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Does CGMS catch lows?

Discussion in 'Parents of Children with Type 1' started by ctwetten, May 30, 2008.

  1. ctwetten

    ctwetten Approved members

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    So I posted this on the "adults with type 1" section, and the only answers I got were from parents. As far as I can tell you guys are online way more:), and I'm sure many of you have an answer to my question, so I thought I'd post it here too. Thanks for the help!!!

    I'm considering trying to get my insurance (Wausau/Fiserv) to cover the cgms. My biggest problem is that I HATE lows and try to avoid them and end up running high. I'm wondering if the cgms "catches" lows right away. It seem that if the fluid that it's measuring is 15 to 20 min behind the actual blood sugar, it wouldn't really help prevent lows, because by the time it gives a low reading you've been low for a while and/or are much lower than what it says. The literature I've read about it seems to give mixed answers about this issue. Does anyone have experience with the cgms and know about this? Thanks!
     
  2. TheFormerLantusFiend

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    For me, yes. Absolutely. It catches them on time and before I can feel them. I have hypo unawareness (I'm not wearng the Guardian right now and tested at 41 feeling hunky dory- will treat in a minute). I have never tested my blood sugar as hypo when the CGMS was above 90.
    But the alarm doesn't wake me up.
    This seems to be a YDMV issue.
     
    Last edited: May 30, 2008
  3. Mama2H

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    I have my daughter's low alarm set to 90 and she has only had one low below 50 since we started it. If she is running in the 90's with no drop I temporarily drop the low alarm to 80 then move it back up to 90 after she eats something. My daughter was terified of lows before the cgms, now she doesn't worry too much about it and actually gets a little freaked when she is in the 60's.
     
  4. Darryl

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    This is exactly our experience as well. Our daughter's insulin pump target is set to 100 all day, and she did not have a single case of "shaky hands" at school this entire school year.

    There are some lows the CGM does not catch in time to prevent mild symptoms, mainly the lows that come on very fast due to excessive bolusing. But "drifting lows" that result from slightly too much basal are caught almost every time, and can easily be headed off with a basal change or drink of juice before they get low enough to be symptomatic.

    The short answer is yes, absolutely, the CGM catches lows. Not every single time, but the great majority.
     
  5. kaismom

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    We've only been a week and a half but have headed of some lows we'd have otherwise missed. our low alarm is set at 70 but we will move that up to 80. what really helps is the trend, I can see how steep his trend is up or down and try to catch it before he goes high or low. we're hooked
     
  6. Flutterby

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    yes, definitely.. I have Kaylee's low alarm set at 90, so if the sensor is lagging behind (which it will if your bs is changing rapidly).. typically her bs is at 60-70 during the alarm.. if she's headed down fast, it will be lower, but for the most part its stopped all the reaally big lows for us. The one thing that I have to get Kaylee to realize is that when its alarming she needs to TELL me.. this is when her lows will get lower.. if she's playing in her room and I'm in the living room I can't hear her alarm and need to rely on her.. well, if she's busy, she doesn't want to bother with it..

    I don't think I could go without the cgms now.
     
  7. tamhome

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    if it is working....

    We had problems with the fast drops.... by the time the CGMS would catch the low... she was REALLY low even with the low setting at 100.

    I think it can be harder in children because they seem to fluctuate quicker than most adults. We also had problems with getting sites to come anywhere near the actualy bg the whole 3 days she would wear them... it was always a guess as to if the site was going to be accurate or not when you put it in.

    We have seen studies on the Navigator CGMS that give us reason to hope that it will be closer to actualy BG readings and allow for wear more that 72 hours like the Mini-Link.
     
  8. StillMamamia

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    I have NO experience with CGMs, but isn't the bs reading with a CGM 15-20 mins behind what it is if tested with a normal bg tester?
    Do you guys increase the low-end of target range number to avoid for fast bg dropping?
     
  9. Mama2H

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    Tammy, we had the same problem when we were trying to use the stomach or bottom for sites. Once we found a good stable place to insert the cgms the readings got much closer.

    Paula, we do have ours set to 90 to catch the fast dropping lows. I hope some day soon MM upgrades our pumps to have the predictive alarms that the guardian has, that will prevent even the not so low lows.
     
  10. Twinklet

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    I think I answered over there, but here goes again:

    YES! Emily used to have a lot of lows, but since being on the CGMS, she is only low a couple of times a week. I think the last stastics said she was low 3% of the time--(with a reading every minute). That is a VAST improvement.

    I have her low alarm set at 80 because if she drops quickly she may be 70 or 60. However, we also use the "projected low" alarm, setting it for 20 minutes, and that REALLY helps us catch lows. It alarms if her BG is dropping more than 2 mg/dl/min and the math says she'll hit 80 within 20 minutes. We stop, test and treat the number if low, the trend if she's not low yet.

    Regarding CMGS being behind--the ONLY time Emily is behind is during periods of rapid increase or decrease. If the arrow is steady, her BG is always within a few points of the CGMS. Or, if she's dropping slowly the number is pretty close. The CGMS read 78 yesterday during an alarm and she was 68. Not bad IMO.
     
    Last edited: May 31, 2008
  11. Darryl

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    We tried the predictive alarms, but sometimes they will predict a low or high that will not really happen, causing you to correct unnecissarily. For example, if BG is heading
    down 2 hours after a meal, towards 100, you might get an alarm, but if you just wait a few minutes you see that the BG would have leveled out at 100 anyway.

    We've found it more useful to just be a little more conservative on the thresholds. Instead of a predictive alarm at 90, set a regular alarm at 100, for example. Then you can let your own eyes do the "predicting" based on your knowlege of the last bolus, the slope of the curve, etc., which we find to be more accurate than letting the Guardian's algorithm do the predicting.

    This is just a suggestion to try. Either way, it's good to have both options.
     

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