Blog Entries With Tag: CGMS


Posted: Jul 21, 2015

It’s rare for me to compose a #dblog that is not all “chirpy chirpy” … I think the last time I did one that was kind of down was at Diabetes1.org  and sleep apnea testing.  Sleep really is vital to everyone, diabetic or not … without a good sleep … well … we become exhausted, depressed, need I say more?

So, here’s the jist. 

  • Been in our new home now for close to a month.  Yippee!!!  Searching for new team of doctors is a job in itself.   
  • Trying to figure out where to shop that isn’t all “meat and potatoes” food (the grocery stores I’m used to that are more Middle Eastern are so far not to be found here)  … yippee … sigh. 
  • Realising the street you moved on is a major artery when you were told otherwise by real estate agent who sold you the property … sigh (so far my explorer cat has survived not getting hit … very scary).  
  • Trying to motivate your DH to unpack with the limited time they have at home due to their work schedule … having lived with limited things since putting our previous house on the market back in March … it’s getting old. 
  • This promise of a new beginning, yadda, yadda, yadda, in the land of insulin pumping program (ADP) … isn’t all it’s built up to be.

Basically, I miss Montreal … my home for the past 26 years (that the new owners just LOVE …. Urrhhh …. why did we make our house so cute).

The biggest thing that is hitting me for the past few months though is that finally I can admit that diabetes is bringing me down.  I rarely will admit that, and am all smiles (damn they create wrinkles around the eyes … and I’m already feeling like I’ve aged 20 years in the past few months with stress).

My basal rate is almost down to ½ of what it used to be … and still needing to be tweaked.  Why I’m become even more insulin sensitive is making no sense at all with the extra hormonal issues I’ve been experiencing that were making life the opposite.  Has my body gotten used to them?

With the use of the Dexcom CGMS … I am now at least getting a better vision of where to tweak things … but what has finally dawned on me lately is … is with my basal portion of my insulin coverage pretty well covered (I mean … .450 / hr seems to be my average hourly rate) it maybe lowered if I continue in this hypo fairy land I seem to exist day in day out.

limp noodle joke

As we all know, hypos are exhausting, they leave you like a limp noodle, and the things you have set out to do that most people take for granted … get in car, drive to store, do your shopping … get on bicycle, go for a cycle, get active … go for walk … yadda, yadda, yadda.  I think you get the drift.  To do these simple tasks lately, I’m not able to do them.  It’s bringing me down to the point where I had a friend force me OUT OF MY HOUSE, to go out for a trip with her (searching for green bacon along HWY 2 of eastern Ontario). That did help, but sadly, getting behind the wheel, even with my Dexcom alarm set at 4 (72) … is not much help.  I am crashing in the blood sugar area … and luckily it’s not behind the wheel.

So, what dawned on me lately is that my other ratios I have been using are wrong for insulin coverage.  I’ve upped my I:C (insulin to carb) ratio … and giving it a test … I see a few times where it will have to be upped more.  Just like our basal rates are different from hour to hour on a pump … and this is where a pump is VERY handy.  You’re sort of stuck with MDI (Multiple Dose Injections) … once injected … you are the insulin slave.

cat at the wheel

My other fear?  Tomorrow, I am going to visit my family that I haven’t seen since last year.  I’m driving alone which I never used to feel.  It’s not far, but it’s that background fear of going low.   So my CGMS alarm for going low is set abit higher for that drive (I usually have it at 4/72 … for driving I put it to 5/90 … to allow for any variance in the blood meter verification test).  I did this last week when driving back to Quebec to have the Ontario MOT form filled out by my endo to certify me that I’m insane … JOKING … that I can drive a vehicle in Ontario safely.   The form from Ontario really goes into hypo unawareness unlike the form my endo filled out for the province of Quebec last year for me.  This all stems from Allan Makii, a T1D  who caused a TRIPLE fatal crash while driving with a low blood sugar back in 2009.  

 comic look at unpacking

So, as I post this blog, and I’ve missed posting them lately, but life has been whacky as you’ve seen … wish me luck … on sorting out my insulin requirements … getting my new home organised with help from my DH when he’s home … and trying to get out of what I think is one of the worst depression bouts I’ve ever had. 

