When at my endo’s office last time I thought why did I bother coming.
It appeared as the only thing he really looked at was time in target on the libre 3+ (which is off by 18 - 72 units). Now I do understand that time in target is the new important feature with a glance at A1c to make sure it makes sense. And we’re not talking blood glucose vs cgm. Even the blood test machine on the Libre is just as bad. My preffered blood machine tests from bang on to within 5 units.
I regularly test preferred blood machine, the cgm reading and the Libre 3+ blood machine at the lab when I get my bloodwork done.
When the cgm is off by so much how do you interpret the data it provides in a meaningful way?
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@Freckles I’m not sure what your/a ‘favorite blood machine” is? Is it a BG meter, a lab test machine? Is there a maker of it you can state (without meaning an advertisement)? I use my BG meter (a Contour Next, at least a few years old) that I trust as a check when my G7 sensor seems off. But I also believe the old addage (Segal’s Law?), “A man with one watch knows what time it is, a man with two watches is never sure.” It’s a conundrum for us all! Interestingly, I had a discussion with my Endo two weeks ago on the subject of TIR and A1c; he’s come around to believing the CGMs GMI and eA1c combined with COV and SD is the best way to measure how well people are controlling their BG levels. He now zero’s in on COV and likes to see something less than 30.
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My favourite for use at home is the contour next.
I believe some of my frustration with the last endo appt was miscommunication and hope it can be rectified. Your explanation helped me understand that he may have been frustrated with my using my cgm reader and not a phone where he would be able to access more info.
When all of this data and other meaningful calibrations come from a sensor that is off (on me) by so much does that play into how you deal with it for better control?
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If it’s possible for you to switch to a different CGM, you might like the Dexcom better. Calibration is super helpful! I understand that’s not always an option though.
If the patterns of the CGM readings are reliable (going up when your BG meter says you’re going up, going down when your BG meter says you’re going down) even if the readings themselves aren’t, you might try focusing in on those patterns. Can you get the COV lower, like TomH mentions? Can you get the spike to be less intense after meals? Can you get the line pretty steady overnight? All of those pattern goals will still lead to better “control,” even if the numbers themselves aren’t accurate.
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Don’t let this endo go, he’s ahead of the rest. Don’t think two watches are the same as comparing different technologies and trying to force them to provide the same data, like a meter and a CGM, similar, but not the same so side by side compare in the moment is not valid.
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RachelMaraii your idea of dialing it back and looking at patterns is bang on. I got too caught up in the precise details and forgot to look at the big picture.
Can’t switch sensors until I get a new pump which is a couple of years away as absolutely no coverage for Dexcom. I imagine it is beneficial to get used to the ins and outs of sensors before that happens though.
Have a phone appt. with the nurse in 2 weeks and will have been to the hospital to see another doc just before that so I can download data for her. She is more patient with my lack of technological awareness.
The COV is something I think I need more technology to figure out and am working on it.
TomH I wasn’t familiar with a couple of terms you used and it took me a couple of days to figure out that I do know what these mean even if I haven’t yet figured out how to get the figures and have been using the idea for years just not the data.
Sjwprod yes of course you and the others are right about comparing 2 different watches. My frustration with the endo I believe was that he didn’t explain what info was useful to him now and how he would like it presented. I must have just got him on a bad day as he always used to do this when there was a change.
Thanks so much for everyones input.
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@Freckles Sorry I wasn’t more clear on the acronyms. I laud your self reliance in trying to find the refs, but if you’ve tried an online search and can’t find something, don’t hesitate to ask; most of the folks here are glad to help (particularly those that cause the issue like me!).
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If it’s consistently that far off, I’d be frustrated too. Trends can still be useful, but it’s hard to trust time in range when the readings aren’t accurate. Hopefully you can get to the bottom of it with your care team.
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Thanks TomH. It just took me a couple of days for it to mull around before I realized it wasn’t rocket science and I really did get it cause it was so simple.
When I talk to the nurse I will ask her if the one I don’t see how to get if its possible with the technology I am using. Awaiting a link from her.
I always get into trouble anyway cause I call a pod a set, etc. when talking to someone.
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Good idea! I know how to get Standard Deviation data and calculate Coefficient of Variation for Dexcom, but unfortunately I’m struggling to research if the Libre easily offers that same data… Good luck at your next appointment!
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Well the consensus is that everything is wacko, cgm included. She thinks I’m a lot more sensitive to weather and weight loss/gain than anybody realized. I’ve always had a real problem with summer ever since I was small and today she says that she’s always known -40 doesn’t faze my diabetes but they never put together than 90+ is a nightmare even sitting on the deck and watching the grass grow.
Lost weight (only about 6-8 lbs), it’s been stinking hot, stress, no real patterns to anything and my pump downloading at hospital didn’t work (I’m not surprised, 4 major appliances at home died in 3 days).
So no, all my this is what I figure but am I wrong question is that I am bang on. Back to basics and eliminate. This time it’s get up (if blood is 5.0 [90] and upward), and sit on the couch with water until you I can’t stand it anymore. No taking phone calls, no making your grocery list, don’t go outside and veg, hubby can say I love you or bring you water nothing else, etc. At least we will check part of it at that.
Moving me to Dexcom G7 10 day also. They tend to find the arrow portion of the reader more accurate. It is slower and demands more proof but the results are strong. And yah ignore everything but the arrows. She says that the numbers on the Libre 3+ can change every minute while the Dexcom says hmm, can’t really yet say if you’re going up or down so hang on til I’m sure. I always check a low alarm with blood anyway so no change there.
I had to agree to grit my teeth and live through the highs for 8 weeks. Lord help me that part is gonna be rough.
So I will have to see what the dexcom reader can do, then see if I can get better info on what I own. Cell service is prohibatively expensive here so we will see after we start the dexcom and start fixing things.
Thanks so very much.