Category Archives: CGM

YouTube

I fully intend on continuing to write here, I’m just a bit burnt out on it for now.

In the meantime I have been making videos on YouTube regarding all the same stuff I write about here. I have a total of three videos posted as of this post.

Check them out if you like.

https://www.youtube.com/channel/UC3KOi-Y0gQioRcQpG17hwGw

I have the videos set to 18+, so you will probably have to log in and/or “verify” your age.

One Month of CGMing

It has been over one month now that I have been using a CGM (continuous glucose monitor).  I am forever grateful for this technology; it is a most useful tool.

In one month I have made note of several pros and only one con.

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CGM receiver screen

Positive things I’ve noted having a CGM:

1. My blood sugars are much, MUCH more normalized.

2. I have not had any severe lows, but have been woken several times during the night by my CGM warning me I was getting low. So I was able to treat before it got dangerous.

*Side note: I much prefer to be woken in the middle of the night to a CGM warning me I’m getting low, than to end up in a severe low or dead!*

3. I have only had three very high blood sugars.  These happened over night, my CGM woke me to warn me I was getting high but I chose to ignore it and so woke up very high. I count this as a positive because the CGM did warn me before it got too high.  It was my fault for ignoring it.

4. I have been able to find a couple of trends in my blood sugar that have lead me to make lifestyle and medication adjustments to improve blood sugar control. Without the CGM I would have had to wait much longer and gather many blood sugar readings over days or weeks to be able to see the trend.  With the CGM I saw the trends in one day because it checks every five minutes and immediately charts, etc..

The one complaint I have regarding my CGM is that the adhesive used to keep it stuck to me tends to begin to lose it’s stickiness a day or two before it’s time to change.  I end up using medical tape to hold it down until it’s time to change.  But it is a bit annoying. My brother told me about some patches he has for his pump that he uses when he takes a shower.  I might try these when I shower to put over my sensor/transmitter to see if staying more dry will help the adhesive to last long enough.

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Medical tape to hold adhesive in place

All-in-all I am loving my CGM and am still as happy and grateful as ever to be able to have such a tool to help me better care for my diabetes.

Next on my list of diabetes care plans is to see about getting a pump.  I used to have no desire to have a pump, but having a CGM has helped so much that I began to look into other modern treatments, and then talked to my brother who has had a pump for years.  He helped to clear up some questions and misconceptions I had about pumps.  So now I am interested in getting one.

Then…all I need is a cure!

CGM Newb

It has been a whole week since I started using a continuous glucose monitor (CGM).  Let me tell you, I LOVE IT!  I used to scoff a bit at those who used CGMs and would say things like, “I don’t know how I ever lived without it.”.  Now I find myself in total agreement with them.  Really, how did I ever survive without this valuable tool?

I barely did; I was totally out of control.  But that is a story I’ve talked about a lot.  Just read my old posts.  I am living proof.

So, how have I done with my first week on a CGM?  What have I learned about CGMing?  What are some misconceptions I had that I now know better about?  Read on for these answers, and more!

My first insertion was easy but I did have a couple little issues.  It was slow and a bit awkward because I was learning. I think I messed up the adhesive a bit, or didn’t insert the sensor quite right enough because every time I took a shower the receiver would show a sensor error and it would be two hours before things would work again.  I think the sensor was getting a bit wet?  We’ll see, I have inserted a new sensor now and this time it was fast, easy, and I didn’t make any mistakes that I know of. So if I still have this sensor error issue then I’ll call tech support.

Also with my first insertion I broke off the transmitter latch by accident before putting in  the transmitter.  This may have also contributed to the sensor errors after shower time because I was only able to get the transmitter in by using my hands and a lot of pressure.  Maybe it wasn’t in quite right?

I had to calibrate often the first night but after that the readings were quite accurate and although The CGM only requires calibration twice a day, I actually calibrate up to four times a day.  This is my choice.

This week has been the most wonderful for me.  I could only guess before what my blood sugar was doing all day. All I had was an average of four glucose tests a day.  Now I can see it in real time and know if it is on the rise, falling, or holding steady.  I can catch a problem before it even becomes a problem!  It is so much easier to keep myself in line when I can see that what I am doing is working…or not.  I can make adjustments now instead of having to wait until the end of the day… or when an emergency happens.

