I don’t remember hearing the Dexcom alarm last night or taking any insulin but I must have. When I looked at my graph for overnight, I went high and came right back down. According to the Dex reports, I peaked at 203 at 2:18. I don’t know why I went up or why I came back down, but I guess this is the diabetic version of sleep walking.
I subscribe to the diaTribe newsletter – which is a newsletter about diabetes treatments and technology. Diabetes names Gary Scheiner, Jim Hirsch and Kerri Sparling all contribute to diaTribe. It is well worth checking out if you have not read it before. The downside is that it only comes out quarterly, but if you subscribe, you don’t have to worry about your inbox being flooded with newsletters you can’t keep up with.
I received a newsletter last night from diaTribe and there was an article about the status of the new Dexcom sensors and Dexcoms integration with both Animas and OmniPod. As most of us are aware, the FDA has been holding up the release of these items.
According to diaTribe, Dexcom will be starting clinical trials the beginning of 2011 for the Gen4 sensors and hopes to have FDA approval by the end of 2011.
The clinical trials for the Dexcom/Animas combination are expected to start mid-2011 after the clinical trials for the new Gen4 sensor are completed. This new combination is already under regulatory review in Europe and they hope to begin selling it in the first half of 2011 in Europe.
Apparently, the Dexcom/OmniPod combination has changed course from the original plans. Insulet is deciding if they want to go forward with the next generation combination or stick with the original combination (first generation OmniPod and SevenPlus). The combination Insulet decides on will determine how soon it will reach the market.
You can read the full article here. It is the 3rd one down.
I put a new sensor in last Friday. Every time I checked my blood sugar both Friday and Saturday, my meter readings and Dexcom readings were within a few points of each other – what I would call the perfect sensor. On Sunday, my readings started to stray here and there, but nothing to be worried about.
Monday was a different day. My readings were straying way off all day. Unfortunately, my Dex wasn’t the only thing I was not trusting. I had opened a new box of test strips and I was even questioning if those were right. My meter would show that I was in the 70s or 80s and I felt like I was lower than that. I even broke out another box of test strips & stuck them in my backup meter. Those were close to my regular meter but I was still thinking “garbage in, garbage out” as far as my Dexcom readings went.
The first thing I do every morning when I wake up is reach for my Dexcom to see what my blood sugar is and yesterday was no different. The second thing I do is grab for my meter and check my blood sugar on my meter. My BS was within a few points between my Dex and meter, so that was a very good sign!
Around 10, I was doing some stuff in the kitchen and felt very weird. I took my Dexcom out of my Spibelt and looked – I was in the 120s with a straight across arrow. I went into the living room to check with my meter and I was 46 on my meter. I felt really bad and could barely see so I was thinking I have to be a lot lower than 46. My eyes sometimes get a little blurry when I am low, but they were so blurry I could barely see the meter. I am sure I over treated! To make matters worse, when I was checking my BS, my dog decided to pick that time that he needed to go outside. He was doing his little “I need to go out” dance and was whining. I knew what he wanted but I also knew I needed to treat my low first.
As soon as I downed some Smarties, I decided I better take the dog out – I could tell he really needed out. I am sure if my neighbors saw me, they thought I was nuts. I have a coat closet in the living room but I have it full of Christmas stuff so there is no place to hang my jacket downstairs. I use my walker as a coat rack. Since it has been so cold, I have been putting a coat on Alex and also keep his coat on there also. His coat is usually wet from the snow so that also makes a good drying rack. I wasn’t sure I could get my jacket on let alone the dogs so I went outside with both still hanging over the walker. It was in the teens and snowing.
As soon as I came in, I sat down on the couch. I could not tell what time it was because my eyes were too blurry to see the clock. I usually like to try and watch the time so I can check again in 15 or 20 minutes. By then, the Dex was also beeping at me – I ignored it because I knew I was low. I also did not think I would be able to read the screen if I looked at it.
