Tag: Dexcom G4

Sugar High Sugar Low: Preparing for pregnancy

Before conceiving I had a lot of things to contemplate such as being fit, healthy, eating well, having tight control of my blood glucose levels and most important of all achieving at least an A1c of 7.0%. Both diabetes and pregnancy combined have their own unique challenges. I knew that I would have a lot of hard work ahead of me.pregnancy tagcloud pictogram

My diabetes appointments are usually quarterly at the diabetic centre. My previous appointment showed that my A1c was 7.5%, so I decided to visit my diabetic team and inform them of my plan, as I did with my first pregnancy. The diabetic nurse retested my A1c and after two weeks I found out my A1C was actually 7.3%. Blood glucose control is vital during pregnancy because if you can imagine even before you’re aware of your pregnancy, your baby’s brain, spinal cord, heart and other organs have already started to form. This totally freaks me out because without tight control I could have possibly affected the way in which my child developed.

I was given the opportunity to have a trial run of the dexcom G4 sensor for a month which I talked about in my post, “Cyborg for a month or perhaps longer”.

Dexcom G4is a continuous glucose monitoring (CGM) sensor which is inserted into the body and is able to give blood glucose readings every five minutes. The sensor automatically transmits this reading to my insulin pump (Animas Vibe) and creates a graph. With my insulin pump I am able to set an ideal blood glucose range. If my blood glucose level goes above or below this range my insulin pump alarms to alert me of either an increase or decrease in blood glucose level.

My trial run actually went on for longer than a month and it was during that time that I conceived. My pregnancy journey had started and with my team we made the decision to continue with the CGM during this pregnancy. To start with the CGM really helped me achieve tighter control and a better understanding of patterns occurring at certain times in the day. After a month my A1c had dropped to 6.4%.

By week five of my pregnancy I had developed severe morning sickness. I was a complete mess. I had no appetite, I lost a lot of weight and I needed far less insulin. My insulin requirement continued to decrease during the next few weeks. The morning sickness continued and to make matters worse my CGM didn’t seem to want to cooperate. The readings on my insulin pump compared to a finger prick reading was completely different. It stopped picking up low and high blood glucose levels. It just did the complete opposite.

I was able to change my sensor and transmitter  a few times but unfortunately every time I got a new one the same problem occurred. No matter where I placed the sensor on my body it would react in the same way. My diabetic doctor seemed to think that it could possibly be the pregnancy hormones interfering with the sensor. I went one step further and decided to contact Dexcom with regards to this. They were unable to conform if this was a possibility or not. I was told that no research has ever been done on the effects of pregnancy hormones and the accuracy of this sensor.

My doctor asked me if I’d prefer to go without the sensor and I agreed to go without it for the duration of my pregnancy. I began my rigorous blood glucose testing and on some days I’d test up to fifteen times.

logbookHaving good control minimised risks such as miscarriage and birth defects. My pregnancy was able to progress well almost as if I did not have diabetes. Four months into my pregnancy I managed to achieve an A1c of 5.7% and it remained that way throughout the pregnancy

With the help of my antenatal diabetes consultant I was able to plan my target blood glucose range so that my blood glucose could be as close to normal as possible during my pregnancy. We also discussed and looked in detail at basal rates, insulin to carb ratio’s and insulin sensitivity. I was able to be in contact with him on a daily basis and then I attended the diabetic antenatal clinic every week. In actual fact I was very lucky to have had a team of people accessible to me which consisted of x3 diabetic midwives, x2 OBGYN’s x1 antenatal diabetes consultant and a dietician. I also still had contact with my diabetes team from before my pregnancy. I WAS VERY LUCKY!

Another important factor with diabetes and pregnancy is the health of your eyes. I had to have my eyes checked every trimester by the Eye hospital to make sure that no changes were occurring. A month after the birth of my first child, I developed changes in my eyes which then corrected themselves strangely enough. However it is routine for diabetics to have regular screenings during their pregnancy here in Manchester.

Preparing for pregnancy and the pregnancy itself was extremely difficult. I had moments when I felt stressed out, happy, anxious, nervous and mostly worried. Regardless, I felt that patience and maintaining a serene demeanour was definitely key to having a healthy pregnancy and ultimately a beautiful healthy baby.

Amina xx

The beeping D ……

As you may know I recently started a sensor trial, which started off really well. I got my sensor fitted everything was running smoothly until I decided I was going to go to the supermarket.

First supermarket trip

The moment, I stepped into the supermarket doors.

BEEP, BEEP, BEEP, BEEP, BEEP! (Anti-theft alarm)

Of course I totally ignored it and kept walking, there were so many people going in and out of the supermarket.

Major Side note: I was coming into the supermarket and in any case it’s not in my nature to shop lift.

I continued with my shopping, arrived at the till, paid for my goods and went through another set of alarms (WHICH WENT OFF).  I looked around because, that surely was not me! So I kept on walking. I reached the exit and walked through the doors with a herd of other people (YES the alarm went off again)! Still oblivious I continued to walk towards the car and go home.

