Who's the best doctor?

Assume you have been seeing the same old diabetes doctor since you were just a young teen. For a very long time, let's say around 30 years, this same doctor has been your hero, the man who has helped you through many ordeals. He has calmed you down when you were completely lost. He understood the high numbers followed by those creepy lows when you had gone out with your
friends. He reprimanded you for not using your glucometer for 2 weeks, because you were fed up with D. He reassured your parents you were going to be okay, when once again, you were in the hospital with DKA. Your parents invited him to your wedding and he congratulated you with your first child. He helped you figure out the lows and the highs and he checked the blue marks on your thigh as a result of the daily nighttime shot. He reminded you to take your vitamin D and to change your needles as often as possible. And then, he announced he was going to leave the hospital. He wanted other, younger doctors to take over. Your world fell apart. How would you cope without him? Not one other doctor knew all about your lows and highs. This man knew you better than your own parents did? Deep down, you knew this day would come. You weren't ready for it. It wasn't easy for him either...

Then this other doctor showed up. He was experienced too. He had a calm voice and a firm hand but he was not your doctor.. You built a shield around you and you were not prepared to let him in. He talked about some device you had never heard of. He tried to persuade you to alter the settings on your insulin pump. Was he out of his mind??? If your settings weren't okay, wouldn't your own doctor have said so? What do you mean, 180 mg/dl is not the best average blood glucose?

You were heartbroken. You wanted to talk to your own doctor and make him come back. He deserved his retirement, absolutely. But why now? Why someone else that you didn't know?

Things are different now. You have to rely on a different method. A doctor with an opinion of its own. Why does he keep saying it is so important to count carbs? Why does he want you to change what has become your way of life? It's not fair. It's still the same disease, then why change it all?

You texted me to ask about the carb content of this and that. We sat down together, to discuss this new device, called Dexcom G4. You were impressed, to your surprise. Maybe it was time to let go. Just like a mom, who is setting her child free to flap her wings, it was time to let go of the old days and the old ways. You were ready for a new milestone. I heard you followed my advice and you got yourself a new insulin pump, bluetooth included. I'm proud of you. Carb counting can be tricky, but seeing what those carbs do to a body infected by diabetes, is beyond interesting. I have this feeling, that you are beginning to like this new doctor. Maybe he's not the enemy. Maybe he's your next challenge in life. You can do this. You're on your way.

A wake up call

For the past 11 years, I have been dealing with Type 1 Diabetes. The first couple of years, I worried about complications a lot. My at-the-time-endocrinologist had made me watch a video on kidney failure, amputation of limbs, blindness and all the other "bad" stuff die-a-beetus can bring you. It horrified me to see this documentary on the day of my diagnosis. It was terrifying to go to sleep at night, so I stayed up real late and set my alarm to poke my fingers several times during the night. Sometimes I would catch a low and sometimes I would have great numbers. I couldn't go to sleep (my endo told me) if my numbers were below 180, which resulted in high numbers all night and a high reading in the morning. After 4 years of injecting insulin, I switched to the insulin pump and I did so much better. There was no reason to have a 180 number before bedtime. In fact, I could go to sleep with a 100 on the screen of my glucometer. And I did.. My numbers were better, but I was never rested in the morning.

February 27th 2013. Another date that will be tattooed into my memory. On February 27th 2013, I started using Dexcom G4. I was completely excited about this device, as I had read very good reviews on the accuracy of the readings. A personal visit from a Dexcom rep and a couple of hours later, I could start interpreting the numbers on my receiver. The first nights were horrible. One night I was alarmed of 4 low readings... It was scary to realize the danger you had put yourself into, for having had diabetes all of those years without a warning of nighttime lows. Never before had I come down to this. I always believed my body would warn me if my BG was going too low. NOT! What a bummer.. I must have had a very, very good guardian angel all those years. No emergency calls in the middle of the night. No rushes to the hospital.

