Prior to getting the Dexcom, he was pretty much on a 4 hr or a little over for meals with snacks anywhere from 2, 2:15, or 2:30 in between. That was working really well.
His Blood sugar is running a little on the lower side, in the morning after breakfast and into the early afternoon.
So he had a low again just before lunch and his blood sugar was lower as well - 77. So he just ate his meal and it must take a while as its been about 20 minutes and the Dexcom still says 58 and dropping.
We’re currently using the Dexcom receiver and the app as well. The app seems to have big chunks of time with no data, which causes gaps with the Follow . I guess that’s the next issue to look into.
So dinner time tonight his CGM indicated steady at 79 while his blood check was 114. I contacted Dexcom who gave the following information/instructions…
First 24 hours of sensor use can have wide variances. If after the first 24 hours readings are still inconsistent (+/- 20 difference), calibrate. If after the subsequent 24 hours readings are still inconsistent, the sensor should be replaced.
It just seems like a roller coaster ride. Approaching his overnight Lantus dose time we got a low warning from the Dexcom, 68. Checked his blood glucose and it was 114. 19 Minutes later a finger stick showed 73!
Regardless of the Dexcom, he’s definitely running low lately. And he’s not liking it .
In this case it sounds like his CGM was a few minutes ahead of his first fingerstick and in range of the second. Did you hear back from his doctor yet about adjusting his insulin?
The readings and which is ahead of which is a bit confusing. They told us that the CGM is usually 15-20 minutes behind the finger stick.
We haven’t heard back from the doctor, but only emailed his numbers early this afternoon. Things were pretty smooth throughout the day until this evening. We’ll be calling first thing tomorrow.
I think his insulin needs to be adjusted - this coming from only 2 months of education on the subject, so no expert. It will take a while I guess to learn how to treat from the CGM, especially since my son seems to have asymptomatic lows for the most part.
Its actually been more finger sticking since using the Dexcom !
@mawa316, you were given good info. MOST of the time, the CGM is behind finger sticks. There is conceivably a situation where the CGM and finger sticks may be close together time wise. I will explain it below. First, EVERYONE is different . Keep this in mind. Your son is an individual and his body works its own way.
Your son’s individuality aside, the way the CGM works is with “interstitial fluid”, which is the fluid that bathes body cells outside the blood stream. For now, think of it as plasma that has leaked out of the blood stream into all body parts. Another example is to think about digging a hole deeper than the water line near a stream. After a period of time, water will start filling the hole as it pushes thru the dirt of the stream bank. The time it takes interstitial fluid to get as ‘sweet’ as the blood is like time time it took the stream bank hole to fill with water, about 15 minutes.
Thinking thru what you described about the CGM to finger stick time being short gave me an idea. It is possible for key parts of the CGM sensor to be IN a small blood vessel causing the chemical reaction that occurs on the sensor to be reacting with blood and not interstitial fluid. This would be very RARE and is only a wild shot in the dark. Stranger things happen in diabetes and the response of experts is, “It is diabetes with a mind of its own.” Check out the acronym SWAG. It is a term I have heard from diabetes educators as the best reason things happen the way they do in diabetic management.
One consolation prize, your comment about “Its actually been more finger sticking since using the Dexcom!” points to your checking because the CGM is giving data inconsistent with your son’s feelings and actions. You are validating. Generally, you have three data points with your son and diabetes: 1) how he reports he feels and acts, 2) the CGM, and 3) a finger stick. Most of the time you are following 1 & 2. If they don’t agree, do a finger stick. One PEARL, unless told otherwise, avoid getting into the calibration ‘circus’. If you calibrate, the system will start asking for calibration, after calibration, after calibration. Give it an hour or two to self-correct.
Thanks for sharing your journey. It helps all of us chase this diabetes dog and its tail, even when we have a mouth full of fur. <<< GRIN >>>.
Thanks so much for that explanation! It seemed like today was going to be better. We had some low notifications during the night, but that appeared to be compression lows. The first time we checked his blood sugar, which was good. When I went back to bed I remembered reading somewhere, I believe in this thread, about compression lows. I had him roll on his other side, and the numbers came back up. Same for the other lows.
The first reading at breakfast was 111 CGM to 103 finger stick. I thought, would we actually be getting somewhere. 3 hours later, we got a low notification from the CGM of 57 while his blood sugar stick was 89. Next comparison was 63 to 72, back on track!
The following comparisons throughout the day and evening were 129/108, 139/111, 169/114, 187/162. So, I’m waiting to speak with Dexcom tech. support as they instructed. These fall out of the +/- 20 benchmark.
I don’t know how one can accurately make treatment decisions using the Dexcom. I know it’s tried and true so my guess at this point is bad sensor. Maybe the Dexcom isn’t the right tool for someone who cannot recognize symptoms yet and we should stick to injections for a while longer.
I don’t mean to rant and I’m sure the Dexcom is great, but our early feelings are that of frustration. On top of all of that, his phone is loosing signal for sometimes 30-60 minutes at a time. Tech support says to watch this behavior while starting a new sensor session. Maybe the transmitter is bad too.