It has only been a week and I am still learning all the wonderful things I can do with my CGM.  I have mostly been stuck on the simple act of checking my numbers every few minutes and giggling with joy at knowing, seeing, my glucose progress.  I love seeing that mostly straight line right across the screen, holding steady in the ideal range.  Pure joy.  I also love seeing all those dots and being able to see where I’ve been, how I’m trending, and learning what my days activity, foods, medications, are doing for, or against, me.  I love going to bed at night no longer afraid that I might fall into a severe low.  I now have a CGM set to alarm when I drop below 70.  I can catch those lows before they become dangerous. I sleep so well now.

I have been curious and interested in getting a CGM for a few years now.  I originally thought it was a replacement for glucose testing, but then I learned better.  Even if you have a CGM, you still need to check your blood sugar the old fashioned way, and still just as often. A CGM does not replace or nullify blood glucose testing.

“What?!” You say. “Then what’s the point in having a CGM? What’s it for?  Why aren’t the CGM readings the same as blood glucose readings?”  Let me answer this question most clearly by quoting The Dexcom user’s guide.

The CGM checks your sugar every five minutes.

“[CGM] …help you detect trends and patterns in your glucose levels. This trend information can help you see where your glucose is now as well as where your glucose may be heading and how fast you may be getting there. Understanding your glucose trends may help you take action to help  avoid high or low glucose levels.”

The reason you do not want to use your CGM readings as direct and exact blood sugar readings is because the CGM does not take its reading from your blood but from other fluids.  This means although the CGM is usually close to your blood sugar, it is not exact.  This is why it is good for trends but not exact blood sugar readings.  This is also one reason you must calibrate the device twice daily by entering your blood sugar reading.

I was worried about exactly how you “hook it up”.  What do I have to do? And how often do I have to do it?

It is actually quite easy and painless.  With Dexcom you get an easy step-by-step training disc and book to teach you, and if you are uncomfortable with that then they offer an in person training session to get you comfortable. It really is very easy, though.

The sensor must be changed once a week.  The transmitter is good for about six months.

The basic parts are a sensor, which is the part that goes into your skin.  It is a very thin, flexible piece that you can’t even feel.  A transmitter, which is the part you attach to the sensor on the surface of your skin.  It is not bulky and you very quickly get used to it being there and will tend to forget it is even there.  And a receiver which is smaller than most cell phones and easy to clip to your belt.  The receiver has a twenty foot range, so you can walk away from it at home most of the time.

The transmitter is water proof, so you can shower with it or even go swimming.  The sensor is not water proof but is protected as long as it is inserted correctly. The receiver is not water proof so you do need to be careful with it as if it was a cell phone.

I can tell you for certain that having this CGM has changed the way I look at food, activity, insulin… life.  I thought I knew a lot about my diabetes.  I thought I was doing so well getting it under control.  Then I got a CGM and saw the effects of everything on my blood sugar in real-time.  Now I understand so much more.

I am so happy to have a CGM.  It is a tool every diabetic can greatly benefit from.  I can hardly wait to see how the future with this tool improves.

I Have a CGM!

On February tenth I started a little journey that I had been wanting to do for a long time but hadn’t the means until now.  I saw an endocrinologist (actually it was the endo’s diabetes educator I saw) for the first time in, geez, almost eight years I guess.  I thought it would take a while to get the OK to get a CGM (continuous glucose monitor) but instead my new doctor was as eager to get me on one as I was to get one. I left that first appointment so satisfied and excited for the future.

The process to get a CGM started with the discussion with my diabetes educator. I did not leave the office that day without first filling out the initial paper work needed to get the CGM ball rolling.  I waited until February 23rd to hear from the Dexcom (company that makes the CGM I was to get) rep.  When I hadn’t heard anything I reached out to her through e-mail.  She got back to me that same day and let me know she was just waiting on my insurance to get back to her with my benefits information.

