The New and Improved Clarity App for Dexcom

Back when I first got my Dexcom, two or three years ago, I downloaded the Clarity app on my phone and also looked at Clarity on my computer.  The phone app had very little to offer, but it did tell you an average of your readings over a 30, 60 and 90 period.  It also gave you a A1C predictor, based on your readings that equated with that average.  But that was about all it showed, that I recall.

If you went to Clarity via a computer though, you could view a lot more information.  There were various graphs that showed different things, like an overlay of your blood sugars over an entire month.  But I never became very familiar with it because it was on my computer rather than my phone, and I never spent the time looking at it. It just wasn’t all that convenient.

Eventually, the app did away with the predicted A1C number.  I’m not sure why.  But I can look on a chart and figure that out anyway as long as I know my blood sugar averages.  So really, who cares?  I didn’t and I still don’t.

This week, I had an appointment with my endocrinologist.  The nurse asked for the code generator for them from the Clarity phone app so they could view my Dexcom information.  It just happened to be, that out of boredom, while I was waiting for the doctor, I was playing around on my phone and noticed the app had all sorts of new bells and whistles since last time I had looked out it.  I use the term new loosely, because honestly, I have no idea when these new features were added.  I hadn’t looked at it in well over a year.

So, this may or may not be news to anyone but me that uses a Dexcom.

But if you haven’t looked lately at the Clarity phone app, it’s worth looking again.

You can now look at your average blood sugars for 48 hours, 7, 14, 30 or 90 days.  I like that!  Sometimes, it’s nice to just take things week by week- or less.

But wait, there’s more!

There are now 8 different reports to view.  If you click “reports” at the bottom of the screen, something similar to this pops up. Then, click in the middle box portion, just below 7/14/30/90 days, and above where it says “view report”.  You’ll then have a list of all 8 reports you can view:

  • overview
  • patterns
  • overlay
  • daily
  • compare
  • daily stats
  • hourly stats
  • AGP

You can then select one or all of those 8 reports by clicking on them.

Some of the reports are a little hard to look at due to screen size on phone, but you can zoom in.  When I looked at some of the graphs, for example the AGP (that stands for Ambulatory Glucose Profile- I looked it up!) I was able to see a repeating pattern I want to improve on.  Around 3-4pm most days, my blood sugar is usually at it’s highest.  I have some ideas on why that’s happening, and how I might improve upon it that I will try over the next few weeks.

I plan to learn a little more about how to read these various charts provided with the Clarity phone app.  Having the Dexcom has provided information that has helped me get me tighten my control since I began using it, and maybe these new features will motivate me to tighten it even more!  It hadn’t really dawned on me how almost every day around 3:30pm, my blood sugar is at it’s highest.  Now that I’m aware, I want to see what kind of an adjustments might make sense.

I’ve said it before, and fortunately, I get to say it again: I just had my best ever A1C with my most recent lab work.  Knowledge is power.  I know a lot more about how things effects my blood sugars, thanks to Dexcom.  I continue to tweak the way I do things regarding my blood sugar control.  Those tweaks are subtle, as they should be.  But little by little, things are getting BETTER.

If I Wrote a Novel About Type 1

It’s NaNoWriMo season.  And in case you’ve never heard of that, I’ll fill you in.  NaNoWriMo is short for National Novel Writing Month.

I can’t imagine writing a novel.  Let alone writing it in just a month’s time.  But what I can imagine is me finishing up my collection of a couple handfuls of essays about my T1 diabetes.  I’ve started and stopped this project a couple of times already.  I always start it because I really want to… I like looking back at how things, and seeing how far I’ve come.  I think you can only recognize your best kind of growth when you look back.  I think all of our stories of diagnosis, and how we dealt (and are dealing) with it are interesting. Every now and then, I get on a roll with this writing project, but then lose steam when I get busy with something that needs my attention.

But hey!  This NaNoWriMo thing is a great kick-start to finish the first draft of my book about Type 1.  I’ve already written an outline and maybe about half of it the essays.  With one dedicated month, maybe I can pull it off.  One month.  That’s 4 weeks.  30 days.  Actually, 29, since I’m starting on November 2nd.

So here’s my pledge- to myself more than anyone else really-

I will write each day this month towards finishing my book about diabetes. According to the outline I made last year anyway, it will have 14 chapters. I feel like I should be able to get the first draft done for all 14 chapters.  That’s my goal.  It’s doable.

And yes, I realize it’s not technically a novel.  But like I said, I can’t imagine writing a novel.  Not yet, anyway. But I can imagine writing the book I have in mind.  I don’t think the NaNoWriMo rules are real strict, so I’m sure it’s okay.

I’ve heard it said before, “Write what you know.” I KNOW you, T1 Diabetes.  I remember how we met, and I know that whether I like it or not, I’m stuck with you.  I choose to see you as a good thing in my life, and I’m going to keep on making that choice daily.  Just know, the tell-all is currently being written.

Sleep. Please Come Back To Me. I Miss You.

Seriously.  This has got to stop.  I’m not sