Flying Below the Radar

This morning before work* I put in my second “undocumented” continuous glucose monitor sensor. That’s the best way that I can think of to describe my use of the sensors that read my blood glucose levels, since I haven’t yet had training about how to do it. I used one last week for about five days, and I’m going to use this new one until Thursday. Then, on Friday, I’ll get my official training from Medtronic Minimed — along with my endocrinologist’s nurse educator.

Why am I using the CGM without training? First off, I was really anxious to use this gizmo that everyone has been talking up. And secondly, all of my online diabetes peeps told me it was no big deal to insert the sensor and use it.

And I’m really glad that I have used it, because now I have questions for the MM rep/nurse on Friday. If I had waited until Friday to start using it, I wouldn’t have had these questions in mind until well afterward.

I imagine our meeting going something like this: “Hey there, MM person. Nice to meet you. I’m Jeff. And I’m noncompliant. I’ve used a couple sensors already, so we can take for granted that I’m not squeamish about the big-ass insertion needle that’s part of the process, motor through the mechanics, and get down to the nitty gritty of how to get the most out of this thing.**”

All of my questions revolve around accuracy. So far I haven’t been exactly impressed with the numbers that I’ve seen appear on my pump. I want this thing to show me what’s happening to my blood glucose as I go through my normal day, giving me a chance to identify trends and then make changes. I hope that it will also alert me when I’ve gone into a high or low BG area where I should take some action.*** And believe me, I fully acknowledge that there are plenty of times when I’m going to need to make some changes and take some action.

Hopefully the MM instructor will be able to tell me what I need to do differently so that when my BG is 63, as it was the other day, it won’t read 135. Or so that it won’t say “199,” as it does right now, when my meter reports “120.” Perhaps she’ll be able to tell me what to do so that when the sensor reports a value in the high 80s, I’ll know whether to expect that it really means the low seventies. I want her to explain the average lag time between big changes in my BG and when those show up on the CGM. Maybe she will even be able to tell me what to do have more confidence in the CGM readings during exercise.

So far these have all been areas where I’ve been less than impressed with the CGM versus fingersticks. To be fair, from time to time the CGM and my meter have been exactly the same. And I shouldn’t complain too much yet, since I’m doing all of this “off the books.” But I need to know what to do — whether that’s changing how I calibrate or where I put the sensor or something else entirely — so that I get on with the intense business of improving my BG self-management, lowering my A1c, and feeling really confident that something extra is there to help catch me when I go low (or high) during exercise.

Onward to Friday . . . and legitimacy!

* — Yes, I have to work on MLK Day. No, I don’t think it’s right to work on the day dedicated to (arguably) the most important American of the 20th century. But I do like my job. That’s all that I’m going to say on that subject.

** — “Oh, and do you have samples for the other kinds of tapes that I can use to attach this thing (and my pump’s infusion sets) more securely? I plan on wearing this thing all the time, and I don’t want to lose it while swimming or have it come unhinged during exercise. Thanks!”

*** — The CGM/pump did wake me up last week when I had dipped into the low 60s in the middle of the night. That was useful.

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4 Responses to Flying Below the Radar

  1. Jacquie says:

    I’ve had the MM CGM for a little over a year, and I feel like I started out with a lot of the same questions.

    “Why is it so inaccurate?” was my biggest one.

    I feel like the instructor I got was pulling answers out of her butt left and right. I think it’s like any other diabetes tool — after a while, you figure out a way to use it that works best for you.

    Now I know that I have to let it “soak” overnight before hitching the transmitter to it. But it’s still not as accurate as I wish it was. I think that’s just the nature of the beast.

    Good luck to you!

  2. Jeff Mather says:

    Thanks, Jacquie! The Minimed documentation says to let the sensor steep for 10-15 minutes before attaching the transmitter, but the “soaking overnight” principle makes a lot of sense, especially since there’s so much variability in the beginning.

    I’ll set my bullshit meter to be super sensitive on Friday. :^)

  3. Ah, my fellow MM CGM user… What an interesting experience it is, huh? I’m on the same page as you are: the training isn’t relly necessary for those of us who’ve been there and done that kind of thing before. Mostly, I find these sessions more remedial than anything. As you likely know, I’m trial-testing the 523 Revel thanks to some free sensors obtained recently, and I’m now on my third sensor in the past two weeks. I think it’s best to watch for trends, not chase the numbers (easier said than done). I’ve found so far accuracy is best after first day, whenever I’m 80-200. Anything higher or lower is usually less accurate, and also when it’s changing rapidly and the CGM gets confused. I’ve found lag to be about 15-20 minutes where I really am. Will be interested to hear how your trainer responds to some of the questions… Good luck, Jeff!

  4. Cherise says:

    Welcome to the world of CGM’ing. I am not familiar with the MM. Good luck and I think you did the right thing by using it ahead of your appointment.

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