I waited a bit longer. I was worried my insurance would deny coverage for a CGM, or not cover it enough for me to afford it. On February 25th the rep contacted me once again with the most wonderful news.  My insurance covered the CGM 100%!  I provided the rep with a bit more information and she took care of shipping the CGM to my house.

On March 1st my Dexcom G4 Platinum shipped, and on March 4th it arrived at my house. It’s wonderful that it shipped from southern California, I only had to wait four days for it to reach me in central California.

I sat there on my couch going through my new loot:

12 sensors (3 month supply).  These things scared me at first, they were contraptions I had not expected to see.  The sheer size of them is what mostly worried me.  But after years of life spent in the doctor’s office, hospitals, procedure rooms, etc., I was sure this wasn’t as scary as it looked.

Dex4
Sensor and insertion device.

One transmitter. This was exactly what I was expecting it to be.  I almost blew it by just jumping in a trying to remove it from it’s cradle.  I didn’t bother to read the nice huge warning on the box that said not to touch it until I was ready to get started.  Good thing I had trouble getting it out….

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Transmitter, already attached to inserted sensor.

One receiver.  This also looked exactly like I expected it to.

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Receiver

One charger.  This was a wall plug-in and also a USB.

One belt clip and case.  Standard, not too trendy looking.  Maybe I can find a cool one online?

One user manual and one CD tutorial. Very useful stuff here.  I was eager to get started.

Yes, I was very eager to get started, but I was also a bit nervous.  I’ve been wanting this for so long.  But now that I had it in my hands, sheesh, I was worried about screwing up my first insertion.

What if I end up with a sensor floating around inside my body?  Just traveling along to my heart and, poof, I’m dead.  I knew better.  That wasn’t going to happen, but you know how it is doing something new for the first time, all by yourself.

A bit worrisome.

What if the sensor breaks off?

What if the transmitter doesn’t communicate with the sensor?  Or the receiver?

What if there’s something wrong with the receiver?

What if? What if? What if?…

I started the tutorial and took the evening to learn everything.  When I was ready I started the step by step process.

It was so much easier than expected.  I knew it would eventually be easy but had thought my first time would be more difficult. I only had one problem.  I snapped off the transmitter latch by accident before installing the transmitter.  I thought for a minute that I had screwed up bad and was going to have to start all over.

Damn it!

But then I just thought I’d try to install the transmitter without the latch and see how far I got.  It worked, I just pressed hard and it snapped into place.

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All done with set-up and first insertion.

OK, the hard part is over, now I just have to calibrate the machine and I’m all started.

It was midnight when the setup portion got to the calibration prompt.  I checked my blood sugar with my normal ol’ typical glucose monitor and then entered the number into my CGM.  I then repeated this task a second time.

All done.  Time for bed.

I was exhausted from a long and eventful day but I still couldn’t fall asleep right away.  I was still so happy about finally having a CGM!  This is going to help so much!  I am going to be able to see how my blood sugars trend, how my insulin, food, life, everything is affecting my blood sugar in real time…not just in little blips every few hours.  I’m going to be able to sleep at night with much less worry about having a hypoglycemic episode while I slumber.

No more worry about “will I wake up in the morning?”…well, at least not nearly as much worry about it since my CGM is set to loudly warn me when my blood sugar falls below 70.

I finally fell asleep.  An hour later I was awakened by my CGM.  My blood sugar was below 70.  I waited a bit, I didn’t feel low.  A bit later I got another warning, 65.

Really?  I don’t feel low at all.  I got up and grabbed my glucose tablets and popped one.  Didn’t even bother to finger stick check my blood sugar first like the Dexcom training had just instructed me to always do before treating a high or low. Don’t just take your CGM reading at face value.  It’s not meant for that.

I went back to sleep and was woken up by my CGM at 4 A.M. once more.  This time I knew something was wrong because I felt absolutely fine but the CGM said I was at 52.

I got up and checked my blood sugar. 129.  I entered the number in to the CGM to recalibrate.  It asked me to check again.  I did.  131.  I entered the number.  There, re-calibrated.

I went back to bed.

