Trying a new area for the CGM Sensor

To some degree I was having some issues with the CGM (Continuous Glucose Monitoring).  One of the things that was getting frustrating was the fact that readings were all over the place.  I realize that the trends are the most important but it is hard to believe a trend when the readings are 60+ points off.  The other issue is sites for the CGM sensors as it is very limited.  I sleep on my stomach or left side so that makes it hard for the pump to be there and the transmitter for the CGM needs line of sight to work well.

I decided when I got back from vacation to call my clinical nurse from Medtronic.  We chatted about the issues I was having with consistency in the readings and the trends.  She was very helpful with some suggestions and off I went to try to get better at this diabetes management.

First thing that was discussed and with a new site have proven to myself that it does matter is that securely taping the sensor/transmitter makes a difference.  When I started using the CGM I used an entire IV3000 dressing to cover the entire site.  It was sort of effective but sweat and and water took its toll pretty quick.  the area of skin, especially under the transmitter part needed to breathe.  I then recalled reading in one of the workbooks or online that using have a strip to cover the sensor and part of the transmitter was a good way to go.  This made a tremendous difference in comfort.  I assume I got lazy with the securing of the CGM with the IV3000 as the nurse suggested to me to make sure it is secure and even use a wipe before putting on the IV3000 to make sure it bonds well and won't move.  The reasoning is that if it is a little loose and moving around it could be coming out slightly and messing up the readings.

The second part of my discussion was concern over finding other areas to use for the sensor where it would still work with transmitting to the pump.  I had used mostly my abdomen but I saw an issue that soon one side was going to be over used.  I also tried some areas on my back above the belt line but those were very ineffective and erratic.  She suggested using my upper buttock below the belt line.  I told her, "Just say butt!"  I was a little apprehensive about putting the sensor on my butt, the current look and insertion method was a little scary.   Plus I was worried about sitting, running, sleeping, etc.  The insertion part was not bad, a few yoga classes would certainly help.  I didn't get in secured very well  the first day as I had my golf league and readings were very inconsistent but I was willing to stick it out.  The next morning I secured it better and since then it has been working much better.  The readings are more accurate and the trends seem to be right on.  The only time I notice the sensor on my rear is when I am driving, but other than that it is less bothersome as it is also covered by my underwear so it gets a little bit more support.

I am very happy with this new site placement and hope that it continues to give me a better rotation.  In addition, my three year old won't be able to yank it off like she has done twice now in the last month, and her accidental sensor removal is not gentle.

IV3000 Tan Line

On our recent vacation I took extra precaution to be sure my site would not fall off in the water or running around the beach.  I used a redi-wipe and an IV3000 dressing.  Everything worked as I had hope and I only had my normal site change during vacation.

After vacation when I did my next site change I noticed something a little different, I had a nice diamond shaped tan line.  There were actually two but with the site change mid week the other was not nearly as prevalent.  In the  least it is a nice reminder of my vacation which at this point was two weeks ago.

The only thing I am not sure of is if the sunscreen helped with the UV protection of the IV3000 or if it was all on its own.

To CGM or Not on Vacation?

We recently went on a little beach vacation and I needed to make a decision as to wear the CGM or not.  The worry was that I would lose the transmitter part of the CGM in the lake or on the beach.  On the other hand I already knew I was going to be on a wacky schedule and the CGM would help in that aspect.

After debating in my head back and forth I decided to go without the CGM.  Replacement cost can be kind of high for something like that and I figured I could just test a little more often.  Overall it went very well, most of the time on the beach I was low from all the activity.  Thankfully we had plenty of yummy vacation snacks.

After dinner each night we would go walking around and get some ice cream at different ice cream places.  To some point with the pump it was so much easier as I ate what I wanted and then just bolused with the pump as necessary.  If I was still on the Insulin Pens I would have averaged about 6-7 injections a day, instead I enjoyed things such as a Downtown Dog, Chocolate Monster, Cappuccino Chocolate Chip, Blue Moon, Birthday Cake, and Chocolate Decadence (only one was not an ice cream).  The CGM would have certainly helped but overall I did very well with bolusing for all the yummy treats.

Out of fear I didn't take the CGM transmitter or sensors along which to a degree made me extra careful because I wanted to enjoy the week without having the highs and lows of diabetes.

Diabetes is Wacky

Diabetes is a wacky thing.  Some stretches I can go for days with no highs and lows then change nothing and be all over the map.  This is frustrating and mind boggling.

I had a pretty good stretch of doing very well with the pump and with blood sugars.  Then for no reason everything went crazy.  I can barely get through a night without running numbers up to 200 and then do little boluses to have some sort of control.  Then I will hear the beeping of a low and can seem to bring it up and then wham, blood sugar going up like a rocket.

I called the doctor’s office on two occasions now and on both they have lowered a basal rate in the night and raised it in the morning.  The funny part is the morning is the best part of the day (sometimes I am even a little low).  I am really confused by this.  I am giving it a few days to try and see where I end up  but so far over the weekend at night I have been high (200-275) every night.

I realize with weather changes activity levels and my body is always changing so things will be difficult.  So far though I think my concerns of the nighttime are not being communicated from the nurse to the doctor.  I have the advantage of uploading information to a website that the doctor can then look at to see what is going on, including my boluses, carbs, blood glucose and sensor glucose levels.  I asked the nurse to give him a specific report although I think the message of my issue was lost.

So I will give it a few more days and then make another attempt to convey my concerns.  It would be nice to get through a few nights in a row without a high or an alert for a high, although with the alerts it has prevented me from waking up 350-450 in the middle of the night.