1/25/2021
Making the Most of your Continuous Glucose Monitor

A continuous glucose monitor can be a gamechanger for children with type 1 diabetes. It provides a plethora of information which can be used to make impactful decisions on everything from insulin dosing to food choices. The Berrie Center has resources available online to help guide patients through the process of setting up and utilizing a CGM, such as a Dexcom.

To begin, click here to learn how to connect your Dexcom receiver to upload and view glucose data and save, print or email reports from home. You will need to create a Dexcom account. To share your data directly with the Berrie Center, first request an invitation directly from your diabetes educator. Next, log in to Dexcom Clarity to begin the sharing process. This software is used for patients on a Dexcom CGM. 

Upload glucose data from a Dexcom CGM device and then view the data in easy-to-read graphs. You can view trends, statistics and day-by-day data and then email them to your healthcare professional -- right from the Dexcom CLARITY webpage.  We recommend looking at your data at least once per week to see how you are doing and if you are approaching your targets.  

Dr. Natasha Leibel explains below why and how utilizing CGM data can have a positive impact on diabetes management. 

What is the goal of looking at CGM data? 

Let’s say you are looking at 1 week of data.  You can see a bar graph showing you your Time in Range for the last 7 days. This means what percent of the time that week you were between 70 to 180 mg/dl.  Time in range should be as close to 70% as possible or higher.  This will correlate with an A1c of close to 7% which is the goal.  Low blood sugars should be under 5%, and lows under 54 mg/dl should be as close to 0% as possible.  

How can you use this data to make decisions? 

If you are not achieving this goal try looking for trends (see Nurse Jaki’s attached guidelines) to troubleshoot why you are going too high or low.  Although it is a lot of work, keeping food logs for a few days can really help to determine patterns. 

What should I do if my blood sugar is rising on the Dexcom?

If you just ate you should expect your blood sugar to go up!  Accurate carb counting and bolusing 10-15 minutes before the meal will help to prevent a big spike.  Taking repeated insulin doses to try and get your blood sugar down once it is rising can be very dangerous and lead to insulin stacking and lows later. Remember – insulin does not work instantaneously. Once you take a bolus it will take 30-60 minutes for the insulin to peak and by then likely your blood sugar will be coming down. So be patient. It is safer to just wait closer to 3 hours before taking more insulin.

What should I do if my blood sugar is dropping on the Dexcom?

If the Dexcom is showing a straight line or diagonal arrow down it and your blood sugar is at least 70 or higher it is generally ok to wait to see how it is trending before taking a low treatment. If the blood sugar is in the 80s and arrows are trending down start with a small amount of sugar to treat – maybe 1-2 glucose tabs, if in the 70s and trending down 3 to 4 glucose tabs maybe required.   There is no hard and fast rule, and each person is different, so experiment with how much sugar you personally need to bring your blood sugar up.  Many variables can affect this - such as active insulin on board or exercise.  Work with your educator to make a personalized plan. Remember that there will be a “lag” in the blood sugar coming up to normal after a treatment so when in doubt check with a finger stick. Lows are often overtreated because of the delay in seeing the rise in blood sugar on the Dexcom – and this leads to rebound high blood sugars. 

Please be sure you are sharing your account with the Berrie Center.  That way when you have an appointment or call with a question about your blood sugars, we can quickly access your data and make the safest treatment plan. 

To learn more about using a CGM to improve your diabetes management, schedule a visit with your certified diabetes educator today.