I knew what I was getting when I signed up for this CGM thing. I knew full well what could happen to myself when given the chance to know my blood sugar, all the time. The consequences of that gift have been two-sided. First, it’s drastically reduced really high highs and really low lows. Secondly, it’s created another distraction in a world full of attention grabbing things. I cherish the ability to be present, let things unfold, and react accordingly. At times, the CGM has challenged that mantra. With each alarm or urge to check it, that takes away undivided attention from studying, conversations, and work projects. With a set of rules developed through experience, I am now apt to deal with the CGM with balance, well, at least sometimes.
Here are those rules for diabetes management with a CGM:
1. Employ multiple ranges.
Most continuous glucose monitoring devices allow for flexibility in your CGM alarm ranges. At night, I prefer to loosen up the reins. Instead of being buzzed and beeped when I approach 200, I prefer to buzzed and beeped when I approach 250. Sleep is the priority. During the day, I take the opposite approach with the goal of being below 200, to optimize brain function.
2.Do not, for the love of all that is good and decent, look at the thing while you’re talking to someone.
Conversations deserve attention. If you feel that vibration in your pocket, it can wait a couple of minutes. I know, it’s tough. If you’re at a dinner with friends, take your bolus and then leave it alone. Try checking it in the bathroom. My friends like to play a game. If we’re eating somewhere, the first person to check their phone buys. It’s simple. That might not be best when applied to a CGM for obvious differences, but let’s apply the concept.
3. Trust your gut.
The other morning, I saw a CGM value of 220 and it was hurtling upward at 30 mg/dL every 5 minutes. 30 minutes before, I had tested with a meter and I was at 110. My gut said this didn’t make sense. I felt good. I pulled the meter back out, tested again, and it was at 118. Time to replace the sensor. A few weeks back I talked about some counterintuitive advice that applies here.
4. Look at it before you get in the car.
Oklahoma just passed a no texting and driving law that punishes transgressors with a $100 fine. I assume this would also apply to checking your CGM while driving down the highway. Be wise, take a look before you start up the car. If it vibrates, take a deep breath and check once you’ve made it to a light.