Replies to This Discussion

Permalink Reply by John on October 27, 2011 at 3:25pm

Hi,

I am using both Omnipod and DexCom (I just switched from the Navigator to the Dexcom).

Without a CGM, my glucose would regularly soar above 350, 400, 450, and stay there. Using the Navigator (and now DexCom), I find that I am able to stave off those highs, and even get them under control sooner. Though it is still challenging, I feel somewhat more in control.

Two controllers--first, I am a 56 year old male--the clothing I wear is not what an 11-year old girl would wear (hopefully). I keep the DexCom in my shirt pocket, my Omnipod controller on my belt. I also have an iPhone on my belt. I sometimes think of Batman's utility belt when I look at all the stuff that I tote around with me.

If your daughter has a backpack/day bag, something like that, I might suggest that she keep her OmniPod controller in there. She only needs it when she boluses, or when she does a glucose test. It might make more sense to carry it there.

The DexCom has to be within 5 feet of the sensor--she will have to carry it on her person in one way or another--on a belt (a belt case is provided with the system). Some others who have been using the DexCom longer than I have certainly will have better ideas than I might.

Two devices: First, my abdomen is going to be larger than your daughter's so I have more surface area to deal with. When the DexCom sensor is in place on my left front side (within, say, 5 inches of my navel), I alternate between my right side, my arms, and my left side at least 4 inches away from the sensor.

Control: vastly improved, as noted above. In the first week that I used the Dexcom, it warned me of three episodes of hypoglycemia (one associated with exercise that I did not compensate for, another two because of miscalculations of carbs).

For highs, the alarm is preset at 200 (but it is adjustable)--dosing insulin corrections is easier at 200 than at 400. I have found that it takes about 50% more insulin to have an effect at 400 than at 200, and it is much easier to address them before they become "super" highs.

How long before you feel comfortable with the technology--you will learn the basics of DexCom relatively quickly. Learning the pump takes much longer (as you are finding), and how to use the CGM readings to assist with the pump, longer still.

Dexcom (and other CGMs) are at their best in helping to catch low blood sugars. With that knowledge, you (and your daughter) may feel less inclined to over-respond to those lows (which is the way that many extreme highs begin).

I have been living with Type 1 Diabetes for 52 years (diagnosed in 1959). I still don't have it all down. Hang in there.

Permalink Reply by Kate on October 27, 2011 at 3:59pm

I use both and love it! Keeping up with 2 controllers can be an issue, but as you know, you only need the pdm on your body for bolusing and bg readings. It can stay in a bag or a locker other than that. The receiver for dexcom needs to be close all the time to receive readings. It also can give an overload of info. At the beginning, one can easily get caught up in staring at the receiver for hours (I kid you not!). I also had to caution myself from acting too quickly. Just because I can see what my blood sugar is doing does not mean that insulin works any faster or better. I just know what it is doing.

I usually placed my sensor in my abdomen area. I used that for injections for close to 15 years and gave it a break when I switched to the pod. I rotate the pod in other areas and use my abdomen for the dexcom.

Between the omnipod and dexcom, I have lowered my A1C by over 2.0 since January 2011. For me, it was essential to my control. With the dexom, I have "eyes" to see what is actually going on and could make informed decisions about the food I choose to eat.

I have my dexcom set to give me a "heads up". I set my upper limit at 120 and my lower limit at 70. I want to know where my blood sugar is headed before I get there. For example, I want to stay under 140. So if I set my limit at 140 and the dexcom has about a 10 minute lag time behind a finger stick, I'm probably above 150 by the time it tells me. Not useful info, IMHO. So I set the limit lower than my threshold so that I can keep an eye on it and avoid hitting the top (if any of this rambling makes sense).

Hope that helps. Good luck in making a decision!

Permalink Reply by jrtpup on October 27, 2011 at 4:33pm

I use the Ping, not the Omnipod. I use the remote on the Ping so I also have 2 devices. Do check out TallyGear's web site. I have 2 of their belts that I use a LOT. They make them for kids as well as adults. They are totally flat when not in use, and can be worn above the belt (or wherever) to avoid bulges you don't want. They have multiple pockets, and a option for one clear pocket which I use for my dexcom.