Last week, I read about this young mom that did not wake up from a nighttime low. She was found in the morning, in bed. Her life had come to an end, thanks to this stupid condition called diabetes. Just like that, a life is lost. Does that justifies why I wanted this Dexcom G4 so badly? Don't you think all of us are entitled to using a life saving device? Our children deserve to have a mom and a dad. They shouldn't have to fear their parent not waking up in the morning. This device is not some gadget, it is a life saver, as you can see from the graph below. There should be reimbursement for all of us. CGM is important, even more important than our glucometer, since that tool does not come with arrows showing what number you are headed to. I love my glucometer, I really do, but it does not alarm me of upcoming highs and lows. It does not show me the trend of my blood sugar.

I'm getting a bit emotional over my Dexcom G4. You may get excited about getting the latest iPhone or fast car or a trip to the Bahamas, but I get excited about a device that saves my life over and over again..

The downside of D

Most of the time, D doesn't bother me. It's not that I could care less or that I don't take care of myself. On the contrary, I do whatever I have to do to keep my numbers in range. Most of the time though, I feel like diabetes is as difficult as science. Every time you think you have finally figured out the correct settings on your insulin pump, something new lurks around the corner to bite you in the bum. It can be really frustrating, you know. Why can't D behave every now and then? Let's say once a month? Is that too much to ask? I'm not even asking once a week, just one day a month or even one single night a month? No lows, no highs, no unexpected swings in that blood sugar. Wouldn't that be the best thing ever?
I don't like to whine about diabetes. It doesn't get us anywhere, does it? It is what it is and we have to take it as it comes. Things have improved quite a bit since I started using CGM Dexcom 5 months ago. The average number on my graphs is lower than it used to be. I'm getting better at understanding the alarms it gives me and I'm doing better at preventing highs and lows. The sad thing though, is that you can prevent the lows, but you have to prevent them by eating or drinking carbs. I can feel the carbs cling to my hips and tummy and that really upsets me. I have come so far and I was so proud of the weight loss. Now it seems like my pants have downsized and my pretty blouses open their buttons all by themselves when I take a deep breath. Me not like.. If only there were a pattern in the lows and highs. It would make it possible to change the basal settings on my insulin pump. But hey guess what: what's new??? There is NO PATTERN! No pattern whatsoever! Are you playing tricks with me, stupid diabetes? Gimme a break, okay? I'm trying to look after myself here. Just bear a bit with me, will ya? Grrrrumble...

I'm done with the rant now. I'm going to correct that high (nowadays 145 is high) very carefully. I have put small boxes of chocolate milk on the way upstairs, to help me beat those nighttime lows, if they will present themselves tonight. Tomorrow is another day. And D will still be there..

Sit back and enjoy the ride

I love roller coasters! The higher they get, the more excited I become. Having worked in a amusement park as a young teen, I would always rush to the roller coaster right after work. We would hang out there with my friends and enjoy numerous rides, screaming our lungs out and getting all wound up. Back then, I never would have thought roller coasters could also have a completely different meaning..

I hate roller coasters! The higher I get, the more fatigued and miserable I become. Going from high to low and back is no longer something to get excited about, on the contrary. I truly despise the alterations in my blood sugar. To be honest: it's probably the one thing I really hate about diabetes. I have discussed the subject with my endocrinologist on numerous occasions. He listened to me and told me it's part of being a T1 diabetic. I know it is. Does that make it any easier or more bearable? Don't think so. I really want to find a way to cope better with these swings. I don't want to be the party pooper because I'm messed up by lows and highs. Going out with friends and having a good time, is just one of those things I love to do. Having a good meal and great conversations, but always with diabetes in the back of my head, is part of it. I prefer to have one cool glass of Chardonnay with my meal, rather than having beer or cocktails. Making sure I have some carbs while sipping my wine, I try to prevent lows later on.