@mawa316. It is never a rant. Dexcom is the best on the market today. If tech support is thinking the transmitter is bad also, ask them to send a replacement sensor & transmitter. BTW, the SWAG definition I was referencing is no longer on line. My reference is “Scientific Wise Assuming Guess”.
Another problem we’ve been experiencing if loss of signal with the App on his phone. I talked with tech support about that as well. After answering a number of questions about frequency of occurrence, time of day, happening multiple days, etc, tech support instructed to monitor this behavior using the same transmitter and new sensor, which we will be swapping out this evening.
That sounds like it may be a transmitter problem, but the Dexcom receiver seems to be functioning fine.
Another quick question, currently my son is wearing the Dexcom on his abdomen. I’ve read that, although not supported, wearing on the arm gives more accurate readings. I was just wondering, since my son takes his Lantus dose in his arms, if we were to switch the Dexcom to his arm, is it OK to still inject the Lantus into the arm with the sensor?
If sensor is in one arm, insulin needs to go somewhere else, belly, other arm, thigh, etc. I am basing this on keeping CGM & pump sites 3 inches (8 cm) away from each other.
Just an update for anyone seeing erratic readings from your Dexcom… in our case it seems to have been the sensor. Once replaced, the readings were much, much closer.
We still have signal loss on my son’s phone. At first Dexcom said to monitor that after replacing the sensor. His signal was lost from 11:00ish PM to 6:00 AM this morning. They said this morning he was probably lying on it all night. I doubt that is the problem as he’s loosing signal today as well. I’m guessing bad transmitter.
Hopefully Dexcom is sending you a replacement sensor - they’re supposed to and on the occasions I’ve called they offered before I asked by keep it in mind. I’m trying to keep track of my sensor and CGM lot numbers - it’s one of the things they usual ask so they can determine if there’s a problem with a batch.
I hope everybody is well! What’s school looking like in your area?
After restarting Bluetooth on his phone, the loss of signal problem seems to have gotten better as well.
As far as school, the school board just approved the hybrid model - 2 days in school, 3 days virtual learning. If it were up to me, schools would be closed until there was a vaccine. I know that some think this whole COVID thing is overblown, but why take chances. All the focus is on kids not getting all that sick. They can still carry it home and the same for teachers.
One of the reasons cited against total virtual learning is child care for those that have to or have returned to work. How many parents send their kids to school with sniffles, a slight fever, etc because they have to go to work? Heck, I’ve done it once or twice. Not to mention asymptomatic children.
There is a total e-learning option, which I preferred, but my wife thinks he should return to school. His endo team agrees and sees no problems relative to his T1D with school re-opening. The one good thing about the partial return is it eases him into school life with T1D.
@mawa316. Hey Matt,
Seeing @wadawabbit made a comment about lot numbers and other easily over looked details, I have two ideas.
when you pull the cover off of the G6 big blister pack, note the date and time it is inserted on the back of the paper and put it in the refrigerator with your son’s insulin. If you need the ‘details’ you have all the gobbledy gook there.
I have forgotten, if you son is on a pump, do the same thing with the cartridge, insertion set, or anything else with a lot number/expiration date.
BTW, low blood sugar will cause ‘crankiness’ in all of us when we get low enough. For adults, it is when you feel like you can eat everything in sight.
Thank you @987jaj. I’ve gotten in the habit of putting my new sensor insertion date and info on my calendar app. When I get a “sensor expiring” alert I check to make sure it’s served its full 10 days. Coincidentally I got one a few minutes before I pulled up the forum - 10 days exactly!
Matt, I was also diagnosed at the age of 12. I am 37 now and the technology has improved greatly. Your son needs your support and love. He will have good time and bad through out his life but having support and his family there will help him through. I am proud to say that I am also a volunteer firefighter, so he can still do many things and live his life somewhat “normal” he just has to plan ahead and keep his spirit up. I can still remember my parents reaction when I was first diagnosed, I can’t believe how they felt. I believe my initial BS was in the 700. You are doing great by reaching out to others. The T1D community is great and are always willing to help if we can. Please let me know if you have any questions or concerns.
Thank You! We’re plugging through a faulty sensor and run-arounds with insurance, but for the most part, everything is going OK.
My concern or questions now revolve around blood sugar levels we were not exposed to before the CGM. I’m wondering what good between meal peaks.
Another area of concern is when my son has a blood sugar level of let’s say in the mid 130’s to mid 140s around a snack time. It always seems he needs that 12-15ish grams of carbs snack between meals regardless of his level. For example, today he was in the mentioned range so he ate a free snack. This was about an hour an half before lunch. By the time his food was on his plate, he was in the high 70’s. We play a little conservative when his levels are ‘higher’, but like I said it always seems he needs the snacks.
I guess that leads back to the good, between levels, but I know everyone is different in reaction to food and insulin.
Continuing with the snacks, it also always seems he needs an after dinner and before bed snack. I don’t know if that’s typical or not.
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Next comparison was 63 to 72, back on track!