The Diabetes Forum Support Community For Diabetics Online banner

1 - 15 of 15 Posts

·
Super Moderator
Joined
·
6,162 Posts
Discussion Starter · #1 ·
Hello all, has been a long time! - and equally long since I paid active attention to my diabetes. These things went hand in hand. Have been gone so long I wasn't sure whether to put this post in Introductions or Diabetes :)

As way of introduction to those who don't know me: once upon a time I had great control. After several years I became a little less exacting but my bg stayed in normal range. Then I needed to take a massive dose of steroids for a while and went on insulin in an effort to control the extreme (to me) highs. Once the steroid was eliminated from my chemo therapy I stopped insulin and also sadly attention to diabetes. Not only did I not come here, I didn't even test. Was quite sick and dropping balls (bye diabetes!) was how I coped with the overwhelm. Not smart, but am not beating myself up about it. It happened.

My continued compromised health means I get myriad tests regularly, including monthly metabolic panel. Even though I wasn't testing, I did watch my bg increase into the 200's and while concerned, all I could manage was to be more diligent with my carbs, but it wasn't enough; bg continued inching upwards. Finally snapped back to sanity and my endo for insulin. It was time. Had it really been 3 years?

Started insulin (Tresbia and Novolog) 12 days ago and am relieved finally to be dealing with my diabetes. The day after starting insulin, got the results of the last metabolic panel and saw my bg had crossed the 300 threshold. Holy smokes! My kind endo said, "at least it wasn't in the 600's" which is where it was at original dx.

The first week I was having 50-70 pt glucose swings. My carbs have been <50/day, some days around 10, and I had started a conservative insulin dose. I'm now after about 2 wks starting to see a bit more stability and am back in the 100's. A urinalysis indicates I'm in ketosis.

I did not get into this trouble by eating bread, rice, potatoes, sweets, etc. During my diabetes blackout, I continued - mostly - eating the way I had. But, portion control fell by the wayside and I stopped eating enough fat. My protein increased a lot and certainly my carbs increased (lots of macadamia nuts!). Things that are fine, and good, in handfuls, become not so great in cups. I cooked almost never.

Definitely encountered a learning curve - even forgot how to use my simple lancing device! But ... am back in the saddle and dismayed by the rise in insulin prices (criminal!). Combined with other supplies, diabetes is definitely a serious budgetary line item now.

My endocrinologist told me about the Libre (man I've been out of the loop for a long time) and that it might be a good option for me. Medicare allows scant strips and on insulin I test 8-10x/day. I think the Dexcom is also Medicare-approved and will discuss if she thinks I could get that instead.

Would love to hear opinions on Libre vs Dexcom from anyone who has used both, or those who chose one over the other and why. From my reading, it seems the Dexcom could have a slight edge in accuracy but if so it's scant and hardly a deal-breaker. Like the fact Dexcom can alert when headed to a low. Even though I've never experienced one, it is inevitable if I'm to remain on insulin and achieve tight, normal bg levels.

Have lots of work to do in order to figure out my ratio (using 1:15 right now), basal, protein bolusing, etc. My diabetes surely was simpler when as long as I ate few carbs and adequate fat I was good. Was never plagued by dawn phenomenon and my diabetes was stable and predictable.

My hope is that once I give my pancreas a rest I might be able to go back to managing my diabetes without meds. That is way thriftier. But if not, am resigned and okay with insulin.
 

·
Super Moderator
Joined
·
9,660 Posts
Hi moon, welcome back. Sorry you lost your way for awhile with D. Knew there were other things involved but so glad to see they didn't have the effects that had run through my imagination.
 
  • Like
Reactions: moon

·
Super Moderator
Joined
·
6,162 Posts
Discussion Starter · #4 ·
Promise! And humble apologies.
 

·
Registered
Joined
·
790 Posts
Hello Moon :)

I've never used Dexcom and would never be able to afford it (I'm in Australia and very few of these things are subsidised). I was using the Libre system for a while, and when it worked, it was magic. You don't get alerts for a BG thats going up or down, but trends are shown on the reader, or your iphone if thats the way you roll. There's a delay with the Libre, they say its about 20 minutes, IIRC, so its 20 mins behind what your bloods would say. Ergo, it will measure higher or lower, depending on the trend. Overall, though, it does help with regaining control. I miss using it and despite having declared I was over it (I'd had a lot of failures either because of a fault in the sensor, or because I knocked it on something) I'm planning to restart. My fingers will thank me. I've been finger testing for a month now and doing it less and less because I hate having to stab fingers several times a day. Scanning is much more convenient.

Hope this helps in some small way :)
 

·
Super Moderator
Joined
·
6,162 Posts
Discussion Starter · #7 ·
Thanks kyteflyer.

Just back from my endocrinologist and can choose the Libre or Dexcom. Asked her opinion and she said the Libre is more user-friendly, the Dexcom more tech, but that that wouldn't be an issue for me. My insurance (Medicare in the US) covers both - Libre 100% but could be co-pay with Dexcom.

