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Your Child Boluses Using CGM #. Are You OK With This?

Discussion in 'Parents of Children with Type 1' started by DavidN, Sep 3, 2014.

  1. DavidN

    DavidN Approved members

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    First thing in the morning? I agree. I would never bolus off a morning number. That is a calibration time. Same with an evening/dinner bolus. But middle of the day we relax the stick requirement. Not all the time, but often. As Sarah correctly pointed out a properly calibrated CGM is more then likely within the meter +/- 20% error range.
     
  2. funnygrl

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    I don't know. I think I consistently get worse CGMS accuracy then other people. I calibrated to the 73. Two hours later Dex 138, meter 71. If I was really 138 I would take a small correction.
     
  3. Zivile

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    We almost always bolus according to CGM to save his little fingers. I find it accurate enough :)
     
  4. Lakeman

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    I would not be upset but I would also mention that it is not a best practice. That it happened at a friends house would cause me additional worry since the people there are less likely to recognize problems that could arise. We have had the dex be pretty far off a few times and it is possible that bolusing could cause a low. For us it would be more likely that there would be an undercorrection. That being said I do occasionally bolus off of the dex but only with careful consideration. My daughter is too young and is not ready to evaluate those kinds of considerations. We treat lows off the dex all the time and yes it is common to find that we undertreated or overtreated. A fingerprick is a small thing but as a parent I hate them and do like when we can skip fingerpricks.
     
  5. suej

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    We bolus and treat lows and highs off the Enlite if sensor behaving. As pointed out above breakfast always preceded by fingerprick, and supper also as calibration times. Having a bad run with sensors tho...... after a miraculous 12 day run that I posted about and clearly jinxed us, they are fading after 3 days (the "new" enhanced ones).
     
  6. jacks101

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    I'm comfortable doing it myself occasionally, but wouldn't want my daughter to do it on her own yet.
     
  7. swellman

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    I'm not OK with it but I would let it slide if it was an occasional thing. I wouldn't be happy if he was high and didn't stick but I wouldn't sweat it too much if he were treating a low. I would be more concerned if this was a result of being too embarrassed to stick or something to that affect. Out general rule is not to make big or potentially serious decision based solely off of the Dexcom. We just got a replacement receiver and it was the pediatric version and there is warnings on just about every screen about relying on the Dexcom for making treatment decisions.
     
  8. MEVsmom

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    We do it occasionally. If I am doing a correction for a high in the middle of the night, I assume the dex is about 25-30 points high and correct off that number without doing a finger stick. Rarely is Dex going to be further off than that.

    At school, my 8 year old routinely corrects a low off Dex. If she alarms, she'll eat a Starburst or Glucose tab out of her purse. That's enough to bring her up above the line and keeps her from going to the nurse's office and missing important class times. This is one of the reasons we like having the Dex.

    As a general rule, we are going to do a finger stick most of the time; however, there are occasions when we feel safe going off Dex. Your meter has a variance as well as others have pointed out so we try to make life as easy as we can while also being safe.
     
  9. rgcainmd

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    Not quite the same situation, but for what it's worth:

    Recently my daughter's honeymoon ended abruptly and/or she began pubertizing (this should be an officially recognized verb IMO) which has sporadically resulted in a lot of wild and wonky BGs, which in turn has led to my DD using an average of greater than 13 test strips per day. Our dee-light-full insurance will not cover this apparently astronomical average number of test strips. I discovered this the hard way when I went to refill her rx for test strips on August 22 and was told that more test strips would not be covered until September 3. The pharmacy was wrong; our insurance did not end up covering more strips for an additional day (until September 4, yesterday). So back on August 22, I looked at how many test strips we had remaining and divided that number by how many days we needed to make our supply last. I came up with eight point something test strips per day. Being the lazy, sleep-craving Mom that I am, I came up with the following solution (based in large part on the fact that, outside of the annoying 10- to 16-hour window of time after starting a new Dexcom sensor, my daughter's CGM readings have been pretty darn accurate and often spot-on compared to meter readings which, as we all know, may not be terribly accurate themselves): I would use Dexcom readings for corrections, including treating lows, during the night. This resulted in my daughter getting more and sounder sleep without my disturbing her dreams in order to ask her to "give me the finger" for a BG check every time her Dex vibrated to tell me that she was over 140-ish or under 65-ish. After nearly two weeks of this arguably "iffy" practice (yes, I continued to do this through last night, even after insurance blessed us with a plethora of copay-only shiny-new test strips) my daughter does not seem to have suffered any ill effects, and I am a bit more well-rested. DD's been just as nicely "dialed in" (or not) based on her first-thing in the morning meter checks as she was prior to my relying solely on CGM readings overnight. I honestly do not believe that the overnight Dexcom readings have been more or less accurate than the meter readings would have been, in a statistically-significant sort of way. That being said, like Ali and other parents, I have come to know when a CGM reading is undeniably way the heck off and I test or sometimes even re-test on those occasions. I also do a lot of meter testing/re-testing or just go ahead and toss a Dexcom sensor and start over with a new one when I get a series of "WTF" readings which sometimes occurs after about Day 14 (I squeeze every possible ounce of mileage out of those expensive sensors) or when we've come across a rare defective sensor (the infrequent ones that give you inaccurate readings consistently from the get-go, even after the "getting to know you" phase has passed). For now at least, I plan to continue being a lazy (I mean well-rested) D-Mom and relying on Dexcom readings overnight (with the exception of when they seem way off) unless my daughter's A1Cs begin increasing faster than our cat can lick his gonads.
     
  10. missmakaliasmomma

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    I'd say ok just not all the time. Sometimes it does happen to be off so I wouldn't do it all the time. But who knows.. when my daughter is older, she might do the same thing lol
     
  11. caspi

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    He remembered to bolus. So kudos to him! :smile: What you might want to do is ask him to double check with a finger poke if he's high and is planning on correcting as well.
     
  12. DavidN

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    Yes, he's not supposed to do big corrections without poking, unfortunately there is only a weak positive correlation between me saying it and him doing it. :cwds: If I had Bolus-In-The-Cloud I'd sit here in my office and use it ... Not really (for a number of reasons including we don't do CGM in the Cloud at school) but I'd be extremely tempted.
     
  13. momof1CWDinohio

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    We do this all the time and never have had a problem. Love the Dex!
     
  14. shannong

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    I always calibrate in the morning and evening. We generally bolus most times off the Dexcom numbers, but may check if for some reason (like an unexpected high) the number is wonky.
     

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