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Got my first CGM Friday (Dexcom G6) and just now got the courage to insert it. How easy! Even for a needle phobe! It is paired and am in the 2-hour warm and wait period before getting readings. I am so stoked!

I had told my endo and the supply house that I didn't want the G5 and would wait until they were shipping the G6 to Medicare patients. So glad I did because the G6 is beyond easy - and lots smaller.

I've been conservative with insulin, so conservative that I've yet to get a <100 reading any time of day. To be able to see what is going on in my body all the day long will be incredible and I think help me get a handle on how best to bolus. Since my carbs are so low, I don't often bolus and perhaps my best guess I:C (1:15) isn't accurate. Maybe I should bolus 1:10 or even less.

Don't have a smart phone and hope the Dexcom receiver will be good enough not to drive me to overkill (getting a smart phone just for my Dexcom data!)
 
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Wow. Warm-up just ended and Dexcom showed 144 bg.

I haven't eaten anything yet today (it's after noon) because I wanted to compare with meter when it was relatively stable with nothing going on. Checked with my Aviva and it was ... 144 on the nose!

Now I get to eat (yay chaffles!) and see what food and my bolus with few carbs will do. It's hard to overstate how exciting this is, and how optimistic I am about what this will mean for my control.

Kid. New toy.
 
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That initial 144 was deceptively perfect. Readings were off the rest of the day with the Dexcom staying up there, once even kicking off my 180 alarm when meter said 140 or something. Called Dexcom next morning they said to calibrate. That helped, then I needed to calibrate again in the afternoon and again this morning. If that doesn't do it, Dexcom will send a new sensor.

Am not discouraged because I see the incredible possibilities and chalk this up to learning curve, possible bad/wonky sensor, whatever. My real discouragement is that my body is doing such weird bg things. Not behaving at all as it used to.

I did buy a used iPhone off Amazon just so I could use that vs the Dexcom receiver and load other software. Too bad G6 software isn't available for my iPads. Just might end up the only person on the planet with an iPhone w/out plan, used only via wifi! Wonder how long it will take me to cave? My flip phone is nervous.
 

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I've been using a Dexcom G6 for about 4 months. I'll share my experiences in hopes that they help someone.

TLDR; It's not all "sunshine and roses" but I'd say that, overall, things are better than before I had it. Certainly my HA1C numbers are much better. I WAS getting 8s and 9s, now 6s and 7s. My wife says I am noticeably "less grumpy"... happy wife = happy life.

This thing is expensive - about half again as much as my insulin pump supplies cost.

Let me be clear, it's a very annoying device - sometimes waking me 6-8 times in a night. It beeps during meetings and especially when I am trying to talk quietly with someone. It beeps for low Bg, High Bg, Falling Bg, Rising Bg, Low battery, you're too far away from it, sensor is about to expire and probably a few other things I am not remembering. It's so annoying that I have nick-named it "little bitch." It seems like it is always complaining about something.

I find that I am sort of "micro-bolusing" now. Before the CGM I'd check my Bg, read 25 (450) and give myself 20 units, now the CGM beeps at 9.5 (170) and I give myself 4 units, then 30 minutes later 4 units more, and so on. The total insulin is about the same, but my Bg does not go super high anymore.... and I fiddle with everything MUCH more often. I do wish that it would track insulin-on-board; with all the small boluses it's very hard to keep track of the overlaps.

I've experienced WAY more lows than pre-CGM; occasionally 4-5 in one day. Having tighter control means I am "close to the edge" more often than I used to be. Raising the alert threshold from the default 3.1 (55) to 4.2 (75) helped. I live in the country so I sporadically do intense exercise - chopping firewood, that sort of thing - so when my Bg is falling, it's sometimes falling fast. I keep a jug of juice handy and, so far, no death (I hate it when that happens).

I've hooked it up to TidePool and it says I am having low Bg about 3-4% of the time; my endocrinologist says that's "pretty good" but I pointed out to him that I only need to die once and dead people have very good HA1C scores - apparently, he doesn't have much of a sense of humour. I am getting better at controlling it but there have been some scary times. Being prepared is essential.

As far as finger pricks go, I am doing many fewer. They are definitely not eliminated entirely but I sometimes go 24 hours without one. Before the CGM, I pricked 4-5 times every day. I don't miss them at all.

The CGM is not entirely trust-worthy. I could probably eliminate 50% of my remaining finger pricks if I had more confidence in the device. Of 12 sensors, I had one that never worked correctly (just gave sort of random numbers) and another that worked well for about 7 days and then sort of "lost its mind" (gapping and giving insanely incorrect readings). I also had one that just quit on day 9 but the remaining 9 sensors worked pretty consistently for the advertised 10 days. The moral here is "don't just do whatever the robot tells you."

