Dex G4 question

Does the G4 reduce the number of finger pricks for your child. I know they advise against using the G4 number to bolus for food. Do you feel confident enough about the readings to use it to bolus for food?

 

In my opinion, no. If I were asked I would say that a CGMS could increase your fingersticks per day. Reducing them is NOT the reason to get one.

$0.02

EDIT: It does, as others have said, reduce your night time testing.

 

CMgs doesn't really decrease the number of finger sticks. What it is good for is letting you know how activity food etc effect blood sugars. It is a god send for basal testing. It also lets us rest easier knowing that between finger sticks blood sugars aren't getting too low or too high. We didn't get it to replace anything but to provide extra information to help us manage our sons diabetes more effectively.

 

DD is a teen, so her dex replaces fingersticks. During the day she only measures when something is off, or if she has to calibrate. When she sits down for a meal she also measures before bolusing. If she just eats a bar during school and nothing is off, she just boluses for it.

I also do less fingersticks over night, I don't even have to go into her room unless something is off.

 

Ya, I have to disagree that it doesn't replace finger sticks. It does not replace the basic before meals and bedtime and before driving fingers sticks. But when the Dex says she's in range, we don't have to check just to get a snapshot of where she is. That means no check before, during or after sports or activity if she feels ok. No fingers sticks at night if Dex says she's in range. That makes nighttime checks so much less intrusive. No check to see if a correction is working. No check before a big test. Some days it seems like the Dex has you checking more. But honestly if things are going well, it does replace most of those annoying extra sticks.

To answer your question about food. My DD uses a finger stick for meals, but I don't mind if she just looks at the Dex for snacks. She would never add a correction to a bolus based on a Dex number though.

 

Well it depends on how many fingersticks you do as to whether it would reduce them. It can bring the testing down to 4-7 a day so if you are doing more because the child doesn't feel lows or to get an idea of where the BG is - then it definitely reduces those types of sticks.

 

Same for us. The G4 is incredibly accurate and we have gone from testing 12+x per day to 4-6x. We still test before meals and before bed, but no more pricking at night unless something is wrong. And no more pricking 2 hrs after a meal to test for spikes. I'm also comfortable giving a little treat for a mild low without pricking.

 

We have seen a lot less finger pricks. We use to do between 10-12 a day and now most days we are between 3-4. If the GCMS says low we just treat the low without testing but if she needs a correction we will do a finger prick.

 

Ditto all of this. I think it does replace fingersticks on an average day, and definitely overnight.

If he's in range before eating, feels well, and the sensor has been reliable, he sometimes doesn't check. I wouldn't recommend that, but keeping it real here. Teenagers don't always do it the way we like! He eats a LOT, and quite frankly doesn't test every single time he's about to eat...that would be a LOT of tests in a day. With the Dex at least there's a snapshot. I just wish he'd use Dex more of the time, he's very sporadic.

IMO avoiding or lowering fingersticks is not a reason to get a Dex, but it can be a nice bonus.

 

Overall, yes. We do fewer fingersticks with CGM than without CGM. There are days where we do more, however, because the CGM alerts us to situations that we just wouldn't know about without it.

The biggest benefit is that we test SMARTER with the CGM than we do without it. If it's 4pm and his CGM is showing him at 100 flat, I'm not testing. If it's 4pm and it's showing him at 180 with an arrow up, we'll test and correct, as opposed to finding a whopping 300 as we're sitting down to eat supper.

ETA: Yes, sometimes we dose for food without doing a fingerpoke if the CGM shows him in range.

 

We've used both the Medtronic and G4 systems now, and there is NO way I would want my daughter dosing insulin off either system without checking in blood. I'm ok with a few carbs to boost her from going low without testing (but she usually chooses to), but these systems just aren't fail-proof enough to dose from. Dexcom is replacing a sensor for us that had me thoroughly frustrated yesterday. During the night check (in blood), it was reading her 60 points lower than she was. I calibrated. She woke up with the sensor almost dead-on accurate. I didn't calibrate. Next BG check, the sensor was once again 60 points off. When I called them, it was reading accurately again, but they told me to pull it and they would replace it. If you aren't doing the basic before-meal tests, how do you know your sensor is reading accurately? That one was the worst we've experienced, but it was giving us beautiful in-range graphs that weren't reality.