“Wow those alarms were going off a lot. I wonder why?”

My second supermarket trip

Off I go to the supermarket nice and early to pick up a few things.

Side note: I love going to the supermarket nice and early. Its empty and I can just pop in and pop out. Job Done!

I reached the entrance and BEEP, BEEP, BEEP, BEEP!  OK I was the only one walking through, was that me? The guard just nodded and smiled so I smiled back and continued walking in. Shopping done and paid for. I approached the first alarm, BEEP, BEEP, and BEEP! No that was definitely me that time. I decided to turn around and go back to the lady at the till to make sure there were no tags in my bag. The lady checks and finds no tags. She encourages me to just go through. BEEP, BEEP, BEEP! That now confirmed that it was me beeping.

So embarrassing! I had a feeling that perhaps it was something to do with my sensor. I was totally dreading going through the exit alarms so I decide to let the guard know I was wearing a sensor and it might possibly go off as I go through the alarm. I showed him my receipt and my pump just in case he didn’t believe me. Off I went!

BEEP BEEP BEEP BEEEEEEEEEEEEEEEEEEEEEEEEEEEEP!

I continued to use the sensor but I just felt that whenever I tested my BGL it wasn’t even close to the numbers on my pump. After 12 days the sensor totally failed and produced an error message that read ERROR 0.

sensor fail

After 5 hours the sensor remained like this so I decided to call Animas (they are so helpful) and I ended up having a lengthy conversation with them. The lady I spoke to asked me several question and tried to get the sensor running again. However she finally said, that the sensor had failed and that I should remove it all together. When I removed the sensor it was bent and had barely pierced my skin. I also mentioned my beeping every time I went through the supermarket alarm. She said that it’s possible that the transmitter may have been faulty. I gave her the codes on both the sensor and transmitter and I was sent new replacements the following day.

I then restarted my sensor trial and I’m now on day 5, no errors or false readings. My BGLs have been spot on when I cross reference them with my BGL on my BG meter. I’m starting to see a clearer picture of what my BGLs are doing and have been able to make adjustments in my basal rates. It still needs some fine tuning but I feel I’m finally starting to iron out all the lows.

Has this (the beeping) ever happened to anyone else? Or have you ever had a faulty transmitter or sensor in general?

 

Amina xx

Cyborg for a month or perhaps longer :/

As a lot of my readers may know I’m from the UK. As a type 1 diabetic living in the UK all my diabetes care and expenses are paid for by the NHS (National Health Service). This means that all my diabetes equipment, my insulin pump, my test strips, my blood glucose machines and even any prescriptions are all free. Actually all diabetics in the UK should have a medical exemption card which makes all their prescriptions free.

Sorry all my T1Ds who I know go to hell and back with their insurance companies and supplies. That’s another additional fight towards diabetes.

I currently have the Animas Vibe which has CGM (continuous glucose monitor) capability. However since I’ve had it I haven’t had a sensor like the Dexcom G4. This is because my diabetes centre have not been able to secure funding for me, until today. YAY!

dexcom g4

* The sensor is supposed to only last 7 days and at this point the sensor session times out. However after talking to Dexcom I was told that the sensor can last between 10 -14 days. The sensor session can be started again and sometimes last a lot longer than 14 days.

I’ve been given the CGM sensor for a month. Now that I’m aware that the sensor won’t last an entire month i’m going to aim to keep this fist sensor on for two weeks. I’ll be documenting my experience with the sensor and my BGL over this month. As I said funding is limited therefore sensors are few, this also means that every two weeks I’ll have to return the sensor to the diabetes centre and get a new one fitted. If I wanted to have the sensors as a more permanent thing I’d have to fund it myself.

 I feel I need to explain why I of all the T1D’s was able to get a sensor.

Since I had my little boy I’ve progressively suffered with severe hypos, especially during the night. For all you T1Ds out there,  you know what night time hypos means. Diabetes is a scary thing to have to deal with on a daily basis, without having to deal with extreme lows in the night. For the non-D’s this means that I can be up several times during the night when others are fast asleep, checking my BGLs in fear of them dropping too low. These lows can cause what we call a rebound (this is when the low BGL rebounds up and you end up with a very high BGL reading). The sensor will allow me to catch some of these severe lows.

Here’s a breakdown of costs:

  • Transmitter and Receiver and cables £975 and they usually last between 9 – 12 months. To replace this it cost £325
  • A box of 4 sensors costs £250. Should last between 10 -14 days, sometimes longer
  • To buy one sensor costs £62.50 plus P & P = £7.50

So if I was to go with the transmitter, receiver and the box of 4 sensors that would mean I’d have to spend £1214.50 to start the whole process. Plus I’d have to factor in the cost of the transmitter and receiver breaking down so all together it would cost £1539.50. One good thing is that I’d get a VAT exemption, so that good ha! It’s definitely something to think about.

For now I’ll see how this trail period goes before I make a decision.

Happy Pumpdexi’ing  lol!