CGMs and diabetes burnout

Although I’ve had diabetes for 25 years, I am still relatively new to CGMs (continuous glucose monitors), having had my Dexcom for just under a year.

Prior to getting my Dexcom, I would test my blood sugar a couple of times a day and I never truly knew what was happening to my sugar levels. My HbA1c was at 8.2 and I would constantly fluctuate between highs and lows.

Since having my Dexcom, my HbA1c has dropped to 6.3 and I have a much greater understanding of what my sugars levels are doing each day. However, this has come at a bit of a price. I am now micro managing my diabetes by constantly looking at my watch to see what my sugar levels are and over analysing my graph on the Dexcom app. If I have a bad diabetes day I can feel very deflated and frustrated that I’m not staying in range. I feel the pressure to have 100% TITR (time in target range) and a flat line (in diabetes terms this is where your graph looks flat with little fluctuation in sugar levels).

I raised this concern with my diabetes consultant and he told me that before eating I should check, inject and then forget.

He told me that I should forget for a couple of hours after eating to let the insulin do its thing. Then I can see what happened and give a correction if needed. I have found that this really helps because I found that I was giving correction doses too soon and then having a hypo later.

He also told me that I don’t need to put pressure on myself to be at 100% TITR. If I have 80-85% TITR then I will still have good diabetes management and significantly cut my risk of having diabetes complications.

I don’t think that I could go back to managing my diabetes without a CGM. It is so reassuring to have it there and for it to pre warn you if a hypo is on its way. I was forced into not having my Dexcom when my transmitter failed and I had to await a new one.

In some ways it was good to not be able to over analyse my graph but it was scary when I suddenly had a severe hypo without any warning. Had I had my Dexcom on then I would have been alerted to that hypo and I could have treated it sooner. I then started to think about whether I actually listen to my body and those hypo signs because I have my CGM telling me I’m low or about to go low. It is important to still listen to your body even with a CGM.

Sometimes CGMs can be wrong so it is so important to double check with a finger prick.

As diabetics, we have to constantly manage and adjust our insulin requirements and we have many stresses to contend with each day. It is important not to put too much pressure on ourselves to achieve 100% TITR and a flat line graph.