I don't know what caused my roller coaster last night, but it was no fun, I can assure you. I was exhausted (well, not just from the highs and lows - I'm nearly 42 and no longer used to staying up that late) and all I wanted to do, was lie down and catch some sleep. Just little time after closing my eyes, my Dexcom beeped. I opened one eye to take a look: 71 Not bad. I would love to have this number all day, but not to go to sleep. I reached for the bottle of Glucotabs I brought from my recent trip to Florida and shook a couple of tabs into my hand. I hate dextrose. They dry out your mouth and leave you with a stuffed feeling, like having chewed on cotton balls. But o well, I had already drunk 3 small cans of coke prior to the tablets. I closed my eyes, turned over and clamped my Dexcom in one hand. Not for too long: there was the alarm again. I looked over to my Hubby, who was sound asleep in the hotel bed. Reaching out for the bottle of Glucotabs a second time, I knew it was going to be a very short night. I was so exhausted and I knew we had to get up in just a couple of hours. Diabetes, I hate it when you deprive my sleep. I feel like crap after short nights and especially if they have been interrupted for lows. Ten Glucotabs later, it was time to get up and get ready for breakfast with our friends. I could do with some coffee and toast. It felt like a terrible hangover, without having had the alcohol. If it's a choice not to have alcohol, is there a way to choose not to have lows at night?

Seventh Heaven

Yesterday, she texted me and I smiled because of the joy in the message. She's in her early 30's and besides being a stunning mom of two brilliant twin boys, she's a lawyer and she's a sportswoman. Did I mention she has type 1 diabetes too? She's out of her honeymoon period now, meaning her pancreas made it final: he's not planning on making any more insulin. Where in the past two years, she could count on her panky to make some insulin, helping her get decent A1c's. That period is gone. It's up to her now, for she can no longer rely on her pancreas to help out. It scared her and her A1c went up. She fears the lows for getting unconscious as much as she fears the highs, for future complications. She was getting a bit desperate and her family was worried sick about her last low nighttime episode..

"He works with computers". That's how his mom calls it. Maybe I'm like his mom, for not knowing exactly what he does for a living. It involves software and Delphi language or something, I guess. He has told me on numerous occasions, since we monthly go out for lunch. D came into his life 3 years ago. He had panic attacks for a long time. They came back right after being diagnosed with D, for a different reason now. The fear of diabetic lows is grabbing him by the throat. He insisted on getting an insulin pump, despite good numbers and a A1c in the 5 region. He needed that pump to keep breathing. But it was not sufficient enough. It didn't warn him of upcoming lows.

I met her a couple of years ago. She has the same age as our oldest daughter. She was too young when she got diagnosed. She was a teen for god's sake. Why did she need to get this awful disease too? She didn't want no insulin pump dangling from her tummy. But we met and I let her figure out where my pump was hiding. She couldn't find it and she called for the nurse to sign up for an insulin pump. 

Her mom worried a lot about her at night. Would she be okay? Would she poke her fingers before bedtime and wake up while experiencing a low? 

A young student of 25, with a girlfriend and a baby boy. His diabetes was a bit out of control. He found it hard to poke his fingers all the time, so he forgot. As a medical student, he knew about the complications diabetes may bring you, so he wanted something else to help him move forward.

It had a been a long time since we've set a date. But we keep in touch and write emails every now and then. She's in a different relationship now and she's doing real well. Being diagnosed T2 as a young woman, she's not entitled to using an insulin pump. Her endocrinologist thought differently and signed her up for the medical device that would change her treatment. It made her feel a lot more secure. Just not secure enough, because lows were hiding behind the corner, to catch her when she was not paying attention. She has a little boy that needs his mommy. She wants to be around for a very long time. If only someone could help her get over that fear for lows, it would help her lower her A1c and get better control.

No more than 1 year ago, he was diagnosed as well. I remember how little insulin he needed in those first months. He was determined to give his utmost and do the best he could to keep this condition under control. Being on 4 injections and multiple finger pokes a day, he dusted his mountain bike and joined his friends on trips. Sports is good for us. Why doesn't diabetes know that? At least, D could be a bit more considerate and leave out the lows and highs during work outs. It would make things a bit easier. Wasn't there something better that could help him during training?

