Dexcom 7 Plus, Love, Love, Love the Dex! But can you treat a low without a fingerstick only if you have not eaten recently?

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Permalink Reply by Leona Peterson on June 30, 2009 at 7:37am

So glad you're using glucose tabs and not orange juice! How old is she and what does she weigh? She will learn SO MUCH. Treating is a NO NO based on the Dexcom or any other CGMS. Knowing it lags behind means that by the time you have an alarm, she will need something. That's where up to the minute information, not a lag number, is needed, and yes, one has to test.
I can't tell you how many times I used my half glucose tabs based on the Dexcom and what i did when I didn't know how far up a Dex4 would take me. But I learned!
How far up does one Dex4 take her? It's based on weight and as she starts to learn how to stay lower than 140 ALL the time, and above 90 ALL the time, she'll be able to prove it to herself. I would suggest a trial during a mid-afternoon about 3 hours after lunch. Test, take 1/2 a Dex4 glucose tab and 30 min. later, test. Then she'll have an idea what 2 grams of glucose does. Otherwise, at 105 lbs, 1.5 grams raises you 10 mg; at 140 lbs, 2 grams does it; at 175 lbs 2.5 grams does it. And so on.
You can test out how soon Novolog starts to act by getting the meal ready, testing, giving the Novolog dose, then at 10 min, 15 min, 20 min, testing to see where the blood sugar is. It is at the point where the blood sugar starts going down that she'd better start eating or she will experience a low. But that will tell you.
Cheers! She's on her way to learning so much about herself!

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Permalink Reply by Jan on June 30, 2009 at 8:07am

We have known for quite some time that 4 grams of sugar (in glucose tab or large Lifesaver) brings her up 20 points; 1 gram brings her up 5 points. LOL, about the glucose tabs, she hates them! We only used the tab because Dex said 80 with an arrow going down. Dexi was WAY off last night any time food/insulin factored into the picture. Keeping her under 140 is our goal; however, I don't think we will be able to achieve it. I would be thrilled right now if we can stop spikes before they go over 200. And if Dex alerted properly for lows. Our first sensor placement (Dexcom Rep thought was not a good spot (high up on tush area, but too near the waistband); however EMLA had been put on so she decided to go ahead and use the spot that was numb). Dex is very accurate once there is no insulin on board and if you don't feed her anything. So good for overnights, definitely. We will be more careful with our next sensor placement. I am just so thrilled insertion was painless and it does not hurt her while wearing it. That was our main obstacle to wearing cgms and it has been removed.

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Permalink Reply by Leona Peterson on June 30, 2009 at 9:01am

You're doing so great with her! When the spiking subsides - when she learns about different foods and her reactions to them and starts making decisions based on that knowledge - you'll see the Dex is lots closer. SO helpful to everyone concerned!

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Permalink Reply by Mommy of Three on June 30, 2009 at 11:23am

I agree with your niece, I don't like a lot of the glucose tabs and the one glucose tab that will really get me to eat them (especially when I'm low) is the Green Apple flavor. I have the hardest time finding the Green Apple flavor glucose tablets. If only the pharmacies and Walmart locations would keep a bigger stock of the Green Apple flavor - one pharmacist said that Green Apple sells out quickly... I'm thinking, well if the Green Apple flavor sells out quickly they need to stock more of that! not the yucky pina colada!

Glad the Dexcom is going great for her. I love my Dexcom Seven Plus even though he yodels to me a lot and he's been yodeling more lately due to me being out in the sun more with the kids (the sun makes my blood sugar levels drop).

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Permalink Reply by Don on June 30, 2009 at 8:05am

Alarming at 80 and being only 9 pts lower on finger-stick is very good. My trainer said the Dex lag is only 7 minutes but CGM aside, I've discovered that food takes about 15 minutes to begin affecting bg and ditto for a bolus. Plus, in my case the fat in a donut causes me to go low early on unless I adjust my usual formula. Lots of variables! In my case I feel okay sometimes forgoing finger-sticking with lows if I understand why I'm having the low such as being extra active. It doesn't take much carbs to raise a low so if I'm wrong the consequential high is not devastating. Congrats!

P.S. Took me several years after diagnosis to look at the graphs on the little paper enclosed with my vials of insulin. It helped me to figure out when and how high a spike I should expect after meals.

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Permalink Reply by Jan on July 1, 2009 at 4:00pm

No, either I mistyped or you misread, LOL. Dexcom said 80 with a down arrow, but that was after she ate a donut and we did not prebolus for the donut. So we were not expecting a low. Her BS had JUST been calibrated for the first time and Dexcom was very accurate with her first calibration. After eating the donut, bolusing for it, Dex read 80 with an arrow going down. So we figured the food had not caught up to the insulin (grease?) and she had a glucose tab. Ten minutes later Dex said 70 with an arrow pointing down. We did a fingerstick and she was 161. But I now know that Dex is 15 minutes behind and a lot can happen in fifteen minutes. Dex has been mega accurate since 5 pm yesterday all the way through today. We are thrilled with the Dex. P.S. Since we usually test BS two hours after a meal, we were not aware what was happening in between. Tonight she went to 55 an hour and a half after eating (I had been checking Dex), we caught it, gave extra carbs and she slowly, quite slowly went back up. I hope those 18 grams of Ex-Carbs don't come back to haunt her but I will be watching carefully.

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Permalink Reply by Leona Peterson on July 2, 2009 at 10:14am

Keep working with it. It's most accurate when it's not flying up and down! I think I learned the most at the 30 min. to 1.5 hours after starting to eat. It made me get serious about how many carbs I could eat and what insulin did and did not cover! I'm a real lover of the Dexcom. I learned SO MUCH.

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