Wednesday, March 16, 2011

CGMs & Gazelles

As many of you know, I went for CGM training on Friday.  Since then, my experience with it has been great overall--aside from the incessant alarms the first day or two (I stopped counting at 36 on Saturday afternoon)!  The CGM has already proved its worth for me simply because it alerted me (over and over again) of the nightime lows I've probably been experiencing since I started insulin and the pump.  That first night, I chalked all the alarms up to the CGM not being calibrated correctly with the meter...But then night after night, I've consistently been running in the 60's & 70's-or lower.  The lowest reading I've had on my CGM was 40 in the middle of one night-the lowest # I've ever had.

Here are a couple of graphs of my CareLink data:

I can't even begin to tell you how ecstatic I am to see 114 as my BG average since I've been on the pump...Well within the range I need to get that 6.0% A1C (which corresponds to an average of about 120-126, depending on which source you read).  And the last few days have been awesome...My sensor glucose average is 93, so I'm super excited about that too.  What's more, my average curve falls (mostly) within the normal range we've set (70-120).  Now if I can just get most of my readings in that range and smooth out my curves even more...And there's that perfectionist coming out in me again!  My CDE said my graphs were laying on her desk while she was meeting with another patient who's been chasing highs and lows for the last six months, and that the lady told her, "Whoever that is, I hate them.  I didn't know curves could be that smooth!"  Every time I talk to my CDE about numbers that I perceive as out-of-whack, she tells me that I'm actually doing great..."probably the best I've ever had one of my pump patients do," she says.  I told her yesterday that it's probably easier for me too since I'm still most likely in the honeymoon stage (and still producing some insulin of my own), but she reminded me that even if that's the case, the experience I'm getting will help me with my control if my numbers do start to creep up.

All of this makes me realize how great technology is...If it weren't for the CGM, I would probably never have known about my nighttime lows.  Even if I tested again at night like I do periodically, I would set my alarm for 3:00AM, before the lows I've been having even set in.  My CDE called yesterday after reviewing my data on CareLink (the Medtronic software for the pump & CGM), and we made some changes to my basal rates.  She told me I was doing very well, but that we needed to take care of those lows simply because once I am pregnant, I don't need to be running in that lower range (where the baby doesn't get the nutrition it needs). 

I've had to remind myself, though, that I shouldn't bolus based on the CGM readings...I've done that a couple of times to catch the highs showing up on my graph, only to end up low later on.  In fact, I did that just today at lunch, so I'll probably end up low again at the two hour mark.  It's hard not to correct those vertical lines when you can see them happening, though!  On the bright side, seeing those jumps definitely gets me up and moving, whether it's running back and forth in the office (I work with my parents) or out in the parking lot with our dog...Whatever it takes to get those double upward-pointing arrows off the screen!  Those little bursts of movement can add up, so I'm getting a little more activity on top of the purposeful exercise I get everyday after work. 

Speaking of exercise, since I've been working out consistently, I've felt so much better.  I wouldn't say I've had a huge increase in energy, but I feel less stressed throughout the day...And call me crazy, but it's seemed to have an impact on my BG numbers, which have been consistently lower since I've started.  I don't know if it's from the activity itself or the decrease in stress (or both), but I like it.  And although I haven't experienced that huge increase in energy that everyone talks about in regards to exercise, I think I'll get there once my numbers are more level (especially during the night).

In my last post on exercise, I wrote about my favorite form of exercise, the Gazelle.  I bought it in January on Amazon (they had the best price and free shipping) after doing some research into different exercise machines and their reviews.  The Gazelle fit the bill for me due to its relatively low price (good ellipticals are $500+) and an overall high level of customer satisfaction.  Plus, it just looked fun.  I remember seeing the infomercials for it back in the day (who hasn't?!), and even though they're cheesy, I thought the actual movement would be a fun (and low-impact) form of exercise...And I was right!  I recently ordered another four workout DVDs to go with it (the Gazelle itself comes with one).  Yes, the cheese factor is definitely there (mainly due to Tony Little himself, I think...I mean, come on! A hugely muscular dude with a curly blond ponytail?), but it's honestly a good, fun workout.  I love it, therefore it's not hard for me to use it everyday...In fact, I actually look forward to it

Well, I've got to go...I was just alerted that I'm low again (surprise, surprise), so I have to take care of that!


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