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Thursday, January 17, 2013

(Over)-Avoiding Lows & the CGM

I avoid lows like the plague. The lowest number I have seen in the last year or so was 77. And while I'm happy about that, I am not so happy about oftentimes running in the 160-220 range, with my A1Cs over the last few years firmly planted around 7.5-7.8%. I know that's not horrible, but I also know I can do better. The truth is I read so many posts about devastating lows other T1s have (sometimes frequently it seems) and it makes me feel super guilty that I am able to avoid that. But then I also hear about all the A1Cs in the 6s (and lower!) and I feel even more guilty for running high a lot of the time (even if it's not super-high)...

The truth is my A1Cs were better when I didn't stalk my BGs like I do today. I started stalking a few years ago with the main goal being not going low, and while I have successfully achieved this, I have also raised my A1C and I see the 200s way more often than I should. My endo is happy that I have (almost) no lows and he is also happy that I don't swing wildly up and down all the time. But I know that (on average) my numbers should be about 50 points lower.

For some time, I avoided the idea of a CGM because I didn't like the idea of something being attached to me. But I must say, testing 15-20 times per day (sometimes more) took it's toll on me emotionally (and financially). Furthermore, running high during times when I can't test all the time (like when I am teaching) due to fear of lows is bad and I know this. So finally, a few months ago, I got setup with the Dexcom Seven+ and I absolutely love it. Finally, I have some peace of mind when I am lecturing or hiking or chasing my dogs. Finally, I can give my fingertips somewhat of a break. And most importantly, I look at the graph and there is no denying what needs to change.

In the last few months, I have been able to push my numbers lower than I have felt comfortable before - i.e. I used to correct 90s and aim closer to the 150s before the CGM. Today, I feel much more comfortable with the 90-120 range. That is not to say I come close to staying there the whole time, but I have re-evaluated by goals from just keeping my BGs under 200 overall, to aiming for pre-meal values under 130 and minimizing post meal peaks to 180. Of course, I am not always successful, but the CGM has really made me reconsider some of the misconceptions I had about my BG trends. I have yet to have my A1C checked after starting on the Dexcom system (that's coming up next month) but I am (cautiously) optimistic. Also, I have to admit that the Holidays still kicked my ass this year (Dexcom notwithstanding) and I was totally guilty of rescheduling my appointment from 1/7 to 2/18 in an effort of avoiding disappointing myself and my doc... =)

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