My daughter had her quarterly endo appointment yesterday. During the last 3 months her 90 day average BG was down significantly from the previous reading at the last appointment. Understanding the imperfections of the BG average on the meter, we were all very surprised to find that her A1C was at the same level. Her endo felt strongly that we needed to at least do a seven day dexcom trial to see if we can narrow down what is occurring. Given these numbers, we of course concur.

Our daughter has the Omnipod. She is a very active 14 year old who is highly ranked in tennis. She checks her blood between 10 and 15 times a day. During a recent all day tennis tournament she checked her BG around 25 times because she could not get her levels to rise to a normal level throughout the day. Any community input would be greatly appreciated as to the pros and cons of the dexcom system for a young teenage girl. I am particularly curious to have input on the practicality of wearing the monitor when engaging in a sport like tennis or basketball. Another area where input would be appreciated is regarding the use of the system while performing on stage or in a march. She is a member of the Colonial Williamsburg Fifes and Drums Corps and performs two to three times per week. Is it practical to wear the system during performances or do the alarms make it impractical to utilize during musical performances?

Thanks for your input.

Larry

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If your daughter tests this many times a day, I am pretty sure she is like me, an information junkie. The knowledge that she gets into her BG's with the Dex will give your daughter the power and the tools to make good choices re her Diabetes and the steps she needs to take to take care of herself. I LOVE my Dexcom... and if the audio alarms are a concern for her during perfomances, she can always set them to vibrate and have the system close enough to her skin that she will feel it. Because when we know the 'why' behind the 'what' is happening with our Diabetes, we know the 'how' to take control and beat it. But without the knowledge....well, its a feeling of helplessness that is frustrating to say the least! There was a discussion started on this group site by a teenager that you may be interested in viewing http://www.tudiabetes.org/group/dexcomusers/forum/topics/help-mixed...

With her athletic enthusiasm, have you checked out two books that come highly recommended for the diabetic athlete? Diabetic Athlete's Handbook and Think Like a Pancreas? Might help a little....
Totally agree with BagLady. I can't say enough good things about basketball and the Dexcom for my son.

He is 11 and plays basketball 5-6 days a week. He has had the omnipod for just over 2 years and the Dexcom for almost as long. We LOVE the Dexcom. The best part about it for us is watching what happens after meals, during the night, and during sports. We can see what direction his BG is going when he starts practice, and he doesn't have to keep stopping to check - partly because now we know what happens in a game, a practice, a morning game, a night game etc. It has given him so much more freedom. You have to learn how to use the numbers and it doesn't eliminate the checks but it definitely cuts down on them. He still checks 10 times a day usually, but with sports he was more like your daughter - it was getting to be closer to 15 if he really wanted to manage well.

You can't rely completely on the Dexcom for accurate to the minute numbers- so if he's playing, he still has to stop and look at it, and then determine what to do. Sometimes he has to check, sometimes he'll just grab some gatorade - we've just learned by analyzing the data what needs to be done. In sports especially, if he's dropping and his blood sugar on the dexcom reads 100 - he's more than likely already low. So if it shows a number under 150 he usually stops and gets a more accurate number. But if he's steady, and around 180 for example - he doesn't stop. Obviously this would all be individual to your daughter, but it's amazing what we've been able to learn and apply to give him more freedom.

Another thing is basal rates. We were able to figure out that he needs his basal reduced about 2 hours before sports - not 1, in order to not drop like crazy when he started. We also figured out that nighttime lows were happening about 6 hours after a long session of basketball. That's something I'd read about but we actually could see it on the Dexcom without getting up all night to find it.

Oh - and as far as alarms, you can mute them, or even put them on vibrate which is what we do when we go to the movies or theater or anywhere he's supposed to be quiet. : ) You can also choose not to carry the receiver if you don't want to - it won't pick up numbers but it will resume when she picks it up again. My son wears his in a spibelt which fits snugly around his waist and doesn't even bother him during sports.

Good luck figuring out what she needs!
Here are my thoughts about your questions. I think the Dexcom would give you a lot of information about what's going on in between finger-stick tests, and help you figure out why, if her meter average went down considerably, her A1c did not. Keep in mind while the Dexcom is not always 100% accurate, it will give you a lot of great information about which direction your daughters blood sugars are trending and when.

As to wearing it while engaging in sports, performances, etc.The sensor/transmitter (the part she wears on her body) itself will not get in the way of her activities any more than her Omnipod will, and probably less than her pod will, in fact, as it's profile is not as tall. The receiver (which is the part that shows the graph of where her blood sugar is) is a little trickier. It has a range of 5 feet (I personally think it's a little bit more than that). She probably won't want to wear it while she's playing tennis or basketball, but she could keep it on the sidelines with her gear and it might be able to pick up a signal. The Dexcom's readings are about 10 minutes behind a finger-stick reading, because they measure blood sugar via interstitial fluid and not a blood drop like a finger-stick, so during an intense game or match, I'd feel better relying on my meter over my Dex anyway, as it will be able to show me more accurately what my blood sugar is at that moment, rather than 10 minutes ago. If she's wearing some large costume while marching she might be able to hide the receiver in it somehow, or it can just fit in a pocket. I wear it in my pants pocket often. As to alerts going off while she's performing. You can set the system to vibrate or to not give you alerts at all, so that's not a problem. I do that when I'm in church and don't want an alarm going off if I start going low. I just make sure to visually check it more often if I don't have the alerts on.