I haven't met too many diabetics that have had their condition for over 30 years. It somehow scared me to hear her story. Having lost complete sight in one eye and partial sight in the other is awful. She's such a pretty woman.  She has a man who stands by her side and accompanies her to doctor's appointments. She's shooting up insulin. Pumping was not her cup of tea. She tried it, about 10 years ago. Things were a bit different back then and technology has improved since. I thought she deserved better aids and better control. I contacted her and we started to write to each other until we finally met and had the chance to embrace each other. 

He has been a great help for many of us diabetics. Of all diabetics I know (and I know some), I've known him for the longest time. It must be more than 5 years now. I know how opposed he is to insulin pumps and how stubborn he is in showing that insulin pens are as efficient.  I like his stubbornness though. I prefer to call it perseverance. He's a good bloke and he's helped me out on numerous occasions when once again, I forgot how many carbs a certain food contained. I would only have to open HelpDiabetes, the program he wrote for us to use for free. As opposed he is to insulin pumps, I could tell he was interested in CGM.

My endocrinologist said I didn't need CGM. My A1c level was 7.1 and that is not life threatening. One doesn't get these numbers just like that. It takes a whole lot of work to get there and it consumes a lot of daily energy to stay there. CGM is expensive and at your own expense. It is my diabetes, a condition I share with many friends. It is my body, my life and my choice of treatment. 

That makes 9 of us already. 9 stories, all different reasons with a mutual factor: diabetes. A new world has opened. A milestone in our treatment. Dexcom is different. It's out there and it's getting closer. It is within reach. You don't have to wait for your doctor to tell you about it. Button up your shirt and ask him about Dexcom. Make your own file and document your questions and express your concerns about future complications. The people at Dexcom are there for you. They can help you get better control. They are there, 24/7, just like Diabetes. That's what we were looking for. Continuous Glucose Monitoring that we can rely on. A device we can trust on for knowing what trend our blood glucose is following. We are happy with our glucometers, but knowing where our numbers are headed to, is a bonus. Not essential to some, indispensable to others. It's your choice. It's your life. It's Dexcom.

In a slight state of shock

I'm not exaggerating but I was truly in a slight state of shock, when I looked into the software of my Dexcom. Since the last meeting with the Dexcom rep and the phone call with my diabetes nurse, my numbers have been so much better. This time I have plenty of energy to fill out my food diary. It's no problem to write down what I've been eating or checking my BG. I have a date with my endocrinologist beginning of June and I'm sure he will be surprised to see the results of these few months with Dexcom. Not many doctors are truly convinced by this concept, but that is because they don't see enough patients who use it on a permanent base. I remember one of my doctors telling me, that by no means I would be able to get those high peaks out of my system. Because they are part of having type 1 diabetes. Well, I don't agree. I won't say it's easy to work things out, but it can be done. It takes a lot of work and I need to remain alert. It's not always possible to bolus half an hour before I start having a meal or a snack. It needs concentration to think about the amount of carbs I'm going to have half an hour before mealtime. But it's feasible. Looking at the results, it's worth the effort and I'm ready to try out new things. My nights have been so much better. Staying away from lows and highs, I am rested in the morning. I wake up before the alarm and my head is not that heavy. I hope my weight will come down again if I can prevent more lows from happening. At least those swings in my BG have reduced and that's what I was looking for.

For the first time in years, I am using my Multiwave bolus for every meal or snack. I dose most of the insulin right away and save the rest to be delivered over one hour. That in combination with the bolus half an hour before mealtime, is doing the trick. Never give up on your diabetes treatment. There is a way for all of us, to get better control...

