Best device for short term use?


(rvedt82) #1

Hi everyone, so I have a question to ask. I’m looking to know what is the best device to use for my situation and here it is: I want to wear a device just while sleeping at night so if I have a bad low, it’ll wake me up in time to treat it myself. I’m on daily injections and keep my A1c between a 6 and a 7. I was on the pump when pregnant with my daughter but a year after wearing it my skin became super sensitive to the catheter adhesive. I’ve been a Type 1 for almost 30 years. When I was a kid I would get bad lows at night and wake up screaming. My parents would wake me up out of them and treat accordingly. Well, as I grew up I didn’t have bad lows like that anymore. Then fast forward 25 years and after having my daughter I suddenly started getting the bad lows again at night and my husband has to wake me up.
I get them about once every month or two months. I’m diligent about checking my numbers and have a strong handle on my long acting and short acting insulin doses. However, I still get these lows every now and then and would like to be able to wake up before my husband has to scramble to grab the juice. So, if anyone out there could post what they might recommend, I would greatly appreciate it! I’m not looking to go on a pump. I’m just looking for the best device to use to track my blood sugars while sleeping. Thank you!!


(Dennis J. Dacey, PWD) #2

Hi @rvedt82 ,

I was going to suggest a “wake up” system that worked for me years before CGM were invented - my wife. Yes, she is a light sleeper and I’d give of lots of heat that awoke her.

A non-invasive Glucowatch CGM which I gave a trial run didn’t work for me, so now I just make certain that I’m high enough before getting into bed. I’ve had extremely brittle diabetes for 60 years and I can drop suddenly drop without any identifiable reason [ it has been documented at least two times when heavily monitored in hospital] . There is currently a non-invasive CGM [I forget the name] under development - see if you can volunteer as a tester.


(rvedt82) #3

Hi Dennis!

Yeah, my current system is my husband, but he’s the one who wants me to get something else because he doesn’t like being woken up when it happens. I don’t see how getting something that’s going to set off an alarm WON’T wake him up, but I think he just wants me to be able to treat it myself so he doesn’t have to get up and wake me out of it. I usually keep myself a bit high before bed too and will have a snack as well but life happens. Sometimes the number is too high before bed (I was running high for a couple days due to a head cold) and even when I’m lighter than normal with my Novolog dose it can still drop too low. My endo hasn’t been too pushy to have me hooked up to anything. I’m really sensitive to my numbers while I’m awake (thank God) and can feel when it drops below 70 or goes into the 250’s range and above. So, it’s just while I’m asleep, and I’d say 50% of the time I’m able to wake up myself.
I’ll look into that non-evasive CGM trial you mentioned. Thank you for responding to my post and congrats on the 60 years. :slight_smile:

Sincerely,

Rachael


(Dennis J. Dacey, PWD) #4

Rachael,
I have another “helper”, my older age now in my later 70’s. I can no longer sleep through the night without needing to visit the toilet; so when I awaken about 3 AM I then head into the kitchen and check my BGL.

The endocrinologist I currently see is not yet pushing me [see what she says this week] to get a CGM and my wife says I’m doing ok without one. I used to be better at recognizing my sudden drops but now I may be “just to stubborn” - on two occasions my wife has found me passed out - the worst time was when I was found with a test strip in my meter, BG 10 and the paramedics worked on my for an hour before my eyes flickered. Yeah, they ran a couple of ample D-50 through an IV.


(rvedt82) #5

Hi Dennis,

Have you heard about or tried this product before? It’s called the Diabetes Sentry Hypoglycemic-Symptom Alarm. It doesn’t track your blood sugar, just body temperatures when you wear it at night so it sounds an alarm when there’s too much of a fluctuation. Since I literally wake up in a pool of sweat whenever I have a really bad low, I thought this might be more practical to me vs. the Dexcom sensor. And dealing with that. It’s pricey up front but then you just have to pay for batteries (like $15) every six to twelve months. However, I’m willing to pay for it if it wakes me up at night to avoid dropping too quick.

Were you awake when you had your sudden lows that required paramedics?? I’m hoping I can still continue to feel them during the day while I’m awake. Only time will tell I guess. :confused:

-Rachael


(Dennis J. Dacey, PWD) #6

Hi Rachael,
I need to look into the Diabetes Sentry Hypoglycemic-Symptom Alarm and see if it might work for me - and for all day wearing; I’ll ask the endocrinologist this week when I see her. When I had tried the GlucoWatch years ago it proved inaccurate because I had too much perspiration in warm Florida.

