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Does anyone bolus off the cgm reading?

Discussion in 'Parents of Children with Type 1' started by Judy&Alli, Aug 25, 2010.

  1. Gracie'sMom

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    We do not bolus off of it for correcting BG, but we will also, for snacks, bolus for food if it is reading in range and has been accurate.
     
  2. 2type1s

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    We do for both girls. As long as the callibrations are within 10-20 points (which I find they almost always are). If they are low, we always check with a stick, or if they are high same thing). I do correct middle of the nights if I see large trend up, and know the callibration was good at bedtime. However, I don't give a full correction. My youngest is horrible to wake up. I have never had a problem doing this. Most of the time, if the Dex is off, my girls know before I do. They will look at a number and say "I don't feel 245" and they finger check, and they're right!
     
  3. chbarnes

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    I think over time you start treating the pattern and the trend on the CGM, rather than just the number. If the calibration is reasonably accurate, the number seems secondary.

    Chuck
     
  4. Darryl

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    Sarah,

    Please take a look at the link CGMS Calibration in my signature below. Only the Minimed has the ISIG, but it is tremendously useful, even essential in my opinion to knowing if the CGM data is valid. We would not correct off the CGM readings, or know if the sensor has degraded in some way, without being able to check the ISIG.
     
  5. kyles_mom

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    Really informative Darryl.......thanks for posting this! I hope you don't mind if I call on you for help once Kyle starts CGMS'ing :D
     
  6. TheFormerLantusFiend

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    I used to do all corrections and boluses off of the Guardian while wearing it, unless I had reason to be suspicious of the number. I hope to do the same with the Dexcom.

    P.S. I felt the Guardian was more accurate than my meter. When I had a Guardian and Accu-Chek reading that were really different and did a second check, almost every time the recheck number was closer to the Guardian.
     
    Last edited: Aug 27, 2010
  7. SarahKelly

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    Thanks Darryl, I've read all the things in your sig before (but when sleep deprived) and am glad I re-read them. I think the problem we had when we tried the CGM is that Isaac's BG seems to be changing rapidly often. There are very few times that things are static for a good calibration - he's constantly eating, running around or plain ol' being a toddler. Do you, from your experience think that it would be feasible to get good calibrations done with a typical busy toddler? I just wonder if the CGM is worth it....
     
  8. hawkeyegirl

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    The longer you have it, the easier it is to get good calibrations in, because you will be able to avoid some of those peaks and valleys. We find that it's generally easy to calibrate when I go to bed (between 11pm and midnight) and when Jack wakes up in the morning (around 6:15am). Then we just do one sometime during the day.

    We started when Jack had just turned 4, so it is possible. And does get easier as you go. How long did Isaac wear the CGM the first time?
     
  9. Judy&Alli

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    I am sorry for sort of abondaning this thread. I should have thought about how crazy my life was about to get before I posted this.

    Anyhow thank you for all your replies. We had a weird endo appt. The cde told us we should never bolus off her cgm. I tried to explain to her that we are not stupid and never bolus the first day, and so on and so forth. Finally after a very long appontment she understood and gave us the go ahead for Alli to bolus for lunch at school. With restrictions of course, the same restrictions that we had already implemented.

    I love CWD, you all have taught me so much, I am ever grateful!!!:D
     
  10. cindyrn6617

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  11. mrcool

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    We calibrate upon waking up, after a nap and before we go to bed. At all these times there's usually IOB, no food and BG is relatively stable. Works fine with our toddler. :)
     
  12. SarahKelly

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    what time of day do you start the sensor?
     
  13. Darryl

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    Same here... wakeup, before dinner, after bedtime. It's not always stable, but usually is during those times.

    Remember, the CGMS is your eyes wide open. If you drove a car with your eyes closed, you'd also be swerving all over the place, but that doesn't mean that having your eyes open wouldn't help.

    With CGM BG management, once your eyes are open 24/7, you can make more frequent and smaller corrections, thus avoiding a lot of the large swings that make CGM calibrations difficult. The tighter your alarms (we use 80/100), the more frequently you correct, the better the calibrations get, and the easier it gets to stay in range.
     
  14. Flutterby

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    Kaylee's endo jump up my you know what when she saw 4bg checks in one day.. she asked why so few.. I told her she was in range, sensor was extremely accurate (which you could tell by the graph) and I was trying to give the kid a break..then I got 'you should never rely on the sensor'.. I lost my cool and told her 'I obviously DON'T because every other day has 10-12bg checks'.. The entire point of us getting the sensor was to cut out all the bg checks.. lately things have been crazy, so I wouldn't dare, but when things calm down I'll rely on the sensor more... the sensor has been accurate all along, reguardless of what her bg is doing.

    I was NOT a happy camper after our last endo appointment.. she was in a mood and took it out on me.. :rolleyes:
     
  15. Ali

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    What about all those decisions after one BG check, without a recheck to see if the high is not an error, or when things are quickly changing and the BG is not too accrate, or all those assumptions about what your BG should be between checks when they only want 4 to 6 a day. No matter how you do it if you are an idiot you will still be an idiot and if you use your brains you will still use them no matter what the measurement. :cwds: With MDs sometimes it is just always a no win situation. But I do think they have good intentions just not very tailored to individuals. Ali
     
  16. Darryl

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    Whenever an endo questions relying on CGM readings, it always makes me want to ask "how do you rely on BG checks?"

    Really, now. Let's say a BG check is 120. What does that mean? If it's 120 dropping it means eat carbs. If it's 120 rising it means take insulin. If it's 120 stable and 120 is your target it means do nothing. So basically BG checks are often about as reliable as a three-sided dice.

    A CGM reading could be 20 points off, but you know which way the BG is headed. It is rare when using a CGM to ever eat carbs on a rising BG or take insulin on a falling BG, and that is why people who rely on CGM readings tend to avoid serious lows and highs vs. when they relied on BG checks.
     
  17. SarahKelly

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    Great points Darryl...I'm sold on the CGM, right now we're just trying to conquer the sensitive skin issues with either IV prep or the tegaderm.
    I truly do appreciate all of the insights on here about CGM and overall care of d.
     
  18. MikailasMom

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    Darryl, I think we need your help!

    We calibrate at about 5 am and 5 pm, with no IOB and no carbs digesting, and Bg is usually very stable at these times, esp the am one. It is VERY rare for us to have a sensor that is within 50 ish points. We do get some "good sensors" that are very reliable, but more often than not they arent. (and when they are good, i treat them like lost treasure!) The first few days are always horrible, but generally if they are going to work "well" its usually not until day3. I would LOVE to cut back on testing and be able to more fully utilize the CGM, but it is so flakey! I love the trending, we use it alot to base descisions off in combination with the meter numbers, but the readings just arent there! It is not unusual to see 100 point differences between meter and dex. Any suggestions for us? Thanks a million!

    Candi
     
  19. Flutterby

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    Darryl, I agree.. her endo is old school and there are only a few people on cgms.. Kaylee was the first one.. she's been on it since 07, you'd think I'd know how to use it by now.:rolleyes: but her endo is so old school.. she has a specific way she likes her logs and information and I don't think she trusts the sensors the way she should.. sure you can have crappy ones.. but for the most part, its very accurate for Kaylee.
     
  20. MReinhardt

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    Chell has bolused off the CGMS once. Only cause she left her meter at home, and we were 1.5 hours away from home. She gave a 3/4 of a correction for the high bg off the cgms, and the full correction amount for the carbs eaten.

    Not having her meter that day, made her more aware of making sure she has it all the time.
     

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