Munchin'

all photos Eva Joos

For over one month now, I have been using Dexcom CGM. It's been great, learning about what food and exercise, stress and emotions do to my body. It's interesting to see how a simple Latte Macchiato affects my blood glucose in no time in a negative way and how 45 min of paddling in the pool makes the insulin work a whole lot better. I'm coming to conclusions I would never have accepted without this device. My favorite coffee is now reserved for low blood sugar episodes. I keep my snacks to anticipate in dropping blood glucose.

It strikes me, that I have so many lows lately. I have to eat all day to kick the lows in the butt. How come I don't remember real coke tastes awful? I hate what it does to the enamel of my teeth.. I don't want all that sugar in my mouth. In the last weeks I have eaten so much candy I'm at risk of getting type 2 diabetes! LOL

No, seriously, I'm gaining useless pounds because of the hypo food. That's a big dislike. I've done so much to obtain my ideal weight. Don't want to spoil that because of lousy lows. The thing with low blood sugars is, that you don't even enjoy the food you are forced to have. If you have like 5 lows a day or you have a low in the middle of the night that asks for more than 50 grams of carbohydrates, I get upset. Looking at my food diary, I eat more carbs from treating lows, than there are in my meals. That is no good.

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My basal rates need to get looked at. I need to interfere more when my Dexcom shows dropping blood glucose, to be ahead of that low. It still means extra carbs when I don't really fancy them. Okay, I can have my Latte, but it's not the same. If you have diabetes too, you will know what I mean..

Tricky situations

I had this weird situation in the middle of the night. Going to bed, I had this feeling of a low coming up. Right there and then, my Dexcom warned me and I had 4 pieces of candy before my head hit the pillow. I was so tired and could only think of ZZZZZZZZ.. Just before I closed my eyes, I switched off the low and high alarms on my CGM, so I could have a good night of sleep without being alarmed of highs and lows. I hear you say: isn't that what CGM is supposed to do? Warn you of dangerous situations? Of course.. The thing is, I normally don't have real high numbers at night. So it's no problem to turn off that alarm. I do get quite some warnings though, that my BG is dropping below 70. That's not really a dangerous situation, so I decided to turn off that alarm too. Don't worry: there is still the < 55 mg/dl alarm that you can't turn off. That's also the alarm you wouldn't want to turn off, since it can prevent you from getting into serious trouble.

Anyway, I put the Dexcom beside my pillow and closed my eyes. Not too long after that first low, the < 55 mg/dl alarm went off. I guess I was too tired an tried to ignore the alarm. But my Dexcom didn't agree with me, so he kept buzzing. In the end, I did respond, but I wasn't aware of it. I overdosed, by eating way too much candy and way too many cookies. Somewhere in my brain, there must have been a spot that told me to bolus for the excess carbs. How weird is it, that I tried to "bolus" on my Dexcom.. It is not possible since there is no insulin involved in CGM, but I did enter 15 grams of carbs in my receiver..

This morning, my husband told me that my alarm had gone off several times that night. That I hadn't responded to them at first. That I had eaten candy and cookies and that I had pushed some buttons on the Dexcom. I had no idea what he was talking about, so I plugged in the receiver in my notebook and downloaded the data. There it was! The subconscious is really freaky! It makes me take action in some daze and that does worries me. So I asked him to wake me up, if I am too low to respond to the alarm. I need to be awake completely, not in some twilight zone. I don't want to give myself a shot of insulin without being fully awake. This time, I only bolused myself on the Dexcom, meaning I didn't give any insulin. I just entered data. But what if I'm low in the middle of the night and I bolus myself on my glucometer? THAT is scary... To keep myself from doing stupid things, I am no longer taking my meter to bed with me. I have my Dexcom. It will wake me up - sometimes I will need my hubby to help me wake up - and I won't have the tools to shoot up insulin. My insulin pump is hidden in a band around my waist underneath my pj's. Okay, I have had high numbers all night, but I corrected those in the morning. And I have learned a lesson once again.. The buzzer is not annoying enough at night. I need that high Hypo Repeat signal.. sorry hubby...

