Please Test
Thursday, January 10, 2013 at 8:00AM I need this post to accomplish two distinct and important goals. The first one will be simple. I want to thank my wife Kelly and my daughter Arden for both being so amazing. You'll see why in just a moment...
Second and maybe more importantly, I want to take this opportunity to remind everyone that while CGM technology is fantastic, it isn't foolproof. Because of that sometimes ignorable fact, we always have to test. Normally when we speak about this topic it's in response to the notion that you shouldn't bolus based on a CGM number. While bolusing without testing is something that we should never do, most of us probably have... but we shouldn't becasue CGM technology is designed to be used in addition to testing, not in place of.
Tonight while I was with my son Cole at his baseball practice (yes I know it's January) Arden's CGM alarmed and reported, "101 arrow straight down". Kelly, being the D-mom rock star that she is, tested.
Please test because sometimes, not often, but sometimes, 101 is actually 36. The DexCom CGM technology is so wonderful that it's easy to forget that it isn't perfect. I've been as guilty as the next person of leaning on it too much when I know that it isn't always spot on. It's difficult not to, especially after the sensor has been on for days and consistently reporting numbers that are so close to our tests. Next time that I'm inclined to think that way, I'm going to remember something that Arden and Kelly told me when I got home and I hope that you will too.
Kelly later said that she tested Arden because Arden said that her eyes "felt funny". Arden told me the next morning that it felt like she had been looking, too long, into a computer screen and then suddenly turned away. "My eyes were getting dark" she told me, with no inclination for how her words were breaking my heart.
I gave her the bolus a few hours before at dinner that caused this low... and her eyes got dark.
Most moments with type I diabetes are uneventful. Our vigilance gives us the sense that we have the disease under control, but that's a foolish notion. It's only under our control until it decides that it wants to run away. When diabetes decides to run you can't stop it. Your best hope is to chase after and keep it in sight until it gets tired of running. Then you can stand next to it again, pretending that you are partners.
We're vigilant because we can't predict when diabetes will take off running, that's why we test. You aren't taking the test, it isn't you that's being judged. It's a test of diabetes, an indicator for whether diabetes is going to stand next to you and play nice or run away.
Please test.
BGnow, CGM, Kelly, technology, type I in Daddy's Blog, DexCom Blog
Reader Comments (7)
I love this PSA. One of the reasons I gave up my CGM was because I was relying on it too much. It was just way too easy for me to rely on my CGM reading and bolus or make basal adjustments. I found a CGM made me lazy. And for me, both CGMs I tried (Minimed and Dexcom) weren't accurate enough on a consistent basis to justify cost. I am going to look into getting the Dexcom G4, but this post is still a very good reminder.
It is so easy to become "lazy" while relying on our CGM data. I learned the hard way not to bolus based on a CGM reading. Overnight once, I corrected a CGM high. Then took a moment to think that maybe I should not have done that. I tested and sure enough was not high. I stayed awake the rest of the night, taking in carbs & testing. Just to get one more minute of sleep. It's so not worth it. Great reminder for all of us; those that care for our own diabetes and those that care for someone else's.
Ohhh, I'm so glad she was okay, Scott. That must've been scary. I agree that we get a bit to comfortable with our technology doing the thinking for us (this blog reminds me of relying too much on pumps to tell us how much insulin we need)...and must remember to stick to the basics of testing!
xoxox to Arden.
It was lucky Arden realized she wasn't feeling great, and Scott, someone had to give Arden the bolus, you also bolus her everyday to prevent the highs so don't beat yourself up with the thought, sometimes when you carb count to a tee and do everything you should,it still doesn't work out. I was at an exercise class the other day with my T1d little sister, she was diagnosed in 2009 and we don't have cgm technology here in Canada so sometimes lows (and highs) are tricky to catch. She felt low about half way through, so we tested, she was 14.1. I asked her if she wanted to correct (she told me no, as she hadn't had any carbs for activity) and told her to be aware incase she was dropping quickly. (With hindsight I kicked myself as when we got in the car, my dad asked how much IOB she had- I had forgotten to check-). Near the cool down she began to wander toward the back (where her kit was) I went after her and she kept saying, "I feel low", she'd suddenly gone pale and her eyes were beginning to roll (I don't know if you've experienced this before, but it's scary.) I didn't test her, but just ripped open the dex4 juice and told her to drink. It was a surreal feeling as I fought with her, "please drink, drink the juice" and the class continued on. A couple minutes later she still wasn't looking great and asked for more juice (a normal low we wouldn't double treat w/juice but I was worried she wasn't about to black out) I ripped open another bottle and she fought only a little to drink it. Throughout this, her eyes still rolled back sometimes and I had to provide a running monologue to keep her attention. When she asked for a third juice (which she NEVER usually does, it's usually one juice and done when only slightly low) I told her we needed to test. She was going to be fine, she had two bottles of juice on the counter; so we tested and she was 9.8. Which is almost out of range but I wasn't going to argue with it. At this point it was the end of the class so we gathered up the juice,etc and made our way out.
Also, I feel the need to mention that we never usually over treat lows like that (one juice, 15mins test again) but I really didn't want to have to break out the glucagon and have all that other hassle at a public place if she did crazy drop. Also, kudos to her she never usually- unless she's crazy low- fights juice,etc, or all the needles for that matter!
Sorry this is so long, I just wanted to tell this example so no one believes they're immune to anything, sometimes the crazy lows hit, but hopefully the diligence pays off and you can cope with whatever's thrown at you.
All truly great comments that I am so pleased you took the time to share. Arden is doing fine now, thanks for the love and concern.
Chloe - your story got to the heart of why I wrote this blog post. I hope everyone takes the time to read it.
Be well,
Scott
D is a rat bastard.
Great post! We haven't been at this whole d thing very long. We are looking to get a CGM, but this is an important reminder that it doesn't show the whole picture. Testing is still very important! I'm so glad Arden is ok.