Today marks the close of Week One wearing the new DexCom STS wireless continuous monitor. I'm still enthusiastic, of course, but I've learned a few things, mostly about managing expectations. Or more specifically: Lessons in How CGM Can Help Us Now.
WHAT IT ISN'T:
- a magic wand for transforming your glucose control overnight (obviously, our rational minds know this beforehand, but somehow the vague hope lingers)
- an escape from multiple daily fingersticks. You now need fewer, to be certain, but you do need to calibrate the DexCom at least twice a day, and need to take a fingerstick reading anytime anything really happens, i.e. prior to dosing insulin or whenever the DexCom shows a High or Low reading
- an actionable replacement for the conventional monitor (as per above). You have to be careful! So far I've seen up to a 40pt difference between the DexCom and the standard monitor, so you really don't want to dose (especially not stack doses) based on the continuous readings alone -- which the company and the FDA are both very clear about, though it sure is tempting
- a relief from the schlep-and-hassle factor of diabetes. In fact, you now have one more device (complete with cable and case) to carry around with you and fuss about. btw, the DexCom only interacts with the OneTouch Ultra meter at this point, so you're forcibly switched to that model (which isn't bad, as long as you're good at getting a generous blood sample onto the strip all at once... I'm learning)
WHAT IT IS:
- an incredible new way to view and understand your own body's reaction to all the relevant diabetes variables: different foods and physical activities, insulin doses, menstruation, sick days, etc. The trick is to be patient enough to start out by simply observing, rather than trying to react to everything you see on the nifty little CGM screen right away
- the first-ever effective tool for people with diabetes to get reasonable, personalized answers to the following key questions:
- how long does it take until my insulin starts working?
- how long is the insulin active in my body?
- does this differ by time of day? (for example: am I more insulin resistant in the morning than in the evening?)
- what do my favorite meals do to my blood sugar?
Again, this requires patience (so totaallly not my strong suit). But imagine having access to a (reasonably) accurate graph of your blood sugar patterns over the whole day -- especially if you're able to compare this to some records of what you ate and did that day. Now imagine detailed graphs for the last 2 weeks, 3 weeks, or even 6 weeks (even without the food records). How powerful is that?! According to the study results that DexCom has presented, within just a few weeks of using the device, patients spent 26% more time in the target range (80-140).
Personally, so far I've mostly been just watching the details as I bounce up and down. Interesting. And I actually was able to intervene and make corrections (after double-checking with the OneTouch) following breakfast and in the afternoon hours when I otherwise would not have been aware of the SUS (sudden unexplained surge). I hope and pray that this will translate into a lower A1c. That is the Big Idea, of course.
Look for my data observations -- and more useful insights?? -- coming soon.