Nitty-gritty

I have known my friend for almost 2 years now and we have gone out for lunch on numerous occasions. In fact, we have made it a monthly meeting and there is always so much to talk about. Not that I know anything about programming software, but I think he's interesting and fun and wise at the same time. When it comes to diabetes, he's a bit of a mentor to me. His insight in the matter is terrific and so are his numbers. His numbers are so within range, that they are the numbers of a non-diabetic person.
We normally order the same lunch and we drink the same soda. Well, he orders coca cola zero and I'm hooked to diet coke. Don't think that's what makes the difference in our BG though..

Foto Jan Adriaensen

I like to try out different restaurants and different types of food. My friend is used to stick to food he is familiar with, because he knows what that type of food does to his bloodglucose. Nevertheless, he has always joined me in what we order and still, his numbers are great. We don't know where things go wrong, but he ends up with numbers that are not much higher than the number he started his lunch with. My numbers stay within range for about half an hour and then they skyrocket up to 400 and back down. Since we have made some improvements in my diabetes treatment, my BG doesn't go that high anymore, but I still saw a 270 on the screen of my Dexcom. I admit, things have been worse, but that 270 is still way too high for my own good. I still enjoy going to lunch with my friend and I am not afraid of the challenge, but I would rather have my numbers share my enthusiasm in a much lower range. I know my endocrinologist is not impressed by the theory, but I do believe there must be a way to prevent my bloodsugar from peeking that high during lunch meetings. I'm convinced that several factors could help me out: the stats and readings of my CGM ; the efforts of both my diabetes nurse and my diabetic friend to interpret and alter the settings ; me thinking straight and counting my carbs more accurate. I'm sure there will be many more lunch dates before we will have cut out all of the bad numbers, but in the mean time, we will enjoy each others company..; 

To each his own

People ask me why I would want a second device attached to my body. How weird is it, that I haven't asked myself that same question? It's that awkward moment, when people give you that pitiful look even when you don't feel sorry for yourself. To me, diabetes is part of my life, just like cooking, going to work and taking care of the household is. I get that wearing a transmitter on your arm is not sexy. Does it bother you? It doesn't bother me at all. In fact, I don't give a **** about what other people think about it. It's there to help me get better control and to make me feel better once the fluctuating blood glucose numbers are more within the area I want them to be.

Can everybody see that transmitter? Well.. I do wear clothes, you know. Yes, there's a little lump underneath my sleeve and maybe you will notice that. There's a little lump in my stomach area as well, where my infusion site of my insulin pump is hiding. People thought the same about this site in the past: what if people notice?? Guess what? I have never ever had anyone ask me what that lump underneath my shirt was. To be more honest: when I give a lecture on My Life with Diabetes, I always ask people to look for the "lump" on my body. Not one has found it so far. Sometimes I even have to pat down my body to find it myself... because it has become a part of me. I forget it's there. I now forget about the transmitter on my arm. Because I don't need to worry about it. It's fine by me. I have come to terms with it. So don't worry about me or my health. Even though you would not even think of wearing one (it's not even worth the discussion because you don't even have diabetes), to each his own. I have a wonderful family. I have a long life ahead of me. I want to live it the best way possible... in the end you will all benefit from the advantages of my Dexcom, because it will make me happier..

I wanna jump for joy

For more than 3 hours, I believed I was cured from diabetes. Despite the infusion site in my tummy, a tube going from that site to my insulin pump, the transmitter in my upper arm and my glucometer sitting on the table, for once I truly believed I could have a wonderful meal without worrying about what it would do to my BG..

