Lunchtime is probably regarded as the most coveted part of my day at work. Whenever 12 o’clock rolls around, I excitedly jump out of my chair and head over to the office refrigerator to snag my lunch bag, filled with delicious (and usually nutritious) goodies that I packed for myself the night before.
This glorious span of time would be impeccable if it weren’t for the fact that I pretty much have to inhale my food each day. This is because I work as a client services associate, meaning that I spend the vast majority of my workday on the phone. I also have a designated one-hour break at 2 in the afternoon each day, leaving me with two choices: either starve myself until 2 o’clock, thereby allowing my break and my lunch to peacefully coexist, or quell my hunger with a hasty lunch at noon leaving me free to answer phone calls as they are coming in. In other words, I rush to eat because I worry about getting stuck on a long phone call and the possibility of my blood sugar dropping too low due to my lunchtime bolus/not being able to eat right after administering said bolus.
With all that in mind, lunch can be a little more stressful than I’d like it to be – and it was only aggravated by my buzzing CGM this past Friday.
I had just tested and was pleased to see 83 come up on my meter. I input the number and used my PDM to give myself my bolus (it still feels weird to say that – I guess I’m not used to pumping language yet!). Not two minutes and two bites of my lunch after this did I hear three concise buzzes emitting from my CGM. The screen reported I was 77 and dropping.
The next several minutes consisted of me devouring my meal and popping a couple of glucose tablets to expedite the rate at which my blood sugar would rise to a more stable level. I think my panic stemmed from the fact that I was dropping fairly fast just after giving myself more insulin. But approximately 20 minutes later, I was doing much better, as my CGM showed that I was starting to come up a bit post-meal.
However, this little incident made me wonder: should I have reacted so strongly? It wasn’t like I was feeling the whole slew of low symptoms, I only felt hungry, which is normal because breakfast had been hours ago. Maybe if I had just ignored the CGM, I wouldn’t have been so concerned about going super low. In theory, if I hadn’t been wearing it, I would have eaten my lunch knowing that my insulin would kick in about an hour after I gave it to myself. I wouldn’t have been anxious for that period of time, and I probably wouldn’t have felt the urge to give myself a boost with two glucose tablets. In turn, maybe I would have had a less noticeable spike after lunch and maintained a more stable, in-range blood sugar.
While all this speculation doesn’t do much for me now, it does beg the question of whether or not I’m overly dependent on my CGM’s reports. The rational part of me knows to use it as a mere guide, and I never, ever use it to calculate boluses. But I do think that I rely far too much on those trend arrows. Again, I know very well that there is a delay in the information the CGM generates, but I can’t help but succumb to paranoia whenever any “extreme” readings come up on the screen.
I’m wondering now that I’m on the pump and things are going (mostly) well, perhaps I should take a break from the CGM and see how I fare with one less device. After all, I spent much of my life with a sole machine – my meter – dictating how I treated my diabetes. I did a good job then, so why not now?
i have worn a Metronic pump for the past 15 years. i love it and it has been life changing. about 4 or 5 months ago i started using a Dexcom G4 CGM. i am overly addicted to looking at my BG numbers and arrow directions. i always test before i eat on my meter and if necessary i re-calebrate my Dexcom. but since i have been on the Dexcom, i can’t control myself from checking it over and over again. However, since i have been on the CGM, my A1c went from 8.9 down to 6.5. i am so… Read more »
Hi Khurt,
I am a CDE and parent to a T1 kid. As Mary Dexter pointed out each glucose tab is 4 gm. The rule of 15 applies to treating lows with the requirement to have approximately 15 gms of fast acting carbohydrate such as glucose tabs. However, if your blood sugar is lower than the 60s treat with 30 gm carb. Your blood glucose will rise before the symptoms of a low disappear. If your endocrinologist or diabetes educator said to chew only one glucose tab then he or she accidentally misspoke. Glad you are doing so well.
Keep the CGM. It’s doing its job. 2 glucose tablets = 8g. Your lunch bolus estimate could be off by that even with the best math skills. Better to know that you might go low and be able to make the decision about how you want to fix it, than to go low while working. 77 isn’t hypoglycemic, but it isn’t very high and you could have started to drop even lower. I substitute teach and dare not go low just as 25 middle-schoolers descend upon me, especially some of the more squirrelly ones. Pumped for 6 years, went back… Read more »
I think you panicked. I had my CGMS a year before I had my insulin pump. I found that a down arrow (straight down) was simply a warning sign that things were changing rapidly. I would have ignored the CGMS and continued eating. Your BG was 77 and not kin the hypoglycemic range. I was also trained to treat hypos (which this wasn’t) immediately with ONE glucose tab and then check BG again 15 minutes later. Basically after 7 short years of living with T1 I have learned not to be concerned until I actually need to be concerned. NOTE:… Read more »