I started feeling a little better so when the Dex started making noises again, I decided to pull it out. I think at first I had a little heart attack, but reminded myself it could not be right because I was feeling better. Since I knew I had been touching something sweet that could throw my BS off, I first went and washed my hands before checking my BS. My Dexcom is usually a little slow coming back up after a low (which I don’t mind because it is not normally slow catching the low) but it levels off and just stays where it bottomed out. I decided this one was picture worthy!
I do want to put a little note here for you non-Dexcom users that this not typical Dexcom behavior. However, it is a good reason why you should always double-check with your meter before making treatment decisions.
Yesterday, I wrote about the Flatliners Club and shared some pictures. When I was taking pictures last week to share for that article, I thought I would also share what a good gastroparesis day is for me. It is far from perfect, but if I can avoid the extremes, that is a good day.
One of the first big improvements for me with gastroparesis was learning to split my mealtime shots into multiple shots. That helped some of the crashing after eating and the highs later once your food finally started to digest. Doing that, I was able to start seeing A1cs in the 5s.
The next big improvement was getting a CGMS – thank you Mary! Although one reason for getting it was because I am hypounaware, I also wanted it for help with the gastroparesis. I am able to set alarms to warn me when my blood sugar starts going up. I especially like the Dexcom because you can set your high alarm to alert you at 120. With gastroparesis, the sooner you can correct once your blood sugar starts going up, the better. A lot of people with normal stomachs will pre-bolus for their meals. Waiting until your blood sugar is high to take insulin with gastroparesis is like someone eating a food that they know will cause their blood sugar to climb rapidly, but not take their insulin until after they eat. The Dexcom has been a great help in helping me catch my blood sugar before it gets too high.
In June, I started pumping with the Animas Ping. Before getting it, I really did not think that it would make that much of a difference in how I bolused for my meals. I wanted it to help with dawn phenomenon. I liked the idea of being able to have more basal rates that I could have using Levemir. I liked the idea of being able to scroll thru the pump and find out exactly when I took insulin without worrying because I did not write it down.
Even after starting the pump, I continued to bolus for meals the way I was on MDI. I would space out my boluses based on when my blood sugar was starting to go up. I was afraid to try the extended bolus feature (combo on the Ping). Then I started using TAG and I have seen an improvement in my blood sugar. If I had tried to use the combo bolus based on what I was using with MDI, it never would have worked. Calculating the protein and fat for the extended bolus has made a big difference. You can read more about TAG here: https://kellywpa.wordpress.com/2010/11/10/total-available-glucose-tag-2/
I shared this picture from last Friday with yesterday’s flatliner post and called it my Rocky Mountain:
It probably looks worse than what it is, but that was actually not too bad of a day. I did two screen shots from my Dexcom for the 24-hour period that picture represented. I wanted to show the Hourly Trend Chart for that 24 hour period. You can’t get everything on one screen so I did two different screen shots. With the Dex software, it is the numbers that are different on the second screen, not the chart at the top. If you click on the pictures, they will get bigger and the numbers will be easier to see.
My average for the day was 104. I was having a very good sensor day and every time that I checked with my meter, I was only a couple points different between the Dexcom and my meter so the 104 is a pretty good reflection of my average for the day. Although 104 sounds high to some people, if that was my average every day, that converts to a 5.3 A1c.
What I am most happy with is my standard deviation was 24. Yes, I know people do much better than that, but for having gastroparesis, that is a good number. If you look at the hourly time periods, 16 of those 24 hours were below 10.
My high for the day was 161 and my low was 39. Actually, my meter logged me in at 44 so I did not technically hit the 30s.
Although I still have more lows than what I want, they have improved and having the Dexcom gives me more confidence in fighting the highs. It is very challenging when you don’t know when your food will digest, but with work and technology, it is possible to have more good readings than bad. I have come a long from where I was before!
Trials & Tribulations of Being a Type 1 Diabetic 