I’ve been using a glucose sensor since 2015 and I’ve noticed that there is an increase in the number of people who are able to access or self fund these devices in Ireland, so I thought I would go through a couple of things that helped me get the best out of it for some of the new users. Unfortunately, there still isn’t enough access or awareness about how life changing and beneficial these devices are. :-( However if you are interested in looking into getting a sensor I do recommend reading this webpage first.
Here are some of the things that helped me get the most out of my glucose sensor.
Timing of a new sensor insert
The research on sensors tells us that they are more accurate if inserted at a time when your levels are stable. I try to insert mine about 3-4 hours after I’ve eaten so that my insulin isn’t at peak and is trailing off. There’s also the issue that if you insert a sensor first thing in the morning that there are reminder alarms when the sensor is coming to it’s expiration while I’m asleep and are really not appreciated. So I usually insert my new sensor in the late afternoon.
Finger Sticks May Still Be Needed
Many of the glucose sensors do not require finger stick calibrations but there are still certain situations where you will still need to do a finger stick check:
If you feel low but the CGM doesn’t show low
If you’re levels are changing rapidly such as while exercising, do a finger stick to check
However, you will most likely not use as many finger stick strips if you are using a sensor and do remember to reduce how many test strips you get from your chemist otherwise you will end up with a stockpile of strips that go out of date which is wasteful.
Do refer to your sensor manual for a specific list of situations where you should check the sensor reading with a finger stick check.
Lag Time: The Numbers will be different
Number one useful piece of information to know about the “lag” time between sensor reading and fingerstick. A glucose sensor reading comes from the fluid between the cells in our skin. A finger stick reading comes from the blood in our capillaries in our fingers. The sensor readings are older than the finger stick reading by between 5 to 15 minutes so the numbers will not usually be the same and it’s best to trust your finger stick meter in certain situations.
Again, do refer to your sensor manual for a specific list of situations where you should check the sensor reading with a finger stick check.
Alarming Alarms
One of the biggest disadvantages of wearing a sensor with alarms is that it can lead very quickly to Alarm Fatigue. The first thing my sensor sales rep suggested for me to do was to set the high alarm really high for the first couple of weeks. I did this for two reasons:
Information: I wanted to gather a couple of weeks of information to get a full picture of where I needed to make changes in my insulin doses because I have a tendency to make loads of changes at the same time, when I need to make just one or two then wait to see if this was all I needed. And
To avoid alarm fatigue; this happens when the alarms go off sooooooo much that it becomes sooo tiresome and you start to just ignore it. It might be tempting to set your target range to what you hope to achieve from the get-go but the best advice I got from my sales rep was to use the highest setting I could for the high alarm, which was 16.6 mmols, and then over the coming months gradually bring it down to 10.9.
It worked! I felt that setting the high alarm would prevent this while giving me time to adjust to a sensor and gather the information I needed to improve my time in range and gradually lower the high alarm to where I wanted it to be.
Patience is Required
Most of us are beyond excited when we get our sensors and can’t wait for better diabetes management. So it’s really difficult to be patient when you see those double trend arrows to not take action. I eventually learned that to avoid rebound highs or crashing lows was to keep reminding myself that it takes time for glucose and insulin to take effect. I found this REALLY difficult in the first couple of months especially when I could see high numbers ruining my nice time in range percentages. Sometimes, it would take up to 90 minutes or a couple of hours for the extra insulin or “fast” acting glucose to have an impact and for that trend arrow to start pointing horizontally, not to mention point downwards. This leads me to my next tip.
Understanding Insulin
Dr Kevin Moore, Consultant endocrinologist spoke about this during his November webinar which can be watched here. I feel it’s really important to know how insulin works and to know about the onset, peak and duration of the effectiveness of your insulin. This is where my carb counting training was really useful and books such as “Think Like A Pancreas”
Useful resources in Understanding Insulin
Additional Resources
There are lots and lots more tips and useful information out there in getting the most out of your glucose sensor and I would recommend contacting the manufacturer of yours about training videos and resources but also to have a look at some of the links below and of course to follow some diabetes bloggers and websites.
Tonnes of videos on YouTube
Beyond Type1 10 tips to avoid throwing your cgm against a wall
Cleveland Clinic Continuous Glucose Monitoring
NHS Scotland My Diabetes My Way Continuous glucose monitoring (CGM)