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Posted: Feb 4, 2015

I'm hooked on you … despite it being out of pocket … I can’t resist the urge to push the button of Bowie, my Dexcom receiver to see how I’m doing.  It’s slightly addictive in away.  I’m not the only one who feels this way.  Another friend of mine, Sarah who lives here in Montreal, and just started pumping for the first time, lucked in on getting approval for the Animas Vibe (unlike myself where I didn’t).  The odd thing, she still has to pay for the sensors, but it’s much less expensive than going the route I will be with averaging about $5K a year with the stand alone system  that I have (which as I wrote earlier – was a “gift” from an islet cell recipient who no longer needs it.

So far the first sensor that I’d placed on my abdomen on December 22nd, 2014 remained working faithfully away until I pulled it off on January 22, 2015. 

Then Sarah questioned me about skin health under our sensor/tape that was holds the sensor/transmitter it in place. I thought, why take a chance, bad things maybe happening underneath and removed the sensor despite it still working. You'd never know anything was on my skin, and I hadn't seen what the sensor bit looked like (I only knew it was width of hair strand).  So cool - it's a piece of metal (anyone reading this - saying ... duh - didn't she know this from the start ... uhmmm no - I just jumped in with my eyes closed when I started using the Dexcom ... no educator ... just did it my way like I have done with the insulin pump).

I am really enjoying this experience with the Dexcom while it lasts.  It is giving me the complete picture of how I am using my insulin, how stress, etc. can affect my blood sugars.  I mean, I always knew why things went up and down with my blood sugars, but never saw the complete picture to fully understand it, but the trend graph doesn’t lie.  Or at least so far it hasn’t.

I’m looking forward to giving this a go when I start to finally get the courage to start working out with more intensity.  In the past, I’ve been having problems sticking to an exercise routine because I’ll be all gun hoe, then I crash either before or during the exercise period.  That’s because I was not using my insulin correctly!  I’ve done a few basal tests, which the CGMS helps (I can actually sleep through the night time one – which in the past meant getting up every hour).

Again, like the insulin pump, YOU are the brains behind how this device works.  It does have a set low alarm, which sadly in the beginning was going off a lot, due to my having the incorrect basal settings for overnight.  I’ve now got my basal settings for the night at my happy zone (I like to be between 5-6.5 mmol/l or 90-120 mg/dl). One thing I find with the Dexcom, is when it warns you are starting to go low. If you treat it right away with the correct amount of carbs (I prefer apple juice during the night) – I no longer wake up with a high reading like I used to.  Nipping it early in the bud makes a big difference, or at least it does for me.

Near the third week of my first sensors life I had it taped up with various items to keep the sensor from coming off (I found the weight of the transmitter could literally make it fall off if I didn’t have it secured on this way).  I found Bioclusive transparency patches that I use for my infusion sets from time to time. which I had cut a hole in the center on the second week, works the best as you see in the picture below (note the grey area off to the right of the sensor - is old adhesive from surgical tape that just didn't work).

Originally I had the sensor on my stomach which is the only place that Dexcom recommends you putting it on (it was tested for use on stomach only according to their manual).  I’ve read of many other people placing it in other spots, which still give them good results.  Arms, thighs, back side, even the breast.  Women who have placed the sensor there say they find it less in the way.  When it came to my 2nd sensor, I was game at the time to try it, but then I chickened out at the last minute. Instead I placed it just below where the band of my bra is, and initially it hurt like heck when the introducer needle put the sensor in (I felt like screaming, then got a slight case of feeling light headed) – but that quickly passed.  I’m now approaching my 3rd week – and it’s actually holding up much better in this area, with tape not lifting up at all.

I’m still on the fence post about wearing the Dexcom during my upcoming holidays.  Whether I pack a replacement transmitter with me for the time I’m away is still something I’m not sure about.  I either take my chance, or hope my sensor lasts thru’ the weeks holidays, or when it dies; I just go without it for a few days until I get back home.