Before the waitress handed us our menu, I poked my finger to check my BG. The meter read 139, my Dexcom said 144 and a steady arrow. I thought it would be a good idea to try out pasta, since pasta can be tricky for D's. Spaghetti all'Amatriciana is what I ordered and a diet coke to accompany it (I was driving, so no wine this time). I looked around us to see how crowded the place was and decided I could bolus my insulin right there and then. Okay, that's when the tricky part came: how hungry was I? How many carbs was I going to have? I know I can finish my plate if I want to, but I knew I wouldn't. I like to stick to maximum 60 grams of carbs for a meal (preferably 40). I hit the button and told my insulin pump I was going to have 60 grams of carbs. Pasta adds up easily and since I didn't bring a scale (I hardly ever weigh my food at home unless I need to scale products in recipes), my eyes would have to remain alert and warn me when to stop eating.

Dinner Date on the Dexcom G4

About half an hour later, the plates were brought to our table by a very nice young lady and we were starved and ready to eat. My BG was still in the same area - that's what a peek on my Dexcom screen told me. My friend and I talked and babbled and enjoyed our dinner (I skipped the bread, since I didn't want different types of carbs in my meal).  I saw her enjoy the bread (and privately counted the amount of carbs in those 3 rolls) and I didn't envy her at all. I added some more fake Parmigiano Reggiano to my pasta and dug in. I really enjoyed the good time with my friend and the taste of my meal. In the back of my head, I told myself to remember this place and come back some other day with my family.

Since my friend was in a hurry, we had Latte Macchiato instead of dessert (I don't regret that decision either). I couldn't explain to her how happy I was with this dinner date. Interesting and warm conversations, great pasta and perfect numbers! What else could I ask for? It has been a long time since my numbers were so great during a dinner date. I not only have a wonderful diabetes nurse who helps me understand and alter my settings, I now also have this great CGM. I'm hooked... Dex is mine, for good. As in: YES, WE BOUGHT IT!

Expect the unexpected

My numbers weren't that bad, but they weren't very good either. With an average of 147 mg/dl over the last 3 months, I expected my A1c to be higher than the last 7.3%. For two years, I had been able to keep my BG lower than 7% and that was prime time for me. It is important to keep that A1c low to prevent complications in the future. So yes, that 7.3% was a bit of a disappointment, although it was still a whole lot better than previous numbers.

This morning I had my bloodwork done at the hospital. I don't mind when nurses poke a needle in my arm to draw blood. Later that day, I got notified by my nurse that I took a wrong guess. My average BG was better than I had expected! I was gobsmacked and didn't believe her at first. But at the same time, it felt good.

I just started working with CGM. I'm curious to know if it will help me improve my numbers. That's why I wanted to have my bloodwork done this week. I'm motivated and driven and ready to kick ass!

Oh! I nearly forgot! My last A1c shows a wonderful 6.9%!

I suck..

I really suck at reading user manuals. Most of the time, I just throw them in the bin, together with the box the device came in. This time, I'm glad I didn't. I started using my Dexcom last Wednesday. I'm still testing this thing, so I can't throw anything out until it's completely mine. And then I get in trouble, when signals appear on the screen and I can't interpret them. I get lost when signals like ???? appear and make me wonder why the thing is asking me questions??? The problem solving notes in the manual explain it all, but guess what: I haven't read them. Well I have read them, diagonally.. Because I always think that I know better... I have numbers I can call and coordinates to mail people who do read their manuals or who are more familiar with technology than this nitwit. They always help me out, but it would be smarter if only I would read my own manual. Okay, okay! I will read it! I already got started, until someone distracted me and told me I didn't blog this week. So the manual is still by my side and I can read some of the words from the corner of my eye. It's like being back in highschool. I would know quite a bit of everything, but I wouldn't focus enough to get the whole of it. I'll be a better student this time. At least, that's the goal..

What if?

What if you could make life with diabetes easier?
What if some device would warn you if your blood glucose is out of control?
What if you would get an alarm while sleeping, because your blood glucose is running dangerously  low?
What if you would be able to know your actual blood glucose every 5 minutes without poking your fingers as many times?

