Couple of things, There currently is no spring loaded or easy inserter for Dexcom's sensors. You have to actually push a plunger in that inserts the needle which the canula for the sensor is on. You take the needle back out leaving just a tiny and thin canula. I've never gotten really good at giving myself shots always doing it slowly and carefully rather than a quick jab so this is no fun for me. I put up with it though so that I can get all the info the sensor provides. Also the CGM is not actually testing blood sugar. As I understand it there is a formula for estimating blood sugar based on the sugars in the fluid present in the upper layers of fat cells under the skin. This estimation is why you need to do finger sticks to calibrate the unit and to be aware that the unit may be off by as much as 20 points. I've found it is within 5 points most of the time and is the furthest off when my blood sugar is at the most extreme either high or low. Each time you change the sensor site you wait two hours while the unit compiles all that time of readings setting a base. At the end of two hours the unit buzzes or beeps, depending on how you have it set, and asks for two blood sugar readings. After inputting those two blood sugar readings the Dexcom takes a glucose measurement every five minutes and creates a graph along with displaying the most recent reading. It also displays an arrow to show which way you are trending Flat, slight incline or decline, straight up or straight down, double arrows straight up or straight down. (I've never actually experienced double arrows straight down) These indications of trend have helped me more than I could ever have imagined.
You can find most of the technical information on DexCom's Website . I'd like to give you an idea how the CGM has helped me, how I use it and why I hope I never have to live without it.
When I first got the Dexcom I couldn't believe how far my blood sugar swung back and forth after meals and with exercise. For everything that we had done and all the experimenting with bolus's and basil rates it just seemed that nothing made things right. I am still amazed sometimes by what I see my body doing that doesn't make any sense.
The first place the Dexcom started helping was with low blood sugars. Over 30 years of Diabetic life have caused me to really fear Low Blood Sugars. I've had some pretty bad episodes and hypoglycemic unawareness has caused me to really not feel it until my blood sugar is close to 40. I had a tendency to feel a low blood sugar episode and eat until I felt better. This normally caused me to swing wildly the other direction where I would take insulin to fix and #1 I set it to warn me when my blood sugar hit 70. I usually feel completely normal at this time but now I know early that something needs to be fixed. I get an earlier start on stabilizing. Also the trend arrow has helped. I know how quickly the low is falling. I can react to it based on that I eat and react differently to 66 and flat than I do 66 and an arrow pointing downward. This has helped me avoid the extreme lows while reacting with confidence in a way that also avoids the spikes afterward.
Learning to use the Dexcom to treat Low Blood Sugar has also taught me exactly how much I need to eat to change my blood sugar. Imagine trying to use finger sticks to figure out how many blood sugar points a single carbohydrate affects. When I treat a low blood sugar I'm able to watch and see how high blood sugar goes before it starts leveling out. A little math and I know that a single carb raises my blood sugar 5 to 6 points.
I should mention that it is not recommended by my doctor or by Dexcom that you use the readings on the Dexcom to treat low blood sugar. They have been very helpful to me and I don't always do a finger stick but remember that it has been my experience that the biggest change for the CGM to be off is at the extreme ends of the spectrum. Also it takes a little more time for the glucose levels to change in the fat and skin than in the blood so that may be a little behind. I will check at these times and find the Dexcom off. Be aware of that. Interesting note though. Because the Dexcom asks for two blood sugars to calibrate. I have tested on both hands to do the calibration before and my left and right hands have been as many as 20 points different. Who knows how real any of the readings we are getting.
The second thing the Dexcom has helped with is overnight blood sugar. #1 that thing buzzes when my blood sugar hits 70, no more waking up with cold sweats unable to think or see and feeling like I need to eat an entire quart of ice cream. "Buzz, Buzz" it's 70, get up, eat half a granola bar, go back to sleep. It'll wake me up again if that didn't work. #2 I had a huge problem with what my doctor calls "Dawn Effect" The idea that your own liver dumps sugar into you blood stream in the morning hours to help you body wake up. I was constantly waking up with blood sugars of 240 - 260. We couldn't add too much basil overnight because of the risk of low blood sugars in the early to mid evening. Being able to look at the graphs and trends from Glucose Measurements every 5 minutes allowed my Doctor and I too see exactly where the spike started happening on a fairly regular basis. We adjusted the basil rate to take this into account and my blood sugars on most nights, (unless I have too much for dinner), hang around 120 to 100 all night long. I think this may have been the biggest factor in lowering my A1c's.
Exercise is another place the Dexcom is invaluable. I have a huge lawn, I used to never be able to mow the whole thing without my blood sugar crashing and starting the whole roller coaster. Even with reducing my basil rate it was a problem. With the Dexcom I can watch the arrow. As soon as I begin trending downward, I take a little break, have a drink and a granola bar. relax for a minute then go back to the lawn. I'm able to check the Dexcom occasionally as I finish to make sure the food I ate was enough and adjust accordingly. I don't end up ruining my whole day after crashing my blood sugar and I don't end up eating so much that I'm in the 200's for the rest of the day.
Finally the Dexcom has made me feel like I stand a chance in controlling this disease. From being able to see what is happening I'm beginning to understand how different foods affect me and when they affect me. I've been surprised at how long it takes some food to begin to change my blood sugar. I've also been amazed at how long it actually takes before you begin to see a correction bolus bring blood sugar down. All of this information has affected the way I take insulin, the way I change my basil when I exercise, what I eat and how I eat. Does it work? In January of 2014 my A1C was 8.3 in August it was 6.2
Needless to say I love the idea of CGM and I think it should be standard for every type 1 diabetic. Doctors should be prescribing it and Insurance companies should be forced to cover it as cheaply as possible for any diabetic. It would save so much money in other things.
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