Dang, I’ve kind of fallen in love with Bowie (sorry – had to give my CGMS yet another name … remember … he’s part of the gang that hang around with me 24/7 --- Ziggy (Animas Ping) – and my One Touch blood meter … Stardust.

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Posted: Dec 24, 2014

As I suspected, the basal settings that I’ve got overnight on my insulin pump Ziggy are a wee bit too much.  A month ago, Animas Canada sent a CDE over to see me (also a pump wearer) – to go over my settings in my pump program as I was having issues with high blood sugars with menopause.

Psst - if you want to see a full size of above to see descriptions - go to this link - sorry Diabetes1.org doesn't allow me to load up larger pics

I actually didn’t get going on the pump until about 3 weeks after seeing her, when I decided to get off MDI (I go back / forth between pumping and MDI).  After 2 weeks of battling lows at night, tweaking basal settings, I lucked in on getting the DEXCOM G4 (see my day before blog on this).

As I went to bed last night, I started seeing the trend going down and put the pump into temporary basal setting.  A few hours later, alarms started,  (freaking out the cat under the sheets – she likes to cuddle up to me at night) – DH … slept right thru’ like a baby (which is usual <lol>).  At that point, because I’m a smart kitty kat, I “lowered” my basal setting abit more.

Little did I know, in my hypo state, I was actually INCREASING!!!

So, here I was dipping in the upper 2ish mmol/l (40 mg/dl) range and thinking – “wow – this is the greatest things since sliced bread” and “no wonder I’ve been tired so much lately, I’ve been sleeping through all of these lows that are alarming”.

Come 0600, with alarming / vibrations almost every ½ hour … I decided in my infinite wisdom to lower the temporary basal setting ….  and when I looked at the history of the basal’s … BING … I’d increased instead of lowered.

Scary stuff – lesson learnt – that sometimes the Hypo Fairy makes me a dumb diabetic – who doesn’t think before they press buttons. 

Overall though, I think this will be a useful tool for me.  If only this tool was available to every diabetic that wants it or even better, if your diabetic clinic/endo could loan you one at a lower cost than what a personal one costs.  I would splash out the cash, with the hopes that insurance might cover part of it.

Sadly, when asking the endo at the Lakeshore hospital that I went to for pre-op earlier iin November – if this was available … no (and neither is Diasend for them to see how you are doing).  The same applies to my other two doctors I see for health concerns.

On the bright side of all this, the Animas CDE has told me of a new young doctor, in my neck of the woods of Montreal that is seeking insulin pump clients.  She said I’d be a good patient to help him learn the ropes, while he’s training with Animas Canada.  I sort of like that idea, and the fact I’ll finally have a doctor that will get what I’m saying when I talk about my insulin pump.

Things are looking good for the New Year for … Ziggy … Stardust … and _______________ fill in blank for name of Dexcom D4 (if you can think of a neat name – let me know).

So, now I’m going to slink away from the desktop, get cracking on my visitors arriving today (ehgads the house is a mess), and I’ll see you all in the New Year (have promised myself and visitors I will not work during the holidays … easier said than done, but I’ll try my best).

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Are you really hypo unaware?  |  Edmonton man denied insulin for 20 hours  |  The Brain Battle  |  Mama - Why Was I Chosen?  |  She’s got legs and she knows how to use them (the semi-Fashionista and her pump)!  |  It's the Most Wonderful Time of the Year ... NOT!  |  Here's an interesting study  |  Revina Garcia: Diabetic Handcuffed, Dumped On Pavement By Police  |  Shame on Johnson & Johnson / Animas  |  REMOVAL – clinical trial for T1D's in UK, Australia, Canada, Denmark and Netherlands
Posted: Dec 23, 2014

... my new Animas One Touch PING (I think of the game ping pong with that name) insulin pump that I started on yesterday aka Ziggy and his side kick Stardust - the OneTouch meter remote (no more lifting my skirts up to reveal my knickers to the world when I want to do a bolus).  