The Dexcom has it's drawbacks (like the 10 minute lag time, or the 5 ft range), but overall I find it really easy to use, and it has given me a lot of great information, I definitely think you would benefit from giving it a trial run. Good luck!
I don't yet have experience with a CGM (hopefully getting one next month), but here's the blog of a young woman who is a professional ballet dancer who was diagnosed a year ago: http://dancethrubeetus.blogspot.com/

I believe she uses the Omnipod and a Dexcom CGM while training and dancing. If you're on twitter, she's @dancethrubeetus and I have a feeling she'd be happy to answer questions for your daughter.
I, like BagLady, am an information junkie. I love my Dex. I look at it probably hundreds of times each day, the same way I'm always checking my iPhone. I can understand the conflict ya'll may be having; wanting to get to the bottom of the problem, but at the same time cautious of allowing yet another device to be attached to her constantly. Though you may be hesitant, I personally don't think the Dex is that obtrusive. See if you can get the seven day trial through your endo instead of committing to the device (and the cost) permanently on your own. I know some offices will lend you a Dex for a trial period of a week or two, you give it back so you can analyze the data and make adjustments. If that isn't available and you're still not down for going all out with the Dexcom, look into the iCGMS Pro through your endos office. It doesn't have a receiver that you look at. You go in for an office visit, insert the sensor, and then leave it alone. At the end of the period for which you are collecting data (say three days to a week or whatever) you take it off and mail back the data collector bulb thingy to the office where they download the info and give you the low-down. This might be a better option if your daughter doesn't like the idea of being tethered to another device or she is concerned about the alarms from the Dex. There are some alarms that you cannot silence, which is a good thing if you are dropping really fast or skyrocketing really high, but less good if the show must go on (or you just walked into a seminar...late) and you already know that you're blood sugar is dropping and you just pounded a juice box and a handful of Swedish Fish (not that that's ever happened to me or anything). That being said, it is a very useful tool, but it might not work with everyone's lifestyle. For me its great, because I don't really care anymore that people are staring at me in discussion section while I am pouring sugar packets that I grabbed from Starbucks down my gullet, and some weird pager/iPod thingy attached to my belt is singing Fur Elise. Hope that helps!
Ha! You made me laugh out loud at your low BG experiences - they are so close to some that I have had as well! After a while you learn what's most important, eh? I love that you can keep your sense of humor about this :)
Hi Larry,
I am not a Omnipod user so I will defer that question to others here who are. I can tell you that the Dexcom is the most accurate CGM on the market today (IMHO). As for the alarms, you can put it on vibrate only, which would be better so that she would feel it - even during a loud march. Your daughter's multiple testing is impressive but the Dexcom gives readings every five minutes. And, it shows patterns, which seems to be the main reason your endo wants her to wear it. Because of wearing the Dexcom, I discovered that I no longer have dawn phenomena, which caused me to adjust my pump settings to correct lows I was having in the morning. As baglady said: The more we know, the more we can control our diabetes. Also, this may enable your daughter to test fewer times and save those finger tips for something else more enjoyable.
My thoughts align with other folks who have already commented. I carry my monitor all the time unless swimming. I would think that if an alarm goes off during a performance that's exactly when you do want to know that something is out of kilter. If there are bunch of "marginal" alarms, you can always set the points at which you are alarmed a bit wider to give more leeway. I carried my monitor through roller coasters and in and out of rides at DisneyWorld a while back. Just put it into a camera case that fastened to a belt loop and I was off and running (literally at times). I can't feel my lows anymore and the meter (although occaisionally wrong) is the only way I know things have gone awry. Good luck!
I agree fully with most of the information here. I bring my Dexcom to Karate Class with me and set it on a windowsill by the mats and unless I'm in the far corner (about 15 ft. away) it has no problem. The only caution I have is that if your sugars fall below 55 often (my unfortunately do) there is no way to shut off the beeping alarm then. It's a built in Dexcom safety feature. While I imagine that you'd always want to treat at that point and actually hear the alarm, if you are going into something you can't afford to have it alarm during you can shut down the receiver during the activity. You'll lose the blood glucose record but there will be no chance of an alarm. The info the Dex gives me has revolutionized my diabetes care methods and I strongly suggest at least trying it out for a bit!
Hi Larry,
I'm a 47 year old historical reenactor of the French/Indian War. I am on the Paradigm 722 pump, and I also have the Dex. As far as plugging in, it's pretty much painless and really quick. The one thing that ALWAYS happens when I wear the Dex is, I become a number nazi, and drive my husband insane due to the number of times I look at the receiver. By the third day of wearing it, I realize how many times I do look at it, and take it off, frustrated. Also, when I wear it, I have my pump on one side of my waistband, and the Dex receiver on the other hip. I used to be on the Pod too, but when I was getting 50% failure rate per box, I went back to the Paradigm. I wish your daughter and your family the best in finding something that works for her!

Thanks everyone for the excellent feedback. The tudiabetes community rocks.

Go for it. You'll love it.

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