The three times I’ve needed paramedic assistance were all in the daytime and all within the last dozen years - not when sleeping. Of course when I ‘needed paramedic assistance’ I’m not counting the times our daughter did stuff, or directed me to do stuff when she spotted me headed low - she was a paramedic for 30 years.

When I look back at the three times, I can [almost] attribute the severity of those hypos to my stubbornness; I recognized that I was going low but each time I figured I could finish the job I was doing before checking BG and getting something to eat. Yeah, I’m not a good model for others in that respect.


(rvedt82) #7

Hi Dennis,

So funny story…after starting this conversation with you, last night I felt myself getting low (around 9pm or so) and I was in my kitchen trying to treat it with a couple fruit snacks which I managed to eat, and the next thing I know, I’m on the floor in front of my fridge and my husband is once again trying to force juice on me. So, eventually I came to, but I think on the way down I broke my foot because I can’t put much weight on it and it is extremely painful when i flex my toes. So, on that happy note I’m going to see my podiatrist tomorrow for X-rays and in the meantime I’m in my boot that I usually wear on my other foot for occasional stress fractures. This one feels a lot worse though, so we’ll see what my doctor says. Just in time for trick or treating with my daughter too for Halloween! My husband started arguing with me again about how I need to be on the sensor 24/7 but I told him I was AWARE of the stupid low and was treating it while it happened. The sensor doesn’t treat the low, just alerts you, and in my case I think if I’d been wearing the sensor it might have blown up. It was pretty bad. Oh, and i know why I got the low. My insurance stopped covering my humalog and switched me to Novolog, and for me, I’ve discovered I’m a lot more sensitive to it. Usually I have the same diet and schedule, but yesterday was spent doing completely different activities and eating a bunch of stuff that i obviously over-treated for. Yay for fall festivities. So I’m still trying to adjust how much I give myself for what I eat. It’s been about two months since I started the Novolog so I’ve figured out how much to take for my blood sugars but I’m still working on the food component. Anyway, I thought I’d share that fun story with you as you are the only one I’m talking to who can truly empathize with what I’m going through.
So here I am, sitting with a bum foot probably for the next eight weeks. Just in time for more holiday festivities. I can’t wait to see how it’s gonna work putting up the Christmas lights this year! (I’m the one who typically does all the decorating). I hope you had a better weekend with the diabetes than I did!

Take Care,

Rachael
rvedt82@gmail.com


(sophiespieg) #8

Hello!

I would recommend the Dexcom CGM. I’m not sure if you’re familiar with it, but it’s a sensor that can alert you when you’re going high or low and sends the info directly to your phone. The actual sensor is extremely light weight and doesn’t irritate my skin at all, since that’s a concern for you. Although it would make sense fiscally to keep the sensor on for as long as you can (usually sticks on me 3-7 days) you can also adjust the settings on your phone so that the alarm only goes off when you’re having a low if you don’t want it to go off on you during the day.


(rvedt82) #9

Hi Sophie,

I am in the process of getting set up with one. I’m hoping it will help catch the lows in time before it gets too serious at least while I am sleeping. Thank you for your feedback!

Sincerely,

Rachael


(Dennis J. Dacey, PWD) #10

Rachael, you’re not to do the scary things until tomorrow night!
Oh, I feel for you and can certainly relate to you when you say that you knew you were low and just a few minutes too late getting the fast-acting carbs working in you. Did your husband get the juice into you? After a couple of times when someone had to try getting juice in my mouth instead of on my shirt, my wife started keeping a couple of tubes of cake frosting on the kitchen counter - it is loaded with sugar and it can be squirted through your lips where it melts and is swallowed easily.

A thought on choosing a CGM - if you are using one of the newer few models of the Medtronic pump, the CGM feeds directly to the pump and has a “suspend” feature that operates when you reach the threshold you set or if you are dropping rapidly. The latest Medtronic CGM is supposedly very good - I’ll learn more soon as the featured speaker at our November TypeOne “Cups of Hope” meeting is from Medtronic - last month the Dexcom representative spoke; I was impressed with her data.

