CGM, WTF?

This message would have been just as effective

I’ve been a bit remiss in my blogging responsibilities for the past few days. And those days have been pretty busy, diabetes-wise. Actually, I’ve been writing a bunch of blog entries in my head, but just haven’t found the time to sit at the keyboard and type them out. Now I’ve got to try to pull it out of my memory and make some sense of them.

But on the topic of sense, my diabetes hasn’t been making much sense lately. Ever since I opened up a new box of CGM sensors (after the “Expired!” incident), I’ve had the sinking feeling that my new box is full of duds. Considering that the manufacture of these sensors is by hand and not by machine, this comes to me as no surprise.

Quite a few of those sensors suffered from child-mortality, as they lost my trust and were discarded even before reaching three days (but no matter, I still had enough to get me through the expiration dates). They failed to track my BG closely, and it seemed that if I was outside of the 70 to 140 mg/dl range, all bets are off. And really, isn’t that the reason for CGM’s to begin with – to alert me when something’s wrong, not to give me a false sense that everything’s gonna be alright.

This discrepancy should not have happened. More on this photo later in the week.

But, finally, the sensor I had been using up through 3 o’clock this morning seemed to be trending reasonably well. Now, my blood sugar had been reasonably in control too. A few hours before bed, the CGM told me I was in the 90s, and my CGM concurred. I had a small (5 carb) snack – and bolused for it – and was 130 by both measures, with sufficient insulin on-board, when my head hit the pillow. Life was good.

Then, at about 3am, I was awaken by a “high” alert. I was 160, said the. No biggie, that’s not bad, considering how my week had been (I described the week in those blog posts that I never actually typed… sorry!). Just a quick fingerstick and…. WTF, 301?! OK, don’t panic.  Let’s try again, just to be sure. 294!  I’m angry that my

Time for a bolus by syringe (twice in one week, must be some kind of record!), hoping it works faster than the pump right now.  According to my Bolus Wizard, I need 2.4 units of Novalog to bring me back to normal.  With syringe-and-vial method, that rounds up to 3 units.

The good news is that the two OneTouch Blue results were magnificently consistent (must be that DoubleSure technology at work!). I’m used to seeing duplicate test results, especially when really high, at extreme ends of the allowable 20% range. The bad news? Well, I think my infusion set failed me. Also, I think my CGM failed me (160 and 301 are quite different, don’t you think?). Perhaps I failed myself. But I was angry at the CGM, which had just re-earned my trust earlier that day, for turning on me. At that time, I was about to declare CGM to stand for Complete Garbage from Medtronic.

Fortunately, before going to bed I had just read an entry in Wil “Motor Error” DuBois’ blog . While his experience with the Medtronic pumps has been far from stellar (it would be a riot if life didn’t depend on it), he really sings the praises – quite colorfully – of the CGM sensor: “They’re running spot-fucking-on for me,” he writes.  “And if they aren’t running spot-fucking-on for you, may I suggest that you read Chapter 9 of Beyond Fingersticks?”  At 3:30am, I was ready to read Chapter 9, because those two readings were so far from spot-on that I was uttering that other word more than I like to.

After changing out both sites on my body (infusion and sensor) at the same time – something I’d never done before in “emergency mode” – I lied down in bed, navigated back to that blog, and clicked the link on my smartphone. I nearly bought the book right then and there. I think, after I’m done with Pumping Insulin, that I will.  I understand that infusion sets sometimes crap out in the middle of the night (OK, only mid-night, never mid-day), but when my protection mechanism (CGM) crapped out at the same time, I got a bit furious.  That defeats the whole point of having it!

Fast-forward to today, and it was rather uneventful.  Woke up in the low 200’s, a correction worked surprisingly quickly, and went about my day in unremarkable fashion.

But thinking back to the overnight hours, that blog post really saved my sanity.  Because if I’m doing it wrong, I can learn to fix it.  Sometimes it’s easiest to point the finger at something, or someone, else.  But when the finger is pointed at one’s own self, then that individual has the power to change it.   That’s more reassuring than giving the finger to the folks in Northridge, CA.

(By the way, I really do love what the folks at Medtronic have done for my life.  This post could just as easily be about Animas, or Dexcom, or Insulet, or anyone else, but I’ve stuck with Medtronic for years, and right now I have no plans to switch.)

Posted on April 16, 2012, in Continuous Glucose Monitor (CGM), Diabetes, Insulin pump, Type 1 and tagged . Bookmark the permalink. 2 Comments.

  1. lovehatediabetes

    Holy smokes. Do you know what is causing the discrepancies?

    Like

  1. Pingback: The “rule of 15″ is so 15 years ago « Rolling in the D

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