The CGM literature says that 90% of the time it's within 20% of actual Bg and that's probably technically accurate. Two things about that though: 1) 20% error is quite a lot when your Bg is 4 (72) and 2) the OTHER 10% of the time can be quite troublesome. Other people on the forum have said that recalibrating helps but that has not been my experience; my experience is that a sensor that is significantly off just keeps going off, recalibrating only seems to help short term.

The 20 minute lag (CGM is about 20 minutes behind the meter) takes some getting used to. You need to always consider the direction and rate of change. That's not something that I ever thought about pre-CGM. The CGM has an arrow that is supposed to tell you direction and (roughly) rate of change; I am not sure how they calculate that but it's often incorrect. I now always look at the graph and decide for myself what the direction and rate of change are.

Considering the lag, the many small boluses, the direction and rate of change, carb to insulin ratios, effect of exercise, and etc., there's quite a lot of (fairly simple) math that needs to be done. If that's not something that you can do easily, then a CGM will make things much more complicated.

But I guess the most telling thing for me was when there was a mix-up in shipping my CGM supplies and I had to stop using it for about 10 days. OMG it was so hard! My expectations had been reset by the CGM and it was next to impossible to match them without the device. Once you get used to a CGM, it's very hard to go back to finger pricks alone.

For all of its foibles, inconveniences and expenses, I think it does actually "make my life better" which is what's really important.
 

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Hello justdave, welcome to the forum.

Very informative, always good to hear of others real life experiences of anything related to diabetes. Myself, as a non-insulin using type 2, probably have no need for a CGM, but would like to try one none-the-less, just to see my BG response to eating, exercise, sleeping, stress, etc. I was under the impression that I would know my BG level every 5 minutes. Am I understanding that you are saying there is about a 20 minute lag between a finger stick and the CGM reading? I am assuming this is for similar reasons of lag time of alternate blood testing sites (ie forearm, thigh, etc) vs the finger stick but just a longer lag time. Have you found that sensor placement sites (arm vs leg vs belly etc) can have varying lag times as well or is it fairly consistent irregardless of sensor placement? I know that the introduction of the CGM has been a great improvement of controlling BG. Looks like room for improvement to avoid over/under compensation, maybe further advancements in the CGMs will shorten that lag to reduce or hopefully eliminate that 10% troublesome time. My hat is off to all insulin users, I can only imagine the extra efforts you have to put in.

Just curious if you also use diet as part of your BG control regimine?
 

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Hello justdave, welcome to the forum.

Very informative, always good to hear of others real life experiences of anything related to diabetes. Myself, as a non-insulin using type 2, probably have no need for a CGM, but would like to try one none-the-less, just to see my BG response to eating, exercise, sleeping, stress, etc. I was under the impression that I would know my BG level every 5 minutes. Am I understanding that you are saying there is about a 20 minute lag between a finger stick and the CGM reading? I am assuming this is for similar reasons of lag time of alternate blood testing sites (ie forearm, thigh, etc) vs the finger stick but just a longer lag time. Have you found that sensor placement sites (arm vs leg vs belly etc) can have varying lag times as well or is it fairly consistent irregardless of sensor placement? I know that the introduction of the CGM has been a great improvement of controlling BG. Looks like room for improvement to avoid over/under compensation, maybe further advancements in the CGMs will shorten that lag to reduce or hopefully eliminate that 10% troublesome time. My hat is off to all insulin users, I can only imagine the extra efforts you have to put in.

Just curious if you also use diet as part of your BG control regimine?
I understand that the lag time for the CGM is because it is inserted into fat cells whereas a finger prick tests the blood directly. I have not noticed any difference by site, but I have not experimented with that. As for diet, type 1 is a bit more flexible than type 2... it becomes a "balancing act" rather than "carb aversion." That said, each dish requires subtly different insulin to balance. An extra half hour of wood chopping has an outsized effect on Bg. What I am am saying is that the balancing is easier if you eat the same things, day in and day out; do the same exercise, day in and day out, etc. This is what my endocrinologist calls a "monkish lifestyle." I try to be consistent but, honestly, I'm pretty bad at it.
 

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A balancing act is a very good description. I too am imperfect with my act as well. JMO we all, diabetics and non-diabetics alike, need to try to keep our scales balanced and not overload either side too much then try to counterbalance. What I've seen in all the reading I've done is that too much insulin in circulation is bad too, especially related to heart issues. Looking forward to reading more of your posts.
 
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