It will take abit of getting used to how much blood Stardust uses compared to Limoncello - my FreeStyle Lite (who will remain as my standby for days I can't squeeze out large droplets of vampire blood.

I had wanted to change to the Vibe, which has the CGMS option on it's screen which is an extra $200 (the PING is $6,995).  I paid for it on my credit card that is allowing an extra 1 year warranty on it on top of the 4 year warranty you get with the pump (having had previous probs with the 2020 - I wanted to ensure I had 1 extra year more).  I'm one smart cookie aren't I?  Well, you won't think so after reading the following.

Laws here in Canada do NOT allow you to change your mind once you've purchased a pump ... even if the box isn't opened - live and learn - or move to US of A - where you have better consumer protection - from some of the thread discussion I've read on forums.   

So, tonight - it's installing a Dexcom G4 sensor - the transmitter and receiver was given to me by islet cell transplant - who now insulin free (whoo! whoo!)  from Alberta.   I may continue to use it out of pocket once the Christmas present of box of sensors that my Animas rep gave to me (ususallly a box of 4 will set you back $340 for a month supply - cha ching) - runs out.

One thing I am finding out about the Dexcom ... after reading/watching the videos on their site.  They keep on telling you that ... the CGMS does not replace your blood meter ... that whatever your CGMS tell you - that you should go with what your finger prick #BGNow number is.  This is one thing I did not realise when looking into the CGMS.  I knew a blood test had to be done a few times a day - but not some of what I came across at this link.  Therefore, you still have to purchase perhaps as many blood test strips as you had before, in order to stay in a good BG zone.

So, between testing still with the finger sticks as some of us call them - and then to justify the the $7K yearly cost is abit scary (like buying a used car every year as my DH put it to me - men are so practical when it comes to justifying a purchase).   Thank goodness for DTC here in Canada as well, but we have yet to see how much we can claim since I was approved a few years ago ... it's sitting down ... pulling out past income taxes, etc. etc.  aka - we'd rather be sailing - than crunching numbers.  Though my DH says he'll keep on working as long as he has to for affording these items - but the rotten thing is ... he's able to retire next year after 35 years. 

GUILT!!!

Can you tell that I feel so guilty that my DH has to work longer due to my diabetes at times?  That shows you how much someone loves you when they give up their retirement plans for you (his are sailing around the world - but you never know - maybe we'll be able to do it).

So, here's to the next adventure with devices from Animas .... 

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Posted: Dec 13, 2013

Right now it seems that it is just the separate CGMS remote that you find in this link as the Animas insulin pump called the Vibe that you see below - has yet to be approved for use here.  

The good thing?  Once the Vibe is approved (Canada only has the Ping at the moment for sale) - you will be able to use the transmitters without the separate remote (or at least that is what I've read at various places online).

Animas Vibe with Dexcom G4

 

The main thing is - we finally have APPROVAL (an online petition by Nathalia Stanichevsky may have helped push it faster).  For those of us who can afford it (either thru' work insurance coverage) or ability to afford out of pocket.  We are one more step ahead of the game plan.

I had seen it a few years ago at a diabetic conference - and was quite impressed (the excuses given by the rep as to why it was so slow to come to our country made my eyes role as normal - we're a smaller population than USA, the French/English bit, the list goes on).  I even met up with an American that was using it - and she showed how well it worked for her when she was visiting Montreal this summer.  I liked the screen - ease of looking at it - just like the Animas pumps are - compared to the Medtronic that I'd tested out earlier in my pumping years (I'm a late bloomer - starting in 2008 after 40+ years of multiple dosage injections).

The good thing is - now we have two systems  available to us in Canada (the other is Medtronic).  For those of us who are hypo unaware (your blood sugar suddenly drops) or just want to have a better visual of what your blood sugars (BG) are doing - more power to you!

Curently, you have to contact Animas Canada for more info - go to this link to request more info .... http://www.animas.ca/dexcom

Psst, if you find out more info than I'm gathering up at this moment - please let me/us know - either via this post - or privately!

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