first i was told that it WAS waterproof and that i would have NO problems swimming with it. the NP knew that i swim for 2 hours a day and assured me that it would be fine. well, the first trial of the Libre worked fine. i had another one put on and it fell off in the pool at the 5th day.
i called their tech support team and was told that it was NOT waterproof, but only water resistant and that you werent even supposed to bathe with it submersed in the bath tub. that showering was okay, so long as it was not lengthy.
their customer tech support/service was horrible. i had a really bad experience with them. for that reason, i will not use their products. i am very familiar with the DEXCOM company, all of their services and i think that they are one of the top companies for assistance with their products as well as standing by and insuring their products. they are a company that i would be happy to work with.
i made a post on this under the bad VENDORs catagory. you can check it out
I check my watch about every ten minutes, and am very sensitive to the information I receive. As a healthcare provider I have to be within range when working on patients. I sometimes run into problems when my Bg is under 45, so I tend to take action early.