Hanging out with the ski patrol.
Goofing around in our vintage ski outfits.
extra, read all about it
Continuous glucose monitors
and "My New Friend Dexcom" blog are national news!
Washington Post just published an article about sensors
and I was given the last word about the realities of this
new technology. Thank you Justin Gillis for your thorough
research and articulate writing about continuous glucose monitors.
and Interesting Realizations
We waited out the snow storm (from my last posting) and had
an epic day of skiing at Lake Tahoe. The Northstar resort
received 3 feet of fresh powder and Decom and I spent most
of our time skiing through the trees on the backside of the
mountain. I didn't adjust my pump's basal rate, but did eat
30 grams of carbs to prevent a low. I kept my receiver in
my ski pants' pocket and checked it periodically. The skiing
was amazing (powder flying with each turn), but it took an
increased amount of effort to ski down each run. After 4 hours
of thigh burning intensity, we called it a day and headed
home. Dexcom's 9 hour graph showed a slow and steady downward
trend throughout my day on the slopes. I didn't go low that
day, but analyzing the graph told me that I would have needed
more carbs if I chose to keep skiing that day at the same
using the Dexcom sensor for a few weeks, I've noticed something
interesting in the morning. An hour or so after breakfast,
my BG soars to the mid to upper 200's and eventually falls
to my target of 120. The first few times I experienced this,
I did a finger stick test, which confirmed the Dexcom reading.
I then thought about correcting with more insulin, but my
Cozmo's Insulin on Board screen showed I had 3 or more units
still active and didn't advise a bolus. It was a good thing
I didn't correct, since my BG started to decrease about 30
some experimenting, I've found that no matter what I eat for
breakfast (oatmeal, cereal, whole wheat toast, scones, waffles),
the morning spike still occurs. I've also found that if I
add espresso to the meal, my numbers can reach above 300 and
then come down. I thought about an explanation for this and
concluded that in the morning I must have a higher concentration
of hormones still lingering from my Dawn Phenomenon (early
AM surge of insulin resistance causing hormones that help
my body prepare for the day). I'm a little concerned that
this morning spike is affecting my risk for long term diabetes-related
complications. Since more insulin and changing my food choices
won't correct the problem, I'm planning to talk to my doctor
about trying Symlin, the new hormone that helps lower post-meal
BG's. Although, I'm not excited that to take Symlin means
giving another shot before meals and I've heard there's some
nausea for the first few weeks/months.
So far, I've had a very positive experience with my Dexcom.
However, I'm finding that certain conditions and situations
cause "weird" things to happen with the sensor.
First, my heart rate monitor does cause some interference
between the transmitter and receiver. I've realized that while
wearing my heart rate monitor, I must point the receiver directly
at the transmitter/sensor and the distance between the units
can't be more than 2 feet. Second, intense prolonged anaerobic
exercise causes the transmitter to inaccurately read "HIGH"
which means a BG value of above 400. This has happened a few
times while running and swimming.
If I were
Dexcom, I would explore how lactate, epinephrine, norepinephrine,
growth hormone, cortisol, and glucagon (hormones released
in high concentrations after intense anaerobic efforts) affect
the accuracy of the sensor. I realize that everyone wont'
be using their sensor at the same intensity that I do, but
I think it's important to report my findings. Last, occasionally,
the receiver will ask me for random calibrations, outside
of the normal 12 hour schedule. After I calibrate, the receiver
asks for another calibration a few minutes later. This happened
a few days ago and I burned through 15 test strips in one
day for calibrations. I'm going to call customer service to
troubleshoot the idea tomorrow.
the Belt Clip Now
The Dexcom data has been wonderful and insightful. However,
in order to get continual readings, the receiver must be next
to the sensor at all times (day, night, exercise, shower,
bed, etc) and the Dexcom belt clip isn't versatile enough
to do this. In fact, on the way home from Tahoe, I almost
lost the receiver due to the clip. I had the receiver clipped
to my ski pants and stopped to grab a coffee to go. While
I was pulling away, a stranger knocked on my window and asked
"Is this your cell phone?" holding my Dexcom receiver.
Here are my complaints about the clip:
plastic clip does not hold well on anything but a belt.
The case's high center of gravity makes the receiver flop
over when worn with loose pants/shorts, workout wear, boxers,
clip must be worn directly on my side or the receiver will
dig into my stomach, sensor, or infusion set (ouch!) if
I bend over. This is another center of gravity issue.
paid $825 for the Dexcom system so far with an expected additional
monthly cost of $175, so I expect a clip (or multiple clips)
that will be functional when I'm working, exercising, or lounging
around in my pajamas.
helped me discover a post breakfast BG spike.
anaerobic exercise interferes with my Dexcom's sensor.
waiting for a new belt clip (and software).
I plan to compare and contrast current continuous glucose
sensors. Thank you very much for all your questions, comments,
not work for nor am I compensated by Dexcom in any way. I'm
writing this story because I think continuous glucose technology
is interesting and exciting. Also, I am not a health care
professional and do not give medical advice. I will share
my experiences, but please check with your health care team
before making any changes to your diabetes or health management.