Dexcom: Staying Between the Lines

The Dexcom G4 Continuous Glucose Monitor

I first had the opportunity to get a continuous glucose monitor (CGM) last year when I made the switch from daily injections (4 or 5 to be precise) to an insulin pump. I kindly declined the extra medical device as I wanted to focus on one piece of technology at a time.

A year has passed, and my mindset has changed. Just like I want to improve as a runner, as a person, I want my diabetes to improve and be the healthiest diabetic I can be. By stumbling across a video showcasing a new CGM by Dexcom (via my Twitter feed of all places), I was sold instantly that I needed this in my daily life.

My nurse Emily,  at the Naomi Berrie Diabetes Center, received my e-mail of enthusiasm that I wanted this and she got onto it straight away (of course, my team are awesome!). I received my Dexcom G4 Platinum at the start of November.

It’s half the size of my phone and slim. Size matters! A huge plus as the previous edition was bulky and not very runner/athletic friendly. I set it up, putting my hypoglycemic level at 80mg/dL and hyperglycemic level at 200mg/dL. If my glucose level crosses over either of these lines, I get an alarm from the receiver. The key to good diabetes control is to stay between these lines. Now I get to visually see where I am constantly.

I injected my sensor pad on my stomach and attached the transmitter which feeds the blood glucose reading to my monitor. The sensor stays on for a week before having to redo this process and changing the site location. My Dexcom contact, Nathan Nava (a fellow T1) told me some good advice “Think of your abdomen as a 4-way grid and rotate the sensor from top left, top right, bottom left, bottom right and repeat. As for the insulin pump catheter, keep that at least 3 inches away or preferably, the opposite side of the Dexcom sensor”.

As much as I love my Dexcom (hard to believe right?), it does have to be remembered, it will never replace a blood tester for complete accuracy. Just like a GPS running watch appears awesome to many (myself included), how many times have you used it knowing it wasn’t quite accurate? Technology is amazing and improving so fast but do yourself a favor: if the Dexcom informs you that you’re hypo or hyperglycemic, do a blood test to make sure before reaching for the Gatorade or injecting a bolus of insulin in your system.

Ive found my favorite aspect of the device is the trending arrow(s) telling you if your blood glucose is going up, down or staying level. If you are rising or falling fast, you’ll see two arrows and an alarm will go off giving you a friendly heads up to take action.

The photo below shows my blood glucose reading vs Dexcom after a long easy pace 16 miler. I started my run at 250mg/dL (slightly higher than I wanted) and dropped down gradually to a good post-race 103mg/dL (which was actually 93). The trend arrow informs me I’m still dropping, which is OK and normal. So what did I do at 9am to avoid the hypo? Eat breakfast and start the rest of my day!

Actual blood glucose: 93. Dexcom: 103.

My A1c (a 3-month average blood glucose) has already come down by 0.9 from my last appointment at Naomi Berrie and I’m sure some credit goes towards having this CGM, even if it has only been for two weeks. I can’t wait for my next A1c in late December. If you have the opportunity to get a CGM, don’t delay. This is a real game changer.

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