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Dexcom Advice For Newbies Please

Discussion in 'Parents of Children with Type 1' started by andiej, Feb 22, 2016.

  1. andiej

    andiej Approved members

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    Hi all.

    So Jack was diagnosed 2 years ago. For the last year we have used the Freestyle Libre and loved it. However now at 12 and puberty hormones going crazy it's time to move to Dexcom. We are going to self fund the G5 (we're in the UK, so funding not available), he also uses the Omnipod.

    The Dex arrives tomorrow. We have pretty good control, especially during the day, night times are erratic at times though. HBA1C has always been 6.2 - 6.9, though before Xmas it had jumped up to 7.3 and really want to get back down to 6.5 if possible.

    Looking for tips on using the Dex day to day but also any tips to really get the most from Dexcom to get the best possible control. Thanks in advance.
     
  2. Sprocket

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    We are also newbies having only had the Dexcom G4 since before Xmas. However, I would have to say that the ability to see how long insulin lasts, peak action times, how certain carbs affect blood sugar and how basals are doing, what trends are occurring are just a few of the pieces of the puzzle I was missing before having the Dexcom. In fact, just this weekend we overhauled my DD's basal routine because I noticed an overlap which was causing her to head low past midnight, but not enough in the PM to take her through until her morning Levemir kicked in. I would have never figured that out without the Dexcom.
     
  3. sszyszkiewicz

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    Good luck! The Dex will give you everything you need to know to tame the T1D beast. The visibility and real time feedback gives you the information you need to grab a hold of those numbers.

    here is my list

    1) For calibrations be really, and i mean really, particular about clean fingers. I think 90% of the problems people have with the Dex are associated with calibrations that are off because of dirty fingers. One swipe with a damp washcloth around here will shave 40 points off a fingerstick. On the flipside, make sure the finger is dry after the wipe otherwise the number will be artificially low.
    2) If you see a big difference between the dex and the fingerstick, do the fingerstick again to make sure.
    3) Dont calibrate if you suspect the number is rising or falling dramatically
    4) On the first day calibrate a few extra times to get Dex dialed in faster.
    5) try and calibrate before bed to be sure the dex is close for the night time.
    6) If you are going to depend on the alarms at night, get into the *habit* of doing these things:
    a) Make sure your "follow" device has the volume turned up.
    b) is plugged in
    c) keep the "follow" app open to make sure the alarm sounds because I have found that the alarm does not always go off if Follow is not on the screen. Sure I get the popup and the vibrate, but the alarm is sometimes silent and sometimes not.

    5) Own the night. We are on a pump. At night i set my high alarm at night for 130 and will correct anything that goes over that while he sleeps. Imagine your kid non-diabetic while they sleep. Very motivating.
    6) Set the low alarm for 80 or 85 to catch a low before it goes much below 70. We go less than 50 less than 0.1 percent of the time with this rule.
     
  4. MomofSweetOne

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  5. rgcainmd

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    My number one tip is to calibrate ONLY when the directional arrow is horizontal (and has been for at least 15 minutes). Nothing will happen if you don't calibrate the moment the Blood Drop of Dexcom appears on the screen. Just wait until you've been doing the horizontal for a little while before calibrating.

    ETA: Don't calibrate too often. More is not better. We keep it to two calibrations per day, with the exception of Day One when we do up to 4.
     
  6. quiltinmom

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    You can use a sensor for more than 7 days. We got almost 4 weeks out of one. In addition to the financial advantage (especially helpful since you are paying out of pocket), we also find that it can be more accurate the second week. At the very least, we don't have the 24 hour settling in period.

    I'd also say, be patient with waiting for highs to come down. You're used to testing an hour or two apart, and not knowing what is happening in between. With dex you see every single number and for me, it makes highs seems worse. It's more 'in your face' so to speak.

    Pay attention to the arrows!!! They give information that is almost more useful than the actual bg number. :)

    Fwiw, we also have the high alert set at 200 at night. I'd never get a wink of sleep otherwise! Set your range for what you are comfortable with. Our low threshold is set at 80 as well, to head off lows before they get below 60 (in theory, at least.)


    Good luck! It can be frustrating at times (ignorance is bliss?) but it is so worth it. Let us know how it goes. :)
     
  7. scarral

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    My son uses the Medtronic pump with tge Enlite sensor. What's the harm in calibrating often? I thought as long as there are no arrows, any BG measurement between 70 and 150 mg/dl is good to calibrate.
     
  8. rgcainmd

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    I can only speak to the Dexcom system, as the vast majority of people both on this Forum and on the TuDiabetes forum choose Dexcom over the Medtronic CGM, so that's what we went with. Calibrating too often essentially supplies the algorithm with extraneous information, causing it to be in a state of correction too much of the time, which as I understand it, doesn't leave it as much time to be as accurately predictive. Perhaps someone more "algorithmically inclined" than I could chime in with a better explanation... And calibrating when the arrow is not horizontal (i.e. when BG is changing too rapidly) really screws it up.
     
  9. andiej

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    Thank you all, that's really helpful especially the information about calibration, we've loved being able to see all the data on the Libre, but looking forward to seeing the information on my phone whilst he's away from me, also hoping alarms will let me get on top of the highs at night before they establish, though how realistic it is on hormonal nights i don't know. Though at least i'll have peace of mind correcting lower numbers that i'll know about it if he drops. Would eventually like to get to the position where our high alert is set at 144 but think it will take some work maybe on basals to get to that stage without me being up all night long, so might start with 162 whilst nights are a bit more settled, we've worked hard in recent weeks to tame the night times again but i do get nervous if i leave him for long in the 4's in case he drops lower and i end up getting up even more on good night than a bad night.
     
  10. kiwikid

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    Libre is now compatible with Nightscout :) That doesn't help with alarms but you can get all data on your phone after a swipe :)
     
  11. nomisimon

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    When I did my training late last year with my Medtronic rep they said calibration 4 times a day (and if possible at times when levels are steady) was the optimum.
     
  12. scarral

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    24 hour settling period? Is that how ling the sensor takes to "initialise"?
     
  13. sszyszkiewicz

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    No. For Dexcom it takes 2 hours. However the first 24 hours the numbers are not as good as days 2 through however many days it is left on. This is mitigated by calibrating a few extra times that first day.
     

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