I wouldn’t have thought that I would have anything new to say about the Bear using the Dexcom G4 since I’ve been a CGMer for so many years, but it is interesting how different it can be.
1. I am much better about always confirming with the bg meter before treating the Bear. I know I should always do that for myself too, but experience has proven the Dex to be remarkably accurate on me and I have body sensations to back up the data I see. If I feel low and Dex says I am low then I usually just have a few glucose tablets before actually testing. I have even been known to correct based on the Dex number if it “feels” right. With the Bear, I have no way to do a physical double-check so the bg test is critical before treating. Not to mention that our experience so far shows less accuracy of the G4 on the Bear than on myself. Interestingly, with the recent announcement of its approval by the FDA for pediatric use there is mention of lower accuracy in children than adults, and even more so in the lower ranges (check out this useful post on A Sweet Life.
2. I had no idea how much this new “thing” would engage the Bear in looking at her bg numbers, rising or falling trends, and what action needs to be taken. She asks many more questions, tells us what the CGM is reporting, and sometimes offers what she thinks she should do (it says low, do I need to have glucose tablets?). I know that the more she understands about her own care, the better her health will be through her life. I don’t know if seeing the information on the screen and having the CGM show high or low will begin to help her to understand how her body feels at different bg levels, but it might.
3. I thought that the Dexcom might quickly lead to more sleep at night — after all, I shouldn’t need to set my alarm to get up every night to see if she needs a correction or treat a low. So far, given the sometimes inaccuracy, we’re getting up more like 3 times/night trying to figure out why the Dex is alarming, or why it isn’t reading, and testing her to see if anything really needs to be done or not. Please tell me that eventually we’ll get more sleep…
4. One thing I have always loved about my CGM is that it helps me make better-informed decisions. If I am 130 before exercise knowing whether I am rising or falling helps me prepare more effectively. This is true for making decisions for the bear too, but it is also so much more complicated than before. Writing out instructions for the school, babysitters just went from 1 page to 4 pages. There is a more instinctive understanding of the data when you know T1 management well — you can do a lot of the if-this-then-that calculations quickly in your head — it’s almost “obvious” what to do given a CGM graph, a bg, and knowing what just happened and what is happening next. But, for others who don’t have such a robust understanding of how the body processes foods, reacts to activity, stress, temperature, that insulin curve (when does it start working, when does it peak, when does it stop working), the impact of basal rates at different times of day, the last i:c ratio employed, etc., etc.
We’re still learning and I imagine we will be for a while. When to react to a trending arrow and when to let it be, when it is most accurate and when it isn’t at all, and – maybe most importantly – when to take a break from information overload.