Too Trusting?

(Second post of the day, I know, but I wanted to blog this in hopes to get some tips on how to boost my testing. What helps you remember to test?)

I absolutely love my G4 CGM system. The increased range is awesome (read: I have left the receiver in my car and forgot about it at night and ran back out to get it and it still had received my readings!) and the ability to wear the sensors has improved from an average 2 weeks for me to an average of about 24 days. And when you’re on a budget and knowing these sensors cost you about $75 each, you wanna make them last as long as possible. I can stomach an average of $3 per day verses $10. BUT, overall, the accuracy has been awesome for me. I know for some, it hasn’t, but with all things diabetes and bionic parts related, YDMV (Your Diabetes May Vary).

But looking over my meter, I think I’m trusting it a bit too much:

Meter Shame

It seems that I have taken a mental note as to how close my Dexcom matches my readings and have trusted it a bit too much. I’m barely making the 4x/day quota that I’m even supposed to check. I take for granted that the CGM is just a guide that it can can go awry and really be off.

I need to get back into the habit of checking again. Before and after meals. Just to have record of them, and to be sure my CGM is right. It’s sort of like the Double-check promise that some company had years ago that was to ensure that your order was right. I need to instill my own “double-check” promise.

I wish my meter would tweet it for me, so every time I checked, you guys could see and it would help hold me accountable. One can wish, right?

Accuracy: Should It Matter Right Now?

Right now, there’s a lot of people testing and trying out new or different meters and choosing one over the other saying one seems more accurate than the other. And while this may be true in some cases, there’s one fact that still remains:

The FDA still has the same standard across the board – They must test within ± 20% of the YSI method for fingerstick analysis if the glucose concentration is above 75mg/dl.

New Freestyle (not Lite) test strips.
VerioIQ Accuracy results

Well, I don’t know about you, but I don’t like to stay around 75mg/dl too long. My comfort zone is 85-125 (YDMV). So that means that outside of that, my readings that come back on my meter are allowed to be ± 20% of that number. So, it’s allowed to be 100-150mg/dl if my actual blood glucose reading is 125.

Thankfully, though, a lot of companies are actually closer to ± 15%, meaning that I could be 106-144, which still isn’t much when you think about it, and still doesn’t seem like much even in the higher numbers:

Actual BG    ± 20%         ±15

300            240-360     255-345

Even still, if I were to choose the VerioIQ over my Freestyle, then “technically” there shouldn’t be a difference, right? Since 98-99% of the tests are within the ± 15% accuracy range?

And yet, we still see pictures of them being so far off. Or were they? Maybe our bg’s were smack dab in the middle and one read the higher end of the spectrum verses the other reading the lower?

I just don’t know if griping over accuracy should matter any more. Not until requirements are tightened up to maybe 100% of tests being within ± 10% or even ± 5%, which would be a dream! Granted, I probably just made a few of you mad by saying that, but it’s true. What’s the use in fussing and raising Cain if the FDA refuses to tighten up on what’s “acceptable”? You can go check your sugar on ten different meters and all of them will come up with a different result, even more so if you use various brands. They all differ from one to another.

Accuracy isn’t any less important to me than it is to you. I still have to treat based off of the result that’s given to me. What we need to do is find a way to more effectively reach out to the FDA to petition for tighter allowable ranges.

I want to do something about this. I want to make a difference. I want our voices to be heard about this issue that is so important to all of us, and I want to do it in an effective way. The problem is, I just don’t know where or how to start.

Technofail and Diafail

Two words from the Diabetes Terms of Endearment that came to my mind this morning.

See, when I woke up at 5am this morning with Erik to get BabyK his bottle, I knew I was low. But I hadn’t been alerted because my CGM didn’t alarm. Why? Because it had “Lost (the) Sensor”. Ugh. I guess I had rolled the wrong way and it couldn’t get a signal. After checking my bg, and seeing the nice 44mg/dl come across the screen, I went into panic mode because it was then that I realized I was out of glucose tabs, fruit snacks, oreos, and juice. Lovely. So, I grabbed a glass, the milk, and the chocolate syrup in the door of the fridge. I figured, “hey, I don’t get chocolate milk very often, and I’m sure it will bring me up, so I’ll endulge thanks to this low.”. And I did. I probably lowbrainingly poured a full 2 – 2 1/2 cups of milk and squeezed a ton of syrup into a tall glass and mixed it and chugged. Then, I found two mini- moonpies in the cabinet… Not sure what flavor they were because they weren’t the classic chocolate ones… I’m not even sure of how long they’ve been in the cabinet either. I just know I was in a rage and ate those too.

Which I shouldn’t have.

And I should have known that.

But I was tired and I knew I had to get BabyK so Erik could rest a bit before getting ready and going to work since he had worked late.

So, this morning, I got up after taking a two hour nap with BabyK and got ready, took him to the sitters, stopped by to get my breakfast and then headed into work (I try to get in early so I can eat breakfast before starting work).

Keep in mind that my CGM had not alarmed this whole time, so I just thought that I must have either been dropping really low in the morning, or my pumping right after eating offset what would have been a high.

That is until I checked my bg….

387 mg/dl

I absolutely could not believe my eyes. This had to be a mistake. I don’t feel high at all. No dizziness, no thirst (other than my need for my morning caffeine), no pukey feeling, no getting up to pee millions of times until I woke up, nothin… zilch… nada.

So, I told my pump to use the number to calibrate and I bolused based on this number. Then I thought, “Oh gosh, what if it is a false reading?? Maybe I still have some chocolate syrup on my fingers from spilling the sticky stuff (I somehow managed go get it all over my hand, not just in the glass)!! I might have just over bolused! OH NO! Test! Repeat! Now!”

And so I grabbed my alcohol wipes, rubbed down, and checked, and while the number came up, I looked at the CGM graph to see what it “read”….

395 mg/dl meter vs 128 mg/dl CGM

Ummm. Yeah… so that answers why I didn’t get an alarm saying I was high when I hit 200.

Ugh.

Technofail… guys. This is why I’m scared to death of the artificial pancreas. I like having my CGM as a safety net, not as a main treatment device. Of course, it could just be my fault for calibrating while I was low, I don’t know. I like having the CGM integrated with the pump, but I would like a bit more accuracy than I have been seeing with it. It seems to not be as accurate as the Guardian CGM was, and that is kinda upsetting. Hopefully Minimed will work on a better, more accurate, less complicated (re: calibration restrictions!) integrated CGM + pump system, especially with Animas heading into the market with their Vibe soon (FDA, ARE YA LISTENIN’ TO ME??? PLEASE APPROVE THE VIBE FOR MY FELLOW DOC PEEPS!).  *Note: The CGM did correct itself after calibrating that massive BG.*

Diafail… Yeah, probably had some user error in there (lowbrain pantry rage, anyone?)… but I don’t remember having this “offness” with my CGM, calibration error or not. But for this high, I can’t blame the CGM. I should have never raided the way I did, and if I did, I probably should have had a “chaser” (quick bolus to cover a rage session).

*sigh*

I guess it’s just another day in the life with D.

Smile

(PS., It’s 11am, and I’m just now eating that breakfast I bolused for…. because now, I fear, I am plummeting….)

117mg/dl on Meter