CGM causing anxiety


(amy) #1

I’ve had type 1 for 30+ years but am new to the CGM and as much as I love the constant access to my BG, I feel like having this access has also increased my anxiety. I’ve found that I’m overcorrecting when I see up and/or down arrows, which results in a rollercoaster. Any advice?


(Lala Jackson) #2

I ABSOLUTELY did this the first month or so I had the CGM. I had been T1D for 18 years when I got it so I wasn’t used to that amount of data. I had to learn not to watch my graph 24/7, put my transmitter (or phone, or whatever you use) face down or in my bag and just rely on the high and low alerts. Because of COURSE we’re going to go down a bit when we exercise or up a bit when we eat carbs, and it takes a bit for boluses/doses to catch up with food, etc. Straight line on the CGM isn’t the goal, especially at first, but more so creating more time in range, even if the line waivers between your low and high threshholds. It’s a learning process, for sure. The good news is, once I learned to disconnect a bit, my A1c dropped a full point after the first 3 months or so on the CGM and has stayed there for 2 years. So it will get better - I think it’s kind of like learning to disconnect from your phone/social media notifications lol


(amy) #3

Thank you so much! It’s that damn graph that stresses me out :wink: You’re totally right. I need to put my phone away and stop panicking/reacting.


(Dennis J. Dacey, PwD) #4

Hi Amy @amymercer, hearing your “complaint” about too much information brought a big smile to my face and brought back memories of the good old days.
you were diagnosed after the advent of BG Meters and you’ve always had a pretty good idea where your diabetes management stood; I was diagnosed 30 years prior to BG meters and even with a good hospital lab never saw the results of a “blood sugar” on the day blood was drawn from a vein.
Don’t get me wrong, I REALLY like the now instant access to all our numbers and hopefully I will use them for proper management and get my HbA1c back up where it should be. Next week I expect the endocrinologist will admonish me [again] when she see the A1c back down to 6.1 instead of the ordered 6.5 - I already read all the labs.


(Janice) #5

I loved my CGM (need to get it back) I never panicked unless my alarm went off- if I stayed within the limits I set that was perfectly fine with me, no panic, no worry. I could sleep all night if my alarms stayed quiet… After 64 years my body reacts slowly to insulin and sometimes food so watching a graph is not a great idea, but as I said, set your limits and enjoy the day ,month, year. Have a great day. Bye jan PS: Your alarms should keep you from stressing, they are reliable, trust them and enjoy life.


(amy) #6

Dennis,
you’re exactly right~I was dx within months of the first BG monitor being made available. My sister was dx 6 months before me (1985) and had to pee on a strip to read her sugars. Amazing how far we’ve come!


(lepley) #7

Yes! I call it being “obsessive” about my numbers! I just have to convince myself to stop looking, and I also take CGM breaks. I"ll just take a few days off between CGM site changes every once in a while; I find it helps level my obsessiveness out! Any advice I can give would be that it’s really a mind game. If it hasn’t been 3 hours since I’ve bolused, I don’t need to bolus again. If I’ve corrected a low with adequate sugar, I do not need to take more, regardless of what my graph is showing! It’s easier said than done!!


(amy) #8

Thank you. This feedback is very reassuring!


(Catherine) #9

I am also T1 for 30 years! And YES I definitely had issues chasing BGs. My first CGM was when Dexcom first came out, and I got in trouble chasing BGs with my Minimed pump. Now I have the Libre and I LOVE it!! But I am no longer on a pump. The first month or so, I was crazy about watching it; however, it helped me to be on shots, so I am less likely to take a shot than I would have been to bolus on the pump. After a few months, I have gotten used to the typical fluctuations and know when I need to course correct with insulin and when I need to wait it out. It gets easier!! You are NOT alone!! Sure is nice not pricking my fingers 10 times a day!


(amy) #10

I’m on MDI also and thats a great point about being less likely to inject versus blousing. And I you’re right about not having to prick my fingers all day, my fingertips are starting to feel like skin again!


(wadawabbit) #11

I’m the same way. I use Dexcom, which is great. But when I see a high reading or those dreaded :arrow_up:️:arrow_up:️ arrows I tend to take a bonus or double my basal rate on my pump temporarily. I end up stacking insulin as a result and end up lower than I want. My new doctor discussed this with me. Minimed had a pump with a semi closed loop system that adjusts for you automatically once you have done some initial programming - at least as I understand it. I’m looking into switching when the warranty on my T-Slim pump express. I love the T-Slim but think the Minimed might be a better choice and help me even things out.