 

If your child is out of range from the CGM receiver for let's say an hour, does that make the CGM readings, once he/she is back in range, pretty much meaningless? Said another way, does your child have to CONTINUOUSLY keep the receiver within 20 feet of him/her in order for the readings to be meaningful? Thanks!

 

Not really. The system only calibrates when you enter BG so if it's out of range it's just that - out of range. When it comes back into range it should pick up where it left off unless there has been some significant change to the system.

IMO

 

I'm just curious where you are placing the sensor.

 

Add us to the group that G4 has definitely lowered number of finger pricks a day. Typically, she now only tests before meals. Three times a day is a lot less then the 9 or so we have without it. Our G4 is usually dead on accurate. It has been much better for us than her Guardian was. I don't know why, but it just didn't work for her. Now we are back to the comfort level her navigator once gave us.

My only exception to this would be the first day of a new sensor. It seems to take a while to get into the swing of things, so we have more test in those first 24 hours to know it's on target.

 

Since we started the CGM 6 years ago, dd does 3 bg checks a day, and boluses off the CGM readings inbetween bg checks. Extra checks are done only if the most recent bg doesn't match the most recent CGM reading.

 

DD has only had one for 3 weeks but I can already tell we are headed in this direction. The readings have been very accurate overall and the times when it hasn't, it is obvious. Being mindful that there are times when the cgm is not reliable enough means also being aware of when it is.

When i see a reading that is 15 off, i don't get worried at all; back to back checks with a glucometer often vary by the same amount. We are cautiously headed toward getting down to 3-5/day.

 

Up until this week I would have said no, the CGM would never allow us to lower the number of finger sticks. That was the MM GCM.

This week we've been on the G4 we've had unbelievable accuracy. So much that I already see the night time testing decreasing by min 2 checks, some nights by 4 checks, and as the weeks go on I'm sure we'll be dropping other tests. With the accuracy we've had this week I would have been perfectly able to bolus off the readings every single time other than the very first day.

Now, I know one week does not tell me anything, but in over 2 years of MM cgm'ing we've never once had this much accuracy. Ever. Frankly, I was starting to really wonder what the big deal was with CGM since it just never worked well for us. No I know.

 

There are some times that she'll do extra checks -

• On the first day, the required extra check at 6 hours.
• If a BG reading is much different from the CGM. This usually means that the BG reading was bad (didn't wash fingers, etc.). Usually the 2nd check confirms the CGM is accurate, except when the sensor has been disloged or is on it's last day.
• If the CGM reads very low but she doesn't feel low (again, when the sensor gets dislodged or is on it's last day)
• She doesn't reconfirm high BG's before bolusing because we've never seen a false high with the MM (only false lows, when the sensor is dislodged, on it's last day, or if she sleeps on it). The high number might not be 100% accurate, but if the CGM says she's high, she is.
• If the ISIG does not match the typical ratio, but that applies only to the MM CGM.

Bolusing or eating carbs off the CGM isn't always perfect, but correcting BG every hour based on the CGM readings has worked great for her vs. correcting, say, only 5 or 10 times a day - or doing 20+ BG's a day which is what she'd need if she tested each time she corrects.

 

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To me this statement is key. You need to use both if you are CGMSing but with a CGMS system you learn to go with trends and worry less about the exact numbers. As stated BG checks vary by 20 points but if you can see the direction your numbers are heading (CGMS tells you this) you can decide to eat, wait and watch or check and dose. It is easy unless heading low quickly, to wait and watch and then decide what to do. It is a very different way of dealing with diabetes than most of us are used to...but for me at least it works very well and ends up with better overall numbers and smoother numbers and less extreme numbers.:cwds:ali