The great CGM experiment
"This thing costs $1,000. Please don't drop it in the toilet. With those words of wisdom, I was ready to go. I had the opportunity in May to use a continuous glucose monitor (CGM) for a week. The CGM tracks blood glucose levels 24/7 to pinpoint potentially problematic patterns.
Being mindful of what I am doing, eating, drinking, dosing at all times. The numbers that the CGM tracks mean nothing if the diabetes educator has no idea what I was doing at the time.
Right now, those numbers are trending unpleasantly upward. Hmmm.
This morning I dutifully calculated my insulin doses, planned my food for the day--all of it healthy--and measured it all out. The end result of all this due diligence?
My numbers are too high, trending in the low 200s. I went from 69 at 3 a.m. to 237 at 8 a.m. There are lots of potential reasons for that 237, which is why I am doing this experiment in the first place.
Overnight blood sugars were rock steady. Unfortunately, the CGM was experiencing bouts of lows. Starting at 3 a.m. it woke me three or four times. The first time I checked my sugar and learned I was a perfect 107. Needless to say, by the 3rd time around, at about 5:30, I was feeling that the CGM was a little too needy.
It's like that school experiment where you take care of an egg or a doll to see what parenting is like. The CGM must stay within 5 feet of me at all times. It goes to the bathroom with me, sleeps with me, and needs to be fed data every few hours. I am constantly checking in with it to see what it is doing and if it needs anything.
It's kind of like...having diabetes.
I am discerning patterns that will need to be addressed, like the fact that I seem to need more insulin at breakfast and lunch, and less at dinner.
By the time the diabetes educator pried the device out of my hands, the CGM had become second nature to me. I found myself going to check it several times, forgetting we were no longer attached at the hip.
At the doctor's office, we printed out the data. Turns out, I go low almost every night, usually around 3 a.m. (this is something that I have long suspected). That's probably causing a morning rebound. That means, rather than take more insulin at breakfast--my first reaction--I will take less insulin at bedtime. We are making other tweaks as well.
Technology is an amazing way to problem solve, in a way that old-fashioned log keeping--and guesswork--cannot.
This experiment also really underscored what it means to be proactive in health care, rather than reactive. That's something that HME providers have long understood, and it's something that I hope insurers and lawmakers are beginning to realize.