The CGM Analysis: Week One
Life has been a bit chaotic around my neck of the woods the past few days, so I’ve been deliquent in posting my initial CGM analysis.
Last Wednesday, Jaimie, a sweet fellow Hobokonite and Minimed trainer, came over to my apartment to show me how to use the Minimed Paradigm CGM. After seeing so many pictures, hearing so many anecdotes and actually using the DexCom, hooking myself up to the CGM wasn’t all that scary or complicated. I think the most troubling part of the whole experience was having to use an serter for the sensor. I use the silhouette sets for my insulin pump and I put them in by hand. I’m a control freak. However, Jaimie told me that because of the thickness of the needles and the depth at which it needs to go, it would be extremely painful to do it by hand.
After the instruction on how to load the serter, I put in my first sensor. Despite my extreme apprehension at having a needle that big shoot through my abdomen at high speeds, it didn’t hurt at all. I barely felt it, actually. I also had minimal bleeding, which Jaimie says it’s actually fairly normal. Only when you have a lot of blood, or it starts to drip and won’t stop (ewwww!) does that mean there is a problem.
I geared up the transmitter and waited patiently for it to tell me I could enter in my first calibration reading from my glucose meter. Unfortunately, I happened to lose signal part way through the 2 hour wait period, so I ended up not calibrating my sensor until after midnight. On a school night. It was horrible. My blood sugars were also frightfully high so the CGM also alarmed about once an hour throughout the night (I ended up having a bad set and didn’t recover until mid-afternoon the next day – but I digress…).
So far, the CGM has been okay.
Not good, not spectacular. But not miserable or a waste of time.
As stated by countless others, the CGM works well for trending and patterns. Not so much for the actual number.
Problem? You can’t actually set the CGM to alarm with trends, only for when you hit an actual number. So you could be dropping sharply or rising dramatically, but you won’t know anything until your CGM says you’ve hit that Magic Number. But you could already have been well above or below that Magic Number by the time your sensor picks up on it. It’s very frustrating.
I’ve taken to checking the CGM about every fifteen to twenty minutes, just to see where the arrows are pointing. It has encouraged me to test my blood sugar when I wouldn’t normally think to. On Saturday night, I had a wonderful dinner at an Indian restaurant in the East Village and then went off to see Nothing Like the Holidays. When I went into the theater, my blood sugar was great. When I left the theater, the CGM told me that I was going up dramatically. I felt fine, but because I had such a big meal and I was going up so quickly, I should test my blood sugar. I was 303 mg/dl, I immediately corrected it and was done within an hour. If I didn’t have the CGM, I probably wouldn’t have tested again until I got home, about an hour later.
The CGM, however, has not been so good with catching the low blood sugars. The CGM, I’ve noticed, trends towards normal. That is, when I’m high, it reads low, and when I’m low, it reads high. The arrows are spot on. Yesterday, I hit a knee-buckling 42 mg/dl, and while my CGM said I was 106 mg/dl, it also had 2 arrows and told me I had dropped 40 points in about 20 points. Again, it would be great if my CGM could alarm when I had those arrows instead of relying on chance that I would look at the screen to see where I am and catch the low or high in progress. Seems logical to me… Anyone from Minimed reading this?
That said, I have only been on the CGM for not even six full days. I’ve used exactly one sensor. I know that different sensors can work differently and that different places on your skin can work differently. I am blessed with a health insurance company that believes in the power the CGM (or at least is wise enough to not deny the option) and I have a three-to-six month supply of sensors sitting on a shelf in my kitchen. My next A1C test is in late March. If my A1C comes down even half a percent, I believe that this will be worth it. Any assistance or insight into this complicated and frustrating disease is eagerly welcomed.