So, most of you know who have been reading my blog know that I am using a Minimed Revel pump + CGM for to control (or try to at least) my diabetes. Lately, I simply could not figure out what I was doing â€œwrongâ€ with the cgm and why it wasnâ€™t catching my lows or highs and things like that. I even posted a request on my DiabetesDaily blog asking for help from other Minimed CGM users as to what they do for more accurate readings. Well, after a week or so of buckling down to really try and figure this thing out, I have a few tips to share that may help you if youâ€™re using the same CGM (or even a Dexcom â€“ Iâ€™m not biased!). Of course, these are only tips that work for me. I am not saying you have to do these things, and as a matter of fact, I would rather you speak with your health care provider before trying these just to get the OK from them.
1. Undercover and overcover. (This one applies to the Minimed sensor â€“ Dexcom users canâ€™t do this one, sorry!)
After inserting a sensor, but before attaching the transmitter, put a piece of tape to cover the â€œsensor headâ€ (the part that is purple-ish and flat), but under the â€œfeetâ€ of it. Take a piece of Tegaderm or IV3000, and cut it in half. Then, cut a slit in it that would look like your eyelid opening (just imagine this: () ). VEEERY carefully, slide the feet and connector end through the hole, so that part of it is under the feet and connector, but the other part is over and completely covering the sensor head, and secure it down.
Why do I do this? As an added layer of protection against water. I have found that if it gets wet and just a smidge of the sensor is above my skin, the sensor readings arenâ€™t as accurate as they could be. Since I have done this, my readings have improved a lot!â€¦ but not as much as also doing this: (proceed to tip #2).
2. Donâ€™t just let it get wetâ€¦. SOAK IT!
Thatâ€™s right. Soak it. Overnight. If you put a reminder on your phone (or use the Medtronic app on your iPhone to remind you!) for the night before the sensor-change day. Insert a new sensor, secure it with the under/over cover method, and also with a total over-cover. Take another Tegaderm or IV3000 patch, cut a small square out of the paper that would be big enough to over the sensor, place it in the middle of the tape, then place the tape over the sensor. That way, you wonâ€™t accidently rip it out overnight or scratch it out (as I have done before). Then, the next morning, carefully remove the top layer of tape, and connect your transmitter, and add a final top layer of tegaderm to secure it and add that top layer of waterproofing. (Which, I have to say â€“ the system is approved to be waterproof, but as I said before, I do it just for sensor accuracy for me.)
Photo 1: Sensor under/over covered and covered for bedtime.
Photo 2: Carefully removed the top â€œsleeping protectiveâ€ cover.
Photo 3: Connected the transmitter. Yey, green light!
The reason why I decided to do the soak it trick is because I noticed that my sensors (seeing as you only get 3 days out of these suckers) would be bestÂ only on days 2 and 3. And, with me, extending the sensors just is not an option because I donâ€™t get very good readings by day 5, so, I thought â€œhey, maybe let it soak and see what it doesâ€. Well, by golly, it worked. And has worked ever since. (note: I also used to do this with my Dexcom, and it worked very well too!)
3. Log to calibrate.
I know it may be a hassle to do, but take one week to log everything â€“ food, insulin doses (for food or corrections), exercise, etc, and find out your â€œquietâ€ times. The times when your blood sugar is going to be the most stable. Granted, yes, I know you Dexcom users are probably thinking, â€œYeah, well, I donâ€™t have to do this because I can calibrate at any time.â€, and this is true, but trust me, it helps you guys too. Use these â€œquiet timesâ€ to calibrate your sensor. My times are (1) first thing in the morning, (2) mid-afternoon and (3) before bed. Your times may differ, just as your diabetes may differ from mine (to an extent). The reps will tell you to calibrate 4 times per day because though youâ€™re required to every 12 hours (2x per day), 4 is the optimal amount of times, and more than that just gives it too much info. But for me, 3 times is a good number because itâ€™s one more than 2, and one less than 4 â€“ sort of the safe zone, so that it has enough information, but I have an extra â€œokay to calibrateâ€ card up my sleeve as well for when itâ€™s needed. And, if you are really, really, really a perfectionist about it (which, youâ€™ll have to lose some of that perfectionalizm anyway to be any brand CGM user as they are NOT perfect), you can even set reminder alerts in your pump to go off at the times that are best for you to calibrate based on your awesome logging data.
So there you have it. Iâ€™m still working on other little quirks that may make it even better, but at this point, Iâ€™m pretty darn satisfied with the improvements Iâ€™ve had so far. And, if you have any tips you would like to share other than these, please â€“ by all means, share them with me by leaving a comment. I would love some feedback from others who have some tricks up their sleeves too!