I understand how Novolog and Humalog switching needs care. I began using Humalog the Month FDA approved its use - April 1996 and switched to Novolog beginning of 2005. The doctor suggested that I I program my pump so that the total insulin I’d receive per day was 70% of what I had been using; I started at the 70% and gradually worked up to about 85%. I have always set all rates and ratios on my pump on my own and tell my doctors [later] what I have done. January 2016 I had to switch back to Humalog [yep, insurance] so I changed all pump settings to deliver about 15% less insulin – it worked well. My theory, and a few medical professionals have thanked me for this observation, is that over time my body [our bodies] become accustomed to a particular formulation and we are more sensitive to the other. One of these “rapid-acting” insulins is made from yeast, the other from bacteria - yet their impact on us is strikingly similar.

Now for your foot - do be careful and take care of your feet. I’ve never had a bone in my foot break but I understand they are very painful. - Our granddaughter, a pointe ballerina, can emphasize with you in that.

Dennis


(T1DJJC) #11

Dennis,

I was waking up shaking and sweating on the worst night I tested at 23, not good as you probably know. I now wear a Dexcom G5 and absolutely love it. It’s alarm wakes me out of a dead sleep and I find it extremely helpful during the day as well. I don’t think there is a “night only” solution that’s reliable enough and I didn’t want to wear something all the time but I don’t even realize the Dexcom is in me until I touch it or see it.

That’s the only reliable way to detect the lows earlier so you can treat before you get hypoglycemic.

Good luck.


(hopekyra) #12

It looks like you already have some great advice in this thread, but I just wanted to throw it out there how thankful I am for my Dexcom! I have kept very tight control of my blood sugar lately (have been below 6.0 A1C for the past two years now!) and I have lost a lot of my hypoglycemic awareness because of it unfortunately. My Dexcom has saved my life/kept me from getting so low that I’d go into a seizure more times than I can count. I highly recommend using Dexcom if your insurance will cover it!

By the way, I also had bad skin sensitivity to the adhesive on my infusion sets when I first switched to a pump two years ago. I tried SkinTac and some other wipes, but I’ve found the only thing that truly works and leaves my skin without any irritation is 3M Durable Barrier Cream. You can buy a tube of it on Amazon for pretty cheap and it lasts forever! The adhesive on Dexcom units doesn’t affect my skin, but the adhesive on pump infusion sets does for some reason. I was SO HAPPY to find a solution that stopped the hives and allowed me to get even tighter control of my diabetes without ruining my skin, so I thought I’d pass along the info :slight_smile: I was like you and kept my diabetes really well managed on shots—kept A1C between 6.0 and 7.5 for 10 years on shots but am super happy that I’ve been able to drop even lower with a pump. Don’t let that stupid adhesive stop you from using a pump if you want to!!


(rvedt82) #13

Hi there! Thank you so much for your reply and for the helpful advice regarding the cream you’ve been using for the adhesive issue! My skin is ridiculously sensitive these days (I’m assuming due to the diabetes) so I moisturize like crazy. I use fabric bandages now any time I have a cut because regular old band aids would irritate my skin and make whatever I had originally going on much worse. Those I also order off Amazon because they’re hard to find where I am or are always out of stock.

The skin irritation was one issue I had with the pump. The other was that I just simply hated having a tube coming out of me which was just a constant reminder about the diabetes. Granted, it’s not like I’m avoiding it (kinda hard to do so after having it for so long) but I just really enjoy the freedom of doing my two long acting shots each day, and then quickly taking my short acting insulin when needed. I’m not hesitant to test my sugar or take a shot while out in public. I know I’m against the norm saying this but it’s just what I prefer.

I literally almost had a heart attack tonight (there’s another machine I’d probably need for that) after getting off of the customer service line for Dexcom. I’m covered health insurance-wise under my husbands plan and he works for a well known tech company so I’ve always considered our coverage decent. But when they told me how much it would cost for the on-going supplies for the sensor let’s just say I’m glad my kid wasn’t in the room regarding my response. So I’m calling my insurance company tomorrow to see if Dexcoms numbers are legit and if they are, I might be scrapping this sensor idea. I might be back on my plan to go with the Hypoglycemic System alarm I found on line that detects sweat levels. I’d only wear it at night and when I have a bad low the sheets are soaked so it might be the best way to go for me. I’m still really sensitive to my lows and highs during the day so I’m not super excited to wear something then. Down the road if I lose the sensitivity, then I’ll be using something, but I’m hoping there will be more progress in the way of a patch, watch, or even maybe a ring that could be worn to detect sugar readings. One can hope, right?

