FUDiabetes

Poll - Dosing from CGM data alone

cgm
insulin

#41

Yeah don’t try to pretend like that was for this. We know you’re lazy… but we also know I can’t deny you a good story, so…

I’m gonna need a few things before I start…

  1. Probably to post in my running thread… I feel it should be there rather than in here because it looks like you guys are doing fishier-than-usual stuff in here, and I’d like not to be associated with it. I assume.
  2. A coffee
  3. To check to make sure no one can verify I was actually at the race
  4. A keyboard
  5. And possibly to go read what’s happened with this thread before I do any of the above in case it’s really in danger of being flushed because then that puts me at having to rely on one of you guys for the story… and then having to believe one of you guys and there’s the trust thing… so I’ll juat read quickly and be back.

#42

Considering I test maybe once every few days on an average sensor, I’m going to go with yes (exceptions being extremely high or low readings get a double check since accuracy is just not good in those ranges; however, I’m unconvinced my meter accuracy at those ranges is great either, esp highs). My G5 has generally been very accurate for me and hasn’t needed the level of calibration Dexcom says. I’ve posted on here before how I suspect all sorts of physiological factors play into that. Not being thin seems to be one of them. I also only use my abdomen. I also have a connective tissue disorder and have wondered if that might help my interstitial fluid readings be better and/or my sensors last longer somehow.


#43

Im curious to know which sensor/transmitter ( G4, G5, G6) is used, and how does one feel confident the sensor is accurate, without comparing it to a BG read.
Would you advise a newly diagnosed diabetic to just trust it because you do?


#44

At initial diagnosis, we were advised to use syringe and meter for a minimum of one year.
The Endo Team thought this would provide the best long term educational approach for us.

I think they were right on.

Any technology can fail.

Possibility of technology failure is a low stress event. We are always ready to revert back to syringe and meter and feel fully confident in our ability to do so. Which removes the stress of worrying about technology failure completely off the table.


#45

We also started off on MDI. I would personally never recommend dising off of a GCM until you are certain it’s accurate for you or not.


#46

We didn’t quite make it to a year, but we did do MDI for 10 months before adding a Pump and CGM. So I can definitely say that this time was invaluable, in that when we started pumping we were always very slow to pick up on when a pump site was failing, and if we didn’t have the MDI experience it may have been even worse.

With that said, I think small children probably should be on the pump sooner, due to the ability to deliver very small doses. But for us the MDI experience was very helpful.


#47

First I’ll answer your question with another question. Would you advise a newly diagnosed diabetic to just trust their BG meter? Everyone does, but there are known discrepancies to BG meter tests. As well as starting on a G6 CGM, I wanted to change to a meter that supported Bluetooth. My insurance company prefers One Touch, so I was given a bunch of Verio strips by my endo to try out. I haven’t had the chance to do similar testing with the Contour Next because I only got 10 strips with it, so I can’t say how reliable it is for me when testing repeatedly. If I manage to get a prescription for those strips I’ll put it through the same test.

For the Verio I chose different times to do four to ten tests with the same finger, cleaning and wiping between each test. Of ten tests I had an average of 155, but a low of 137, high of 172. Of four tests I had an average of 160, but a low of 153, high of 182. These are different enough between high and low that it would change the amount of correction insulin I would take by one or two units. So it is a pretty substantial difference. Now obviously a CGM is designed to be calibrated. So if you find it off from your BG meter reading you adjust it. But there is no way to calibrate a BG meter, so it is necessary to take the value as it is. And clearly there are inaccuracies in any technology, including BG meters.

Here is another case where I tested the three meters that I had strips for against each other at the same time, and hopefully you can see the results (80, 95 and 119)
IMG_20190219_110004034A

Now to actually answer your question, I would of course say no, that a diabetic has to be responsible for their own care, and to trust no one and no technology without trying it out themselves. Given this context, I’ve tested the G6 CGM on myself and found it to be surprisingly reliable.


#48

I think we did MDI for maybe 3 months max. I do worry about the idea that Samson would revolt if we needed to give him multiple shots a day. But otherwise I don’t have regrets; I feel like he needed such teensy doses at diagnosis and the diluted insulin (at 1:10) was very very unstable. I’ve thought about if he needs a pump break at some point.


#49

Sometimes, Liam’s POD sites are clearly irritated and I have to find new sites. I’m thinking of using MDI as a way to allow his sites to fully recover. I have not done this yet but have considered it.


#50

We go about 6 weeks per year without the pump and it comforting to know he is capable and has practice transitioning back and forth. Of course, right now this doesn’t apply to either of you, but is a good thought as they get older.


#51

It’s always good to know the manual method inside and out, and practice it to stay fresh


#52

I think it will become more and more feasible as Liam grows older, and before he goes into puberty. We spend over a year on MDI. We primarily went to a pump because of sports. However, now that we are in puberty, being on a pump makes a huge difference!

We learnt a huge amount from being on MDI. I wish we could afford to spend more time on it these days.


#53

We did MDI for six months before going to the pump


#54

Great for you.

As stated, i am still using G4, and prefer to use dexcom reading, but also use Meter BG reading, before dosing in some situations. Many factors involved that result in choice.


#55

Interesting Poll @ClaudnDaye, thanks for putting this one out there.


#56

Agreed.


#57

I haven’t answered the poll yet but I’ll probably select yes, just because I do SOMETIMES bolus based on my G5 Dexcom. Maybe about 50% of the time. The g5 is accurate for me only about that percentage. I did finally receive the g6 but since my g5 transmitter is still active for another few months, I’ve not yet switched. Based on many responses here though, @docslotnick and others, the g6 is much more accurate. Maybe I should switch now??


#58

@Trying

The range of experiences with the G6 seems to be more varied as opposed to the G4 and G5.

It seems there really is only one way to find out how it will work for you.

I have found the G6 to be quite frustrating at times however that is more than offset by the G6 (when working properly) driving the Basal-IQ algorithm. So for us, there are significant benefits to the G6. It very much changes our viewpoint.


#59

Oh, yes, that is great benefit! Wish OmniPod had that :slight_smile:


#60

Ah- that wasn’t in the question and I already clicked yes! I never trusted my CGM enough back when I was on a G4 and I’m only starting to with the G6. I dose on CGM data alone, but not every time. I’ll dose from the CGM (after I trust the sensor) for lunch, and also rarely at dinner if I’m eating out, but if I’m at home and definitely in the mornings I’ll fingerstick to check and calibrate. So my answer should be “Yes- sometimes” rather than “Yes- all the time”.