Like Kate, I have my lower/upper set to 70/120. One of the best things about the dexcom is the trend arrows. They show if you're stable, or going up/down quickly or slowly. The reading is 10-15 minutes behind, so it's essential to do a FS before any basal or correction. My A1C went from 8.4-5.8 in 3 months with the dexcom, and to 5.6 in another 3 months. "My name is jrtpup and I'm a Dex-aholic" :)

Permalink Reply by Kate on October 27, 2011 at 4:42pm

Oh, thanks jrtpup, I forgot to mention SPIbelts. I use one for jogging to hold the receiver, my keys and tabs. It's AWESOME! http://www.spibelt.com/

Permalink Reply by jrtpup on October 27, 2011 at 4:34pm

Oh, forgot... the instructions for the Dexcom say only to use it on your abdomen. That's because it was only tested there. I use my thighs, arms, upper butt... anywhere you can put a pump site, you can put the dexcom.

Permalink Reply by Brad Ringer on October 27, 2011 at 8:36pm

I use both too. I am very hypoglycemic unaware, so my lower alarm on my Dexcom is set at 90 for safety. I have had both units about 2 years. Both units, especially the Dexcom unit, helped me as soon as I started using them. I do feel that it has taken more than two years to get to the point where I am optimizing their use.
Please be very careful about doing correction boluses with the OmniPod. The insulin on board amounts exclude insulin taken for meals.  Despite knowing that, I got myself in trouble this week.  I was 190 two  hours after breakfast and took a correction bolus.  In the space of one hour I dropped from 190 to 90 - not a great feeling. I continued falling to 50 - 60.

I am working with a CDE to fine tune my pump settings.  We are working on my basal rates now.  It requires skipping meals (not fun), but it validates or invalidates the basal rates.  Right now I have six different rates over 24 hours.  Once we get the basal rates correct, then we'll move on to testing the insulin to carb ratios and finally finish with the correction factor.

My A1C is 7.1 and my endo doesn't want it much lower because of my hypoglycemic unawareness.  Despite not changing from last quarter to this quarter, I am in better control.  The previous quarter I had highs and lows which averaged out.  Now my readings are much tighter.

I am a big fan of having a good CDE if insurance pays for self management education.  The appointments I have are much longer than those I have with my endo.  I would not be nearly as successful with the fine tuning if I were trying to do it with my endo - the appointments are not long enough to be able to analyse the trends on the Dexcom reports.

Permalink Reply by barbraann on October 31, 2011 at 4:30pm

Hi!
I've been on the omnipod and dexcom for about a year (wow how time flies!) I also wear the Dex mainly on my stomach and rotate the pod but I've used other areas for the dex as well but it seems to stick best on my stomach. I recently spoke with a Omnipod rep who gave me the most promising info that the omnipod will soon be the smaller version and that we will all be upgraded. Didn't say anything about the combining of the pod with the dexcom but I've been told it is coming so hang in there.
When I don't want to carry my purse with me I keep my Dex in my pocket. If I have no pockets I have a small cute little zip bag that I place my Dex, phone, and sometimes my Omnipod PDM, and test strips. It has a long strap and that way I wear it crossed. I'm usually in jeans so pockets aren't a problem.
I have extreme lows and hypo unawareness so the Dex has been a lifesaver for me at night especially. I set it on my side table where it vibrates and rattles against the wood or I lay on it. (I just have to force myself to actually get up and test and not just roll over and ignore it)
If she is very athletic be careful. I find when I run that it can't keep up with the fast drops that usually happens and keep in mind that the Dexcom is usually 15 to 20 minutes behind. Mine can read 60 or 70 and can actually be 40 so like Brad I have mine set relatively high to catch it before it falls too low.
Another bit of info, you can wear the sensor for 14 not 7 days. In fact, I find the readings to be more accurate the second week. Some people have problems keeping it stuck on that second week but it works just fine.

My A1c's have always been good so there wasn't a big difference, run around 5.8 - 6.5. It's the night lows that I needed help with! Good luck!