20 years+ what effects us now?

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Permalink Reply by Brunetta on October 20, 2009 at 1:32pm

Hi Stu and Crew; I just got a MM CGMS about three weeks ago. It has been helpful in spotting trends and in avoiding highs. That is what I like the most about it. It is not to be used for immediate treatment decisions without a finger stick blood glucose check. I feel that it ehlped me to even out my evening and overnight basals by showing me the times that blood sugars start to climb or fall without having to wake up in the middle of the night; unless necessary for treatment. If I fall too low,this thing shouts like a banshee !!! But I have never really had quick dropping lows and the CGMS just confirms that....

Back to the topic at hand. I know where you are coming from Stu, at 41 years type one, a single high does not shock me, no more than a hypo or two. I do not like the excursions, that is why I got a CMS, to help with stabilization of blood glucose throughout the day and night. But not much about my diabetes care or the reality of the conditions really shocks me anymore. I am not blase', just accept it as it is, all the daily tedium and the experimenting and the 'Why did that blood glucose value HAPPEN?"... It is just how it is.. But I am healthy and pretty happy.. I am going to work on experimenting with what exercise does to my blood sugar level while on the CGMS.. I am going to take a relatively longer walk this afternoon, at either a local mall and outside in my neighborhood. Check out my post , Jim, on the CGMS users group, if you want more info....

Live Long and Prosper, Stu

from Lt . Uhuru
(LOL)

God Bless,
Brunetta

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Permalink Reply by Stuart on October 30, 2009 at 8:38pm

Tears streaming down his face from the major laughter....

Thank you Uhuru always wondered what your first name was.....Brunetta.... a beautiful name

Stuart

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Permalink Reply by Stuart on October 30, 2009 at 9:13pm

Hello Jim:

If it guarantee no more hypo's/hypers either I'll take two thanks; here's my first born, my car, whatever you want its all yours... Unfortunately the CGM's are NOT accurate. If they were we'd use them to generate our insulin doses wouldn;t we? A second test (confirming) would be totally superflous...

Yet apparently given that a test is mandatory before we believe the numbers generated by the CGM's, there is some kind of serious screw-up/potentially lethal gap in those numbers interstecial readings apparently have the identical kind of problem as capillary readings which we get from finger pricking. There is some kind of flaw in capillary readings (ie distorted/inaccurate) which veinous reading/labratory testing eliminates.

If we can generate the accuracy of veinous reading with a CGM, we'll have excellent control, right?
.
I feel confident they find patterns, big and small, things we already know and those we don't quite realize too. If someone can crunch the numbers a CGM generates on individual basis for a couple weekly for a couple months then I'm in. But that's a heck of a lot of data 288 readings per day (1 reading every 5 min).to crunch & understand.

With profound regret I do not believe/accept this generation of CGM's will stop anything from happening, until they can fix that issue, at minimum. If the CGM reading is able to be that off, then what the heck good is it? If I've got to confirm those numbers against another finger prick, why the heck would I bother?

I know I'm overthinking it, but I can't get around that either.

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Permalink Reply by Jim Devlin on October 31, 2009 at 8:22am

Your underthinking.There is a section within this website called CGM. Here it is loaded with info. from people who have actually a working history with CGM's. Their opinions are worthwhile.
No where does anyone say it is supposed to eliminate finger pricking. These machines should be calibrated 3-4 times per day after a new sensor is installed and less after a couple of days to assure accuracy. This seems like a lot to you, I know.
If you have hypoglycemic unawareness you would benefit tremendously with an alarm telling you when your glucose level gets down to 70mg/dl.
When I was a kid I would have low sugar warnings for 20-30 minutes. Now it falls like a rock. To be notified at 70 would be, very possibly, a hypoglycemic saving alarm. Same situation with 200+ numbers.
At this time I set my cell phone alarm for 4:00 AM and get up and test. I have tested at 57mg/dl, and lower, and immediately corrected this obvious problem. With the CGM this alarm would no longer be necessary.
There is an arrow on your monitor which tells you which direction your sugar is heading. If the arrow is pointing down, and your at 70mg/dl, you know to get some sugar in you. If the arrow is pointing up at the same number, however, you would skip the extra suger. Ideally, a level arrow is good. This, presently, is the only way we can know which way were headed.
All this info. three yrs.worth, can easily be downloded to your computer, if you choose.
Very soon, the CGM WILL WORK IN CONJUNCTION WITH THE INSULIN PUMP. BASICALLY THIS WILL BE A CLUMSEY BUT EFFECTIVE ARTIFICIAL PANCREAS. Worth reading about.
Please check out the CGM section on this diabetes website before commenting.
Jim

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Permalink Reply by Stuart on October 31, 2009 at 2:02pm

Hello Jim:

The topic is what phases us, being we are all expereinced diabetics here. Mandatory testing for "dosage purposes" blatently means to me there is some kind of problem/issue with the data a CGM generates if we cannot use that data straight out to calculate insulin coverage.

