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DexCom and driving

Discussion in 'Parents of College Kids and Young Adults with Type' started by Amy C., Dec 20, 2013.

  1. Amy C.

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    Yesterday, my nearly 20 year old son jumped into the car, glanced at his new DexCom to see he was in range and drove off.

    Pre-DexCom, he did a blood test.

    My husband and I were appalled he did this. My son's thought was that the DexCom has been spot on the past couple of days and reflects his blood sugar, thus he doesn't need to do a blood test.

    Any other arguments I could offer to my son so that he performs a blood test prior to driving or is the DexCom a good way to determine the blood sugar?
     
  2. MomofSweetOne

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    We won't be entering into the driving realm for another few months, but after 2+ years using CGM, what I would probably do if it were ME is that if the sensor is extremely reliable one and had a reading 150 or above, I'd probably trust it. If the number were lower, then I'd test & if necessary, carb up.

    I'm very curious to hear from adults like Ali how they manage.
     
  3. RomeoEcho

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    It depends on the exact circumstances, but yes, I sometimes do the same. Early on, I had strict rules and hard line cutoffs for driving and operating heavy machinery and drinking alcohol or any other activity that could be considered risky. But honestly, we all know that diabetes doesn't follow strict rules, and me following a hardline set of rules doesn't solve this. I've been a driver with diabetes for over 10 years. Early on it made good sense to have a mandatory fingerstick and a number that was too high or low to drive. Now I have a lot more information on which to base decisions that make a lot more sense, and in a lot of cases the dex is giving me a better basis for that decision than a fingerstick does. Since I no longer have hard rules, it's harder to share the evaluation process with you, but things that enter into the equation of whether I will trust dexcom, and what numbers are acceptable or not are: How old is the sensor, how accurate has it been, arrows or flat, how long ago was the last finger stick, how recently have I eaten, was I extremely active recently, how far am I going, highway or local driving, do I have a passenger, night or daytime, etc.

    A quick trip to the grocery store on local roads, I normally won't fingerstick. A multi hour highway trip, at night, with no passenger to stick a strip in the meter for me or open a candy wrapper, I would.
     
  4. TheLegoRef

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    My son will be driving soon, and we will let him glance at his sensor if his sensor is trustworthy. That's the same for reacting to bg's at sports. If his sensor is trustworthy, and says he's 90, he can have one starburst to bump him up, without testing. If we don't trust his sensor, he'll have to test. If the last 24 hours, every time he tests, his sensor is within ... 20 points... we consider it trustworthy. However, if his sensor says 80, he should test, because that might be a 60 bg. If it says 150, he'd be fine to not test.
     
  5. Joretta

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    If my daughter Dex is running depot on I am fine with it. After all, if push came to shove we could prove the realizability. After all, who to say the meter was not off by 20% or was malfunctioning. Nothing is perfect all the time.
     
  6. nanhsot

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    I pushed on this issue for a while but bottom line is that the combo of his own internal barometer + Dexcom is actually very reliable. He can usually predict within a 20 points where he is before he tests, which is pretty amazing. So if he feels good and Dex confirms, he goes with it.
     
  7. TheFormerLantusFiend

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    I don't drive, but I do go swimming, and I think avoiding hypoglycemia in the swimming pool is as important as avoiding it while driving (because I don't want to drown). And before swimming, I think CGM data is considerably more useful than a fingerstick. What I care about is risk of going low, and even a sensor that's 20 points off tells me that better than a fingerstick does.
     
  8. ChaosRules

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    My 17 yr old son doesn't wear his Dexcom G4 very often at all (maybe a week or two every three months), and almost never tests before driving. He seems to do a pretty good job of judging his carbs & insulin needs pretty well, and also can feel when he's getting low. He also doesn't drive very far, since we live in a small town. Probably never more than 10-15 min.

    He doesn't like to hear any suggestions from me regarding his diabetes, and always gets rave reviews from his endo, so I guess he's doing fine by himself.
     
  9. Amy C.

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    I would say that the endo doesn't know your son doesn't test before driving.
     
  10. Sarah Maddie's Mom

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    Are you aware that something like 70% of all accidents happen with 20 miles of home?