I don’t recall how much longer it was before the CGM alerted me again.  I ignored it.

I woke up at 8 A.M. and despite the night’s fiasco I was still so very happy to have my CGM and eager to see how much it would help me to fix my control issues.  I checked the CGM to see what it had tried to alert me to just a couple of hours earlier.  It wanted to be re-calibrated, again.

I checked my blood sugar, 179. I entered the number into the CGM.  All calibrated, again.

Now it alerted me to a high blood sugar.  I was above my 140 setting.

This is going to take some getting used to.

I expected a period of time like this.  A time to work out all the bugs, to get used to properly using the system, etc..  I’ll get there.

Despite the scare with insertion, and the rocky night, I am loving my CGM.  I can just push a button and see a graph of my days blood sugars, where my current blood sugar is trending.  It lets me know when I’m getting low or high so I can take action before it gets dangerous. I can’t wait to learn all the other wonderful things I can use this CGM for!

I will be writing future posts on my life with a CGM.

Dex3
Sensor/transmitter, receiver, and standard case.

The Eyes, Burritos, and CGMs Have It

This morning I had my second round of laser surgery to get rid of scar tissue that had formed on my artificial lens in my right eye.  The original treatment was supposed to be the only one needed but the scar tissue proved to be quite dense and so I was required to have a second round.

The doctor did his work which was fast and painless.  I sat leaned forward at the desk with my head and chin resting on the head contraption.  The doctor sat on the other side of the desk with his eyes peering through his laser device.  All in all it took about ten minutes or so, just like the first time.

Once he was done he informed me that the scaring was very thick and would require one more treatment.  Hopefully only one more.  It doesn’t surprise me that the scar tissue is very thick, I have always developed very thick and puffy scars.  It’s just the type of body I have, I guess.

If you haven’t read my blog before then it might help for me to let you know exactly how I got to this point.  I have diabetic retinopathy that has required four surgeries.  These multiple surgeries lead to the development of a cataract that required me to have a lens replacement.  After the lens replacement I developed scar tissue that blocks light from getting into my eye. What is left of my vision has been greatly decreased because of this.  So here I am having laser treatments to get rid of the scaring.

The treatments are working.  I can perceive much more light now and seem to notice a tiny bit clearer vision.  Hopefully once the treatments are done and all the scaring is cleared up my vision will be much better.

After my appointment my mom and I went to Chipotle for lunch. This was my first time eating at this Mexican restaurant.  It works kind of cafeteria/Subway style.  You walk along the counter and tell the person what you want and they prepare it right in front of you.  I chose a burrito and picked brown rice, chicken, mild salsa, black beans, sour cream, cheese, guacamole, and lettuce.  They wrapped it all up in a huge tortilla. I got a diet soda and then sat with my mom and her rice bowl salad and diet soda. The food was delicious but huge.  I couldn’t quite finish all of mine even though I wanted to.

After lunch we headed over to Walmart to shop off lunch. As I was getting out of the car I checked my phone and noticed I had an e-mail.  As I read the e-mail I grew more and more excited and squealed with joy. It was an e-mail from my Dexcom rep.:

Woo hoo – this is my favorite email to send…when I get to tell you that your Dexcom CGM system is 100% covered through your Blue Shield via Sante!   So, we submitted all of the requested documentation to Sante and are awaiting authorization from them.   It usually takes 3 days for authorization, so we should be able to ship this to you by the end of the week. 

 I just need to confirm the following 2 things from you:

1.        What is the best address to ship to:

2.        What color receiver would you like:  Black, Blue, or Pink?

Once approved I can send you a quick email to let you know it is being sent and Dexcom will send you tracking information so you know when to expect the package.  Once received, there is a training video in the box that explains everything you need to know to self-start.  We also have a patient care specialist team that will reach out to you via phone and email to see if you need any additional support or training.  If you watch the video and find that you would like face to face help inserting your first sensor…just let me know and we can schedule a time to meet at Diabetes & Endocrine Specialties for a training appointment.  90% of our patients self-start, but I am here for you if you need additional support.

I am so excited!  It’s been a good day.