Due to the number of hypos I’ve been having my consultant decided it was necessary to have a CGM fitted to try and see what is going on. This was decided at my hospital appointment in June 2014. It couldn’t be done straight away as the CGM’s were being updated and the DSN’s needed to be trained first. So originally I was given a date for August, but unfortunately I was on holiday at that time and was told I’d be sent a new date.
In the meantime (4 months later rather than 6 months) I was sent another clinic appointment. When I went in the endo thought I’d have had the CGM fitted, the trial would have been done & she’d have some information to work with. When she realised it hadn’t been done she was on the phone to find out why. Well, apparently due to the NATO Summit (thanks Mr President etc lol) the hospital computers had had firewalls put on them and these had caused a problem that prevented any tech connecting to their computers and had to wait for it all to be sorted out before they could see me or anyone else.
I was then given a date for 5th November 2104. I went into the appointment, accompanied by my dad as parking is usually a big problem & at least he could drive my car around for me if I couldn’t find a place. I didn’t need the stress of being late. Thankfully we found one pretty quickly so he came in with me. I went in with my DSN with a little trepidation. Concerned if the fitting of the sensor would hurt. No need to worry, all I felt was the “click” from the inserter. I was given an extra monitor that their computers were compatible with. I had to test my BG level an hour later, then 2 hours later to calibrate the CGM sensor. I was also asked to check my BG at least 4 times a day (breakfast, lunch, tea & before bed). The DSN have me a food/insulin/BG diary and asked me to record everything I ate & drank including their carbohydrate content, blood glucose levels and any insulin I injected. All this with the time it was done. I was told the sensor would read for 6 days and given an appointment for 11th November (dad would be needed again as hubby would be in work).
During the six days I had quite a lot of hypos that I was aware of. Sunday, after our late lunch, I was rather high for a while which took some time to come down. So I was a little nervous of other scrutinising my data.
The DSN & dietician were fab though.
This is the site where it was. I’m not giving anyone a wider shot of my belly, you’d need wide screen, and you wouldn’t want to see that!!!
Whilst the DSN (& student DSN) were downloading the data from the iPro2 the dietician was looking through my diary. She asked what I used to calculate carbs. I told her I use the Carbs & Cals app, packaging & I have a set of nutritional scales. She asked a few question about different parts of the data. She said I’d calculated the carbs very well and she was impressed (I heaved a sigh of relief). She asked about the hypos & we chatted about Sunday’s high. But no blame/finger point at all, just a discussion about why it may have happened and what I could try to prevent it in the future, e.g. Splitting my dose to before & after I’ve eaten. She was very helpful.
Unfortunately the BG monitor wouldn’t download to the computer so my DSN had to input the readings manually with the help of the student.
Once it was all done we were all (dad included) invited over to the computer to have a look at the graphs. On the computer it was all in colour and I could tell straight away that Sunday’s graph was the red one, the one with the big high that lasted hours.
She then showed us day by day graphs. I was really pleased to see that a good majority of the time my levels were either within the “target” range or just above for a short while. Some were even stable within the rage for a time which I was hugely surprised at. I was expecting it to be much more up and down.
It was noticed that I was spiking mainly after my breakfast. Having hypos through the busiest part of the day when I was in work and also at night. One night I slept through a hypo for about 2 hours before waking and then treating it. Saturday’s trace was fabulous I was pretty much within range all day apart from 1 hypo after pizza in the evening, this was another time that myself and the dietician had discussed splitting my insulin dose already.
My DSN said that my trace was probably the best one she’d seen for sometime. Excuse me here as at the moment I can’t fit my head through the door. To be honest it was such a huge relief to hear that praise. I thought I was doing so much worse especially with the hypos.
After a discussion it was decided to lower my evening basal from 14u of Levemir to 12u to try and prevent the night time hypos. Unfortunately that means some basal testing, so I’ll be seeing 3 am a bit more than I would like.
My breakfast ratio has been 1:10. I’ve been asked to try 1:9 to see if that prevents the bigger spike after my breakfast. If not then try 1:8.
I then mentioned my interest in a pump. DSN said I would need to hit certain criteria, that I would need to go on the Daffyd course (Welsh version, I’m presuming, of the Dafne course). I said that attending wouldn’t be that easy for me with working in a school but the dietician did say that as I was already doing so well with my carb counting that I could probably just attend a one day “refresher”. The DSN agreed. DSN said that as my Endo was retiring in the new year I could probably be transferred to the pump Endo or my current Endo could refer me. The DSN was very positive about the pump and said that my interest would be passed on. So watch this space.
On the whole a very positive experience.
Thank you for having the patience to read to the end of this blog. I know it’s a bit long.