CGM vs Meter, can’t we just all get along?

I woke up this morning to the sound of my continuous glucose monitor (CGM) vibrating on my nightstand. This means one of two things, either it is telling me that my blood sugar is too high or that it is too low. Sure enough, it showed that my blood sugar had dropped during the night and was now in the 60’s. However, I found this to be a little odd since I was feeling pretty normal. I took my glucose monitor (the one that uses a finger prick) and tested my blood sugar. 124. A perfectly fine number.

The issue here is not just that a reading of 64 and 124 are 60 points apart, although that is not ideal. It’s the fact that the 64 reading would normally require me to treat the low with some sugar while the other reading of 124 is right within range. So here I was staring at two medical devices, telling me conflicting information, not sure which to believe.

So let’s complicate this even further. If I were to listen to the medical advice that I had been given for the management of my diabetes, it would be to go off of my meter reading of 124, which would mean that I would neither eat sugar nor give insulin. At this point, however, I started to pay attention to how my body was actually feeling. I didn’t feel how I normally feel when my blood sugar is at 60, but I was feeling a bit “off”. Sometimes I feel this way from drinking coffee on an empty stomach or if I’m hungry. Since neither was the case, I started to think that maybe it was related to my blood sugar after all. My intuition was telling me that it might be a good idea to eat something.

Let’s recap:

  • device 1 says I’m low
  • device 2 says I’m normal
  • typical medical advice would be to do nothing
  • body feels like it could possibly be low
So what do you do in a situation like this??
Intuition is a powerful thing. I’ve learned to trust it in most cases, but usually they are non-medical. I get a gut feeling about things like people and situations. But how much of a role should intuition play in the management of a chronic condition? Like I’ve said before, I can usually feel when my blood sugar is high or low, but then this suspicion is confirmed by my medical devices. So here I was sitting in my bed, thinking to myself, “should I trust my body and my intuition or the medical devices and technology?”
 It was only when all the numbers and feelings didn’t match up that I realized just how many of my daily decisions are based on a number coming from a medical device. Should I eat? How much? When? Should I give insulin? How much? Over how long? All these questions answered by a single number. It’s all so calculated, with my carb to insulin ratios, blood glucose targets and sensitivity, and hours of active insulin. So robotic. However, while the forumla might be calculated, the results are certainly not. Blood sugar rises and falls from so many different things besides food and insulin: stress, adrenaline, exercise, colds, menstrual cycles, the list goes on. Although my glucose monitors might tell me one thing, I’m the only one that knows what my body is feeling. Intuition definitely has a place in diabetes management, but in combination with other forms of glucose monitoring.
So back to this morning. What did I end up doing? Sometimes diabetes management is your personal experiment. Try something, see what happens, and make adjustments. Too much insulin? Lower it the next time. Not enough carbs? Eat more. I decided to eat half of what I normally have to treat a low and to see what happens. It was a compromise between all the information that I was given. I also knew that I would be exercising in the morning, which usually makes my blood sugar drop naturally. Sure enough, when I tested after my workout, my blood sugar was within range and I was feeling fine. Although there are many devices and formulas for the management of type 1 diabetes, it isn’t always an exact science. I’ve found that sometimes you have to trust your instincts, stay vigilant, and make adjustments when necessary.

Anyone else have a similar experience?

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3 thoughts on “CGM vs Meter, can’t we just all get along?

  1. I feel like I had this exact same experience just a week ago (http://wp.me/p2aBl3-DB). I'm not sure where on your body you wear your CGM, but I can only suspect that, when sleeping, blood doesn't flow to the fingertips quite as quickly as it ordinarily would, so the meter readings have a huge time lag. Maybe if we stood up and did fifteen jumping jacks before testing, we could get a fresh supply of accurate blood to our fingers to get an accurate test!

    Then again, if our blood sugar was really 64 and falling, it may not be such a good idea (or even be possible) to do those fifteen jumping jacks…

    Such is life. A life that isn't described in medical textbooks or doctors office pamphlets.

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  2. So strange how that happens! I just read your post too. I wonder if any of it is psychological too, you see a low number and our bodies are so used to reacting a certain way to a number that maybe its almost like a placebo effect. Either way, hopefully that doesn't happen too often!

    Like

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