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Rely only on G4 for nighttime corrections?

Discussion in 'Parents of Children with Type 1' started by DavidN, Mar 6, 2013.

  1. DavidN

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    It's the middle of the night. G4 indicates your child is high. Do you just go ahead and correct or confirm the G4 reading with a blood glucose meter?

    The G4 readings have been so darn accurate I'm tempted every time not to prick his finger but so far I have verified with a BG meter check. And each time the G4 was within a few points. I just don't want to let down the guard for that one time when the G4 is way off. Just wondering what others are doing in the middle of the night.
     
  2. Christopher

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    I don't use a CGM, but if I did, I wouldn't care how accurate it was, I would always do a finger stick before I gave my child insulin. Why would you not do a confirmation check?
     
  3. Beach bum

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    Nope. Wouldn't trust it (in this case) as far as I could throw it. Even though it is spot on, I wouldn't trust its accuracy for a nighttime correction. Last night, for example, the CGM read 220 and holding steady, so a correction was needed. Did a finger stick and she was actually 190, so while a correction was still needed, it was considerably less than what it would have been if I relied on the CGM.
     
  4. Lisa - Aidan's mom

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    We always confirm with a finger stick, day or night, to make a correction. I LOVE the G4, but I have seen some wacky #s here and there.
     
  5. swellman

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    I have occasionally when I am really confident in the G4 and when I know the risk is small. Last night was a great example. BG was stuck high-ish, a little over 200, and had tested and corrected several times. G4 was spot on every time and the BG trend wasn't moving much so I used the G4 data to do my last correction.
     
  6. DavidN

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    We've been CGM'ing for several weeks and every G4 high (night or day) has been validated within +/- 10%. My son is suffering through a horrible cold and is sleeping poorly because of a persistent cough. I think, "do I really want to risk waking him when I 'know' the reading will be right on top of the G4?" So far I have not relied solely on the G4 reading but I have been tempted.
     
  7. Christopher

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    Understood. That is a tough situation. Good luck.
     
  8. hawkeyegirl

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    We use the MM, and I have corrected without a confirming finger poke as well. We do have five years of experience, and I'm very good at knowing when I can trust the sensor and when I cannot.
     
  9. Mouchakkaa

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    Lately I have just been relying on the Gen 4 at night.
     
  10. Darryl

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    We always bolus from the CGM reading if all of these are true:

    - The CGM's was cal'd using a real BG check right before bedtime, and the BG was close to the CGM reading at that time.

    - I know for sure that she washed her hands before the BG check.

    - The sensor is at least one day old (fully acclimated)

    - There is no reason to believe the reading might be off (old or loose sensor, etc.)


    Most (perhaps all) failures in a sensor that I am aware of are due to the sensor getting old, the child sleeping on it, or if it's coming loose. In our experience the sensor always gives a false low in these situations, never a false high. This experience is based mainly on our 5+ years with the Minimed sensor, and the most recent month with the G4.

    I encourage you to do confirming BG checks at first, and in time you may find that you are just confirming the CGM reading.

    MOST importantly - if the BG does not match the CGM, don't assume that the CGM is wrong. Often the BG will be off due to dirty fingers, etc. Repeat the BG check to be sure it was good before re-cal of the CGM or second-guessing the CGM.
     
  11. joy orz

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    I've never corrected with the cgm, but often send her to a friend's house with the instructions of "if this beeps below this line, give her a juice.

    I have given carbs to head off a low plenty of times.

    Also, those of you frustrated that it doesn't match the meter, MORE often than not, I find it's the meter that is off or there is schmutz on her hands. Seriously, meters are frequently off. Don't assume it's the cgm that's wrong.
     
  12. Logansmom

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    For school, they always confirm with a BS check. At home, we confirm with a BS check 90% of the time.
     
  13. Mish

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    If we're stuck in a flat high pattern with an accurate sensor I will correct off the G4. At that point, for us anyway, it's more about getting insulin into him in an amount to get the high down. It's less about if the correction is going to get him to 110 or 120. It's about getting into a range where something budges. (does that make sense? )

    never would have attempted it with the minimed sensor.
     
  14. DavidN

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    Yes. There is a big difference between being "stuck" at 230 vs having a "moveable" number at 180. The key, as many have said, is to do my best to keep him from getting stuck in the mud up above 200 plus.
     
  15. mmgirls

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    I do dose at night on a sensor that has been good all day.

    But last night after a late bath the numbers looked funky, the 1/2 shea was in the bath was kind of a up and down and scattered looking. Dex had came done to 218 decided to do a poke and got 290, big difference, so used 250.

    Should has used 218, because she krept below the 90 mark by morning and had to give 1/2 a juice box to be able to prebolus right.
     
  16. Megnyc

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    Yes!!!! If there is a huge difference especially with a high I retest. I had a situation the other day where my meter was saying 130 and sensor was saying 318 double arrows up. If my vision hadn't been blurry I would have just ignored the sensor but I tested ketones and got 3.2 (or 3.7? I don't remember). Test on another meter said 470 and my site was attached but the cannula was out of my skin. In my experience the CGM will not read higher then actual blood sugar is/was 5-10 minutes ago. I would be careful with assuming that the meter is always "more correct" then the CGM.
     
  17. ecs1516

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    We do not. I always do a BG check for a correction. I have have had good running Dex sensors suddenly give a off number. Most of the time it is okay but have had 100 points off for no reason.
    We do sometimes give carbs for lows if it says so.
     
  18. MommaKat

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    I might have been tempted when we first started dex, but haven't ever and won't. I've seen some interesting blips with dex as it gets older. Now we're having our receiver and transmitter both replaced. System just kept getting further and further off. Still love dex, but it's tech, and tech can and does have errors.

    That said, whether to bolus or correct off of cgm is a personal decision - and honestly the only one who can truly decide if that's safe is you. The manufacture and your CDE / endo will always say NO. They also all say to never wear a sensor beyond the recommended time, yet we all do it. I'm okay with that, but not with dosing without confirming with a finger prick. Then again, my dd's biggest problem isn't getting stuck on the high end, but either with lows or massive swings. If the cgm and meter are far off, (and hands are washed), we have occasionally averaged the cgm / meter readings and dosed on that 'bg' because her symptoms suggested she was higher than the meter would lead us to believe.

    You're also talking night time - if you over corrected, would you hear or notice if there was a problem? That's my line in the sand on this - unless I can guarantee that I'd wake for however a low presents, I'm not gonna dose off of cgm. Good luck with your decision, and hope your kiddo gets well soon.
     
  19. Jensmami

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    Actually I did just that last night. I was deep a sleep when the G4 alarmed, and I was so tired, I checked the monitor and it showed that she was rising 180 going up slowly but surely. So I just gave her one unit and went to bed, her factor 1:40. I wouldn't give her 2 units, but I felt comfortable giving one. I also knew I would hear the low alarm again. I think I did everything half a sleep, so much that I wasn't sure this morning if I just dreamed it. :p
     

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