    I guess I'm having a hard time relating to much of your comment. Mine is 16 and has just gotten her learner's permit and I feel strongly that she must look at her dexcom before getting behind the wheel and check if there are arrows down and her bg < 120. It just seems that establishing this habit early on in her driving career will make her more likely to take pre-driving testing/checking seriously and the repetition will make it routine.

    Life with Type 1 is hard enough, I'd hate for her to take any unnecessary risks that might harm others, or harm her physically or financially or god forbid legally.
     
  11. Jordansmom

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    My DD started driving before Gen4 was released and she wore the Dexcom 7. It was not nearly accurate enough to trust while driving and at that point I did not let her drive without a finger stick even though she looked at the Dex as well. She tested 100% of the time before starting the car. And I know she followed the rules because there were inconvenient times when she didn't drive because of a low or high bg. Sometimes she sat after school and waited to come into range. Once in awhile I picked her up somewhere and she left her car. Movie popcorn could be a serious pain.

    At 17 she started wearing the Gen4 and for the first year she still looked at the dexcom and tested. It became a good confirmation for us that she could rely on the Gen 4 before she drove. At some point we decided together she could just look at the dex if it had been reliable and if she was above 100 and it did not have down arrows. Honestly I am much more secure with her driving with the dexcom than I was with fingersticks because of the trending and the ability to see what her bg is all the time.

    My one concern is how seriously they take the dexcom number and how long they spend making the decision. In our case, I don't think it was a bad thing to establish a strict procedure of taking the time to stick her finger and evaluate how she was feeling before she started the car. Its become a good habit even now that she uses the Dexcom number. If I had told her in the beginning to just look at the Dexcom I'm not sure it would have become such a conscious decision point.
     
  12. Michelle'sMom

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    Dd is just starting drivers ed & these are our exact rules. At this point, Dex is used to determine direction of BG but a finger stick is absolutely required.
     
  13. Megnyc

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    With the medtronic CGM I always did a finger stick before driving. With the dex I will only check if I am under 100 or I am uncomfortable with the accuracy of the sensor. I have never had a situation in which I thought the dex was accurate and it was actually really off so I am comfortable with those "rules."

    I think my situation is a bit unique in that I didn't really ever drive until I left for college. I had a license but only ever really drove (you couldn't drive where I lived until the age of 18) when we were away skiing upstate. Honestly though, I don't really view driving without checking BG (either via finger stick or CGM) any different than drinking and driving-- in both cases the choice you make is putting others at risk. I guess I might feel differently if I had started driving when I was younger. There are plenty of risks I take with diabetes (drinking, leaving sets in for too long, correcting off the dex etc.) but those are only put me at risk not everyone on the road. JMHO.

    Also, if I was in an accident I would want evidence that I was not low when it happened or had at least taken precautions to reduce the risk of hypoglycemia before driving.
     
  14. Jordansmom

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    That's a point I made to my DD. A PWD is probably guilty until proven innocent as far as bg is concerned and as long as she checked before she started the car and the number was in range, then hopefully anything that might happen would be treated as a typical accident and not blamed on her diabetes.
     
  15. MomofSweetOne

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    If my T1 doesn't either look at her Dexcom and/or test, she won't be driving. Period. I'm not paying to insure a driver who could hurt or kill others because of a low that could have been prevented. And if she wouldn't listen to me, then I'd be asking her doctor to withdraw the required medical approval.
     
  16. ChaosRules

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    Good points, everyone.

    I am relieved (and embarrassed) to report that it turns out that my son does actually do finger sticks before he drives - I just don't usually notice. He is almost 18, a senior in high school, and has always been a very independent person. Over the past year, I have released much of the reins of his care to him, although even before that I let him make most of the judgement calls as long as they seemed reasonable. So I guess I haven't really paid attention every time he drives, and just assumed he wasn't testing. But when I asked, he said he was, and when I checked his meter, it showed that he had.

    What I can't seem to get him to do is wear his G4 more often.

    But his A1c is pretty steady around 6.0, and he takes insulin every single time he eats carbs. Someone once pointed out to me that the goal when raising a diabetic child is to end up with a diabetic adult who can move away from home and confidently handle their disease. Of course there will be times they need help, either from parents or a doctor, but in general they should be doing it themselves. My son has been doing that for years now. I used to check his meter every night to see what his values were, but I've backed off on that and only check every once in a while.
     

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