Wouldn't that be reassuring to say the least? I would think so.. What if I tell you, this kind of system is available/for sale? Wouldn't you hop up and get one? Right.. I guess all of us would like this kind of CGMS (Continuous Glucose Monitoring System) help us get better control. Alas, only a couple of people will get the opportunity to get reimbursement when using CGMS. My doctor talked about pregnant diabetics, young children with diabetes or people with hypo unawareness. Since I'm no longer a child and I'm not pregnant, I guess those two options are out of the question. I'm fortunate that I feel most of my lows in time and although my diabetes can play games with me, I am not that brittle a diabetic. Meaning: CGMS will be at my own expense. Yes, it's expensive. And yes, it's good for me. It can help me get better control and it can help me reach my targets. It can help me prevent lows and highs and it can warn me from nocturnal out of rage numbers when I'm too tired to wake up.

I have a Dexcom G4 in my pocket. It's working just fine and it gives me RealTime bloodglucose numbers without poking my fingers 8 times a day. It tells me to watch out when a low is coming my way and it warns me if my sugar is skyrocketing. The first night with Dexcom G4, I got warned because 2 lows were hitting in. The lows didn't wake me, but my CGMS did.. When that buzzer went off, I pushed the button and grabbed for candy that was sitting on my night stand. I went back to sleep to be awakened again, only two hours later for a second low reading. Wow... I was truly impressed by the efficiency and the accuracy of this device.

During the day, my Dexcom helps me keep track of my numbers. Finally I can really tell what food does to my glucose levels during the digesting process. I'm sure it will prevent me from eating foods that aren't good for me and it will show me how to dose my insulin when eating other meals.
The software helps you understand the numbers and tells you about patterns in your BG. It is then up to you to alter your insulin schedule and prevent future highs and lows.

If only insurances could get informed about the purpose and benefits of CGMS. It could help us prevent severe complications in later life and a better overall life. I'm glad it's sitting in my pocket and I hope we will find a way to pay the bill..

If you want to know more about it, check out their website.

I struggle to understand

It was nice to shake hands and be welcomed into your office. You were friendly and we had some small talk before I popped my question. You were happy with my HbA1C, that has been lower than 7% for the last 1.5 year. I'm happy with my number too, but I worry about the standard deviation. Having a blood glucose of 45 and one of 450 in one day, is not exactly motivating. It wears you out and you feel like crap. The problem is: I have too many fluctuations in my blood glucose. There's this one book I like to follow, when it comes to diabetes treatment and that is Pumping Insulin. A standard deviation of 50 or lower, helps you prevent complications in later life. Think kidney failure, blindness, amputations of limbs. I'm an optimist, I really am, but when it comes to complications, I'd rather prevent than treat them.

You understood my question about CGM. I told you about my black out in the beginning of February. Yes, I know that is not hypo unawareness. And no, I'm not pregnant. Because those reasons are more or less acceptable if you want to apply for CGM. I do have several low blood glucose numbers a day and sometimes I don't sense them, ending up in trouble. CGM would help me prevent that. You get warned that your blood glucose is dropping rapidly or getting way out of line.

You said you wanted to discuss my application with your colleagues. That's a good idea, I assume. We'll have another get together in April. In the meantime, I'll poke my fingers 10 times a day, like so many of my friends do..

Let's call it a date

I set this date just three weeks ago. Because I definitely wanted to see him. Our next date was too far off and I needed a good conversation. It couldn't wait till May, so I scheduled a new date.

He's tall and blond and Dutch. Absolutely not the kind of man I would date. He's my endocrinologist. And what I'm gonna ask him today, will be a tough question. I would really like to convince him of the profits CGM (Continuous Glucose Monitoring) could bring me. I have my eyes set on the Dexcom sensor, in combination with my Accu-Chek Combo insulin pump. I hope he will have time to hear me out. He's a good doctor and we get along. CGM is still at own expense and since it is very expensive, I'm looking for a way to get it reimbursed after all. And I'm getting there... if only the CGM is prescribed by my physician. So Please Doctor R.. try to reason with me and help me get through to the doctor who's investigating my medical file. It would be the present of the year..