(Dennis J. Dacey, PwD) #12

Just a thought @wadawabbit, before adding more insulin to your body do you glance at the “Active Insulin / Insulin on Board” reading on your pump? The really obsolete MiniMed 523 that I wear has that reading at the top of the screen; and my pump’s wizard algorithm recommends deducting that from the correction bolus.
Your wanting to change brand pumps at warranty expiration is just the opposite of mine although I’ve only ever used Medtronic pumps…


(wadawabbit) #13

Thanks @Dennis. I know I should check my IOB, but sometimes I get so concerned about the numbers - particularly if the are rising fast - that I just go ahead and manually bolus without using the bolus wizard to do the calculations for me, or waiting for things to level out. At other times, I have waited, only to keep rising into the mid 300s or so. I imagine I could do more to help myself, but it sounds like the Minimed would be a good option for me if my insurance covers it. Thanks for the advice though - much appreciated. Stay well.


(Louis) #14

Make sure you wait long enough for all the insulin to work, and it should come down gradually, but if you get a double arrows point you better start eating !


(Dennis J. Dacey, PwD) #15

You and I react alike @wadawabbit when our “sugars” are rising rapidly - treat with insulin and then think. Almost contrary to what I “preach” when talking diabetes management.

One of the times I ignore supposedly active insulin is when my BG is high [<300] and when following sick-day rules. Under sick-day rules I follow Dr. Joslin’s instruction from 50+ years ago and take fas/rapid acting insulin every two hours - by needle and syringe, not through pump infusion.

Right now my insurance will only cover Medtronic pumps - I really think that for me a better solution would be the closed loop t-Slim / G6. I’m not using any CGM now because of the sketchy reliability of the devices that are compatible with the MiniMed pumps I’ve used since 2009.


(wadawabbit) #16

Thanks for sharing, Dennis. I recall Minimed’s initial CGM was not very accurate and Dexcom’s was reputed to be more reliable. I was under the impression that Minimed had made some improvements and they were much more on track now. It’s my understanding that Minimed’s 670G system will automatically adjust when you are falling - and perhaps rising as well, I’m not sure - that once it’s programmed it “intelligently” determines on its own if it should pause delivery for a time to keep you from going low. I hadn’t heard about T-slim offering this function. Do you know when it will be available? I see my diabetes nurse educator in a few weeks so I can check with them. Thank you again for your feedback.


(Dennis J. Dacey, PwD) #17

I understand that the t-Slim / G6 configuration with auto-suspend functions has been approved and is now going into production. so probably available this summer - optimistic thinking. I’ll be discussing this on Wednesday with the endo.

The G6 [and the G5] is approved for dosing insulin without a confirmation and the G6 is precalibrated and the user does not need to do a couple of fingersticks every day, as with the Medtronic CGM.

Although my pump warranty expires this month, I suspect Medicare will make me wait another year - so I have time to investigate further.


(Chrissy) #18

I used to do the same Amy, turn off or adjust the alarms. I prefer the Libre now as I was getting frustrated by the alarms and was always chasing too. Now I can see with the Libre what is happening in the background without being beeped at!
I can keep a pretty much straight line when I am eating LCHF diet, but when I am eating carbs I have to remember to let the insulin do it’s thing.


(hardyju) #19

Hi Amy!
I have gone through the same thing!! My endocrinologist had me set my high at 350 so I would stop overcorrecting. He told me to let my basal rates work and if I am running high then we’ll adjust those rather than overcorrecting, going too low then bouncing up too high. I’m much better now about checking once in a while. Another thing that helped was to connect my Dexcom to my phone rather than using the receiver as it’s not quite as easy to access the information from your phone with just the push of a button. Good Luck!


(dobers) #20

Hi Amy - I was totally the same way! I got my CGM in January of this year and it took me a few months to adjust. At first I was constantly checking it, making bolus adjustments, going low, eating sugar, going high and so on. Eventually I got used to it and I’m thankful I have one now. I use it as a guide, rather than habitually adjusting. Good luck!