And yeah forgive me the calibrating issue (yikes) would definately reduce its benefits in my book. It would phase me. As a CGM user you feel differently, and its benefits outweigh its possible drawbacks?

Stuart

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Permalink Reply by Jim Devlin on October 31, 2009 at 6:54pm

The purpose of the CGM is not to eliminate blood tests. Each generation of new CGM's has vast improvements over the CGM it replaced. I wonder if your aware of some or any of these.

As I recall, you test once per day unless you are feeling so fedup you don't test at all. In other words, the necessary 2-4 calibrations of a CGM would make your having this operation pointless because you would quickly get disgusted and refuse to use it regardless of your new absence of hypo and hyper complcations. This is its sole purpose.

This has happened to others.

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Permalink Reply by Stuart on November 13, 2009 at 9:04am

(Appalled)

I'm not saying in time they (CGM's) won't be helpful toys, I merely cannot understand how something so blatently fundamental, (eg readings cannot be used w/o mandatory re-confirmation) can be so easily "overlooked"!

If the readings are not trustworthy enough then how accurate can the "patterns" be Jim? Btw, you recall dead wrong thankfully.... am I disgusted absolutely, but have the callosued fingers to have earned that perspective...

Point of clarification, are these 4 extra "calibrations" on-top of whatever BG readings that you normally perform?

Stuart

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Permalink Reply by Jim Devlin on November 13, 2009 at 11:01am

Stuart, The CGM is approved by the FDA and ADA. You know how difficult it is to get approval from the FDA. They approved the CGM because it has evolved into an accurate enough toy to satisfy them.
The fact that it must be calibrated twice per day is a nothing price to pay compared to the benefits and safeguards, in my opinion. This toy will be a part of the first artificial pancreas as it becomes in sync with the insulin pump. This will occur sometime next year (or later). Yes, it will be a lot of shit to carry around but think of the no concern of hypos for the first time since your diabetes was discovered.
Four times per day was an older model.
Type in DEXCOM SEVEN PLUS and hit search. This will help you agree or disagree with some knowledge.
Also, due to litagation concerns, ya can increase their stats by 25-35%. I'm sure you know how conservative a company like this, or any medical company, has to be.
Jim

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Permalink Reply by Jacky Del Hoyo on October 24, 2009 at 6:49am

I think the thing that effects me most os seeing the variability in different people who have diabetes. It amazes me how some people seem to be able to live with this disease almost as an afterthought, and experience little BG fluctuations. Some of these people live very very disiplined lives, doing frequent BG checks, tightly controlling diet and excercise, and their hard work has just seemed to intergrate into their lives, and become a part of who they are, and what they work towards. Others also work hard, but for whatever reason, they still see a lot of variability, and often grow frustrated, and then kind of burn out on the effort with so little result. . I've lived it myself. At some periods of my life, it was almost like my pancreas decided to start working again, my insulin needs decreased, and variabilty was very small, then it just went away, and I needed to start paying attention again.

As far as what can still effect me that is definitely D related, a bad bottle of insulin : ) Since being forced to switch to mail order by big ins. co, I have noticed that on occasion, I'll get to the last of the insulin, or the first bottle of a new batch and find that it acts like water. That really got me going the first few times it happened, I was kind of like, OK, what the heck is going on, bad site- Switch it out, still no difference, do an injection- still climbing, What the heck- am I on the verge of a massive infection or something. Now, I know, call the mail ordre pharma, explain to them, yet again, that insulin sitting on my porch since 10 in the morning till 6 in the evening will NOT be kept cool enough and can they please get me a bottle at my local pharma till they can ship replacements. When I think about how much spoiled insulin I have thrown away, it makes me ill.

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Permalink Reply by Jim Devlin on October 24, 2009 at 11:06am

Don't you have a neighbor who would accept delivery?

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Permalink Reply by Jacky Del Hoyo on October 24, 2009 at 1:26pm

All my neighbors work during the day, and I work 20 miles away from my house, so I can't stop by during lunch and pick it up. It's a stupid policy they have, to drop off a package of insulin early in the morning to sit on the steps of a stone house in a foam insulated bag with 1 freezer bag in it. It still can get to over 80 in NC even in October. When my mom lived in Las Vegas, her insulin came wrapped in a styrofoam container with multiple ice bags, always cold. We used the same big pharma mail order, but when I asked if mine could be packed similiarly, they said they no longer ship like that. Breaks my heart to throw away so much insulin, but there's a reason is says "keep refridgerated".

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Permalink Reply by Jim Devlin on October 24, 2009 at 3:40pm

I get only my 2 insulins from Costco. The rest all comes from a distributer. Insurance works either way.
It is cheaper at Costco anyway.
Don't know if you have Costco in NC.

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