Wanted to know if I start with Libre if insurance would allow me to switch if I wanted - she said yes. So that's probably my answer. Will start with Libre.

Have read that some people placed the Libre on their belly (even though not recommended) and that it worked okay. My endo hadn't heard of that but didn't tell me not to.

Since they are both measuring the same thing, they're equivalent in accuracy - at least from my readings. My endo claimed I didn't have to do finger pricks unless it shows high or low.

Have read once we get used to the Libre and its quirks, what to expect from a sensor so we know when a new one is wacky, etc, that it goes a lot more smoothly. Hopefully this will happen with you.

I won't be able to get approval for it for another 3 wks or so, but when I do, it will be great to compare notes on how it's working for us.
 

·
Registered
Joined
·
790 Posts
I havent restarted yet, the costs are fairly prohibitive and I’m saving for a new air conditioner, the one I have seems like its going to die pretty soon. I really want to, I’ve started not testing again (though I am bolusing if I do have carbs) but a lot of the time I dont bother testing because I am over finger stabbing. Going to have to redo the budget to account for the extra cost of the Libre ($204/m). I guess the other thing is that having the sensor tell you what your BGL is doing (as in trending up or down) does give a better idea of how to manage. When finger testing, you dont get trends.
 

·
Super Moderator
Joined
·
6,162 Posts
Discussion Starter · #9 ·
Sorry about your A/C - and the horrific cost of simply trying to manage our diabetes. Hope you're able to work it out soon.

I'm fortunate in that the Libre and Dexcom are both 100% covered by US Medicare. Will just have to buy strips (they won't cover both) to verify some readings along the way. Have decided on the Dexcom 6 which isn't yet shipping to Medicare patients but is due to later this month. Hopefully. In the meantime am finger-sticking but not at the 10x/daily rate I was when I started paying attention again.

Agree about the trends. That will be interesting and I envision some OCD monitoring in the beginning. Will really help in understanding my bolus curve with various foods, something that is near pure mystery right now. I need to learn how to bolus more effectively.
 

·
Super Moderator
Joined
·
6,162 Posts
Discussion Starter · #10 ·
2-month Progress Update:

Got my A1C back yesterday, 2 months after my last one, and went from 9.5 to 8.1. Thought it would be a bigger drop but know I'm on my way.

Got a Dexcom G6 cgm, on my 4th day w/ it, and on a learning curve. Love it so far though clear on the down sides. The pluses are far greater than minuses. Now I just need to find what software will help me track things better. Did break down and get a smart phone (used iPhone 7 Plus) in lieu of the Dexcom receiver (no, won't pry my flip phone from me!) so I can better see the chart and it should open up software possibilities. Dexcom's Clarity isn't totally what I want but it will be a start. It's fully unlocked so if I really really get the bug I can get a plan. :devil:

Have not broken 100 fasting dadgummit, but have been in the 100-naughts a few times. My bg seems to hover in the 100-teens/20's during the day.

Last night I splurged on a meal that was calculated ~45 carbs. That's huge for me and I'm no longer Keto ... just barely out I think. Bolused 3 units and kept watching bg. It worked perfectly! I didn't go over 122, stayed pretty much in the teens, and that is giving me confidence. The dish was a chicken tangine and the carbs came from tomato, artichokes, onions, currants, spinach, etc so those carbs were hitting my system over a longer period of time and the bolus handled them beautifully. Will go back into keto soon, but currently am around 50-60 carbs/day.

I went from my head firmly in the sand, to tracking myself constantly, and that's the best progress there is. The goal is to settle into an attentive normal!
 

·
Super Moderator
Joined
·
6,162 Posts
Discussion Starter · #11 ·
Woot! Am having surgery the week after T'giving and was concerned about my A1c going in to it (and figured they would be at my anesthesia appt later this week). Although I had brought my A1c down from 9.5 to 8.1 in 3 months with insulin, it was frustrating since I was super low-carb, keto a month of the time, testing 10x/daily at least, etc.

Enter Dexcom! I've had it a month and it has been revelatory. Definitely changed how and when I bolus, when to eat what, etc. Anyway - because of the surgery, I asked for an A1c to be included in my monthly bloodwork to take to my appt and just saw it online ....

8.1 to 7.1 in a month!

Thank you Dexcom!

- moon, en route back to the 5% club
 

·
Super Moderator
Joined
·
6,162 Posts
Discussion Starter · #13 ·
Thanks VeeJay! It is amazing to see the graph of my bg throughout the day, comparisons, impact of activity (and lack thereof), hydration, fats, protein, time of day, everything. I have learned so much.

Can you tell I'm enamored of my CGM? :)
 
  • Like
Reactions: VeeJay

·
Registered
Joined
·
790 Posts
Thanks VeeJay! It is amazing to see the graph of my bg throughout the day, comparisons, impact of activity (and lack thereof), hydration, fats, protein, time of day, everything. I have learned so much.

Can you tell I'm enamored of my CGM? :)
Brilliant! I have finally restarted my Libre, too. I love being able to see what my BG is doing.
 
1 - 15 of 15 Posts
Top