So yeah…I’m going to call my insurance company tomorrow to see what’s up with coverage, and then I guess I’ll go from there.

Thank you again!

Rachael


(hopekyra) #14

Oh my, that’s awful if they’re wanting to charge you an arm and a leg! Thankfully, my insurance considers CGMs to be preventive care, so all my Dexcom supplies are covered at no cost to the patient. :raised_hands:t3:

Best of luck with insurance and with your other options if the CGM doesn’t end up working out!


(45yrsT1) #15

I use a Dexcom G4 CGM covered by a waterproof Tegaderm dressing. When applying the dressing do not stretch it as stretch causes shearing burning effect on the skin. Hope this helps.


(rvedt82) #16

Hi again! So just curious…how did you get your insurance company to deem the CGM’s as preventative care? I just got off of the phone this morning and mine said a glucose monitor is covered but the sensor is billed under medical equipment and supplies which goes towards my high deductible. So yeah…how are regular people able to afford this thing??? $300 a month for one kit is crazy and at that rate I’m paying in full for almost a years worth of kits until my deductible is met.


(hopekyra) #17

Ugh, I’m sorry. That stinks. I actually was expecting to need to pay for my Dexcom supplies, but it was like magic–the first time I ordered, there was a bill of $0.00 and it’s been that way ever since. I have Anthem Blue Cross Blue Shield in Indiana. I also pay for the highest premium insurance through my work–which is thankfully still really cheap at around $125/month because I work for a large university and we get great rates (part of the reason I will probably never leave this employer)–so that my deductible is low (I hit it within the first couple months every year). So, I’m not sure if it’s the insurance company itself that considers it preventive or if it’s just considered as preventive and covered under my specific plan. I would assume it’s the insurance company, though. It completely makes sense to be considered preventive since it means reduced hospitalizations that the insurance company would have to pay for due to crazy high or low sugar levels.

Unfortunately, I think your situation with your insurance company is pretty common. I was actually reading a thread in a diabetes advocacy facebook group today about this exact problem. Someone had posted that they’d been denied coverage for an insulin pump (even though they’ve been on one for a long time) because their A1C is below 7.0. Other T1Ds and advocacy groups commented that the same thing happened to them with Dexcom:

“we have seen rejections for CGM renewals for people whose A1Cs are low because insurance companies don’t see them as medically necessary in general. Which is also awful, but we see those much more often than pump rejections.”

“We have a huge local insurance company that monopolizes everything in our state. Their policy on CGM is if your A1C goes down you can get your cgm supplies. If it goes up youre denied. There’s no way to get it back either. If your A1C goes down when you’re denied, you obviously don’t need CGM.”

Obviously insurance policies are set by people with no medical degree or background, which is dangerous. They don’t understand the diseases they are covering… or not covering. Maybe there is some way to appeal your insurance’s decision about it not being considered preventive care?


(rvedt82) #18

So I think I’m just going to try the Diabetic System Sentry Alarm. It’s $430 but I’m pretty sure I can use my HSA account for it and not pay out of pocket. I also won’t have to worry about calibrating things or skin issues. I’m so fed up with health insurance companies right now.
I have Premera Blue Cross and I know my husband pays for the best plan available through his company. It’s just sticker shock I guess because the syringes, test strips, and insulin are next to nothing.
I had to purchase a boot for my foot that’s prone to stress fractures earlier this year and it was ridiculous how much back and forth work was involved going through the medical supply company where i bought it and my insurance company just to cover the cost. And I still ended up having to pay for a part of it. There was one on Amazon and if I remember correctly I could have spent $20 more out of pocket and just picked up that one. Was all that time I spent going through insurance worth it to save $20? NO. So yeah. And I’m still trying to figure out how the Novolog is affecting my numbers based on what I eat after my insurance stopped covering my Humalog a couple months ago. So then there’s that.
Do you belong to any Diabetic groups in Indiana? I’m in Seattle and haven’t found many in my area through the internet. I’m 35 so I’m a little too old for the juvenile diabetes association group out here :wink: but it would be nice to be able to meet up with other type 1’s just to talk and empathize about things related to this fun disease.
Anyway, thanks again for the reply. Your company sounds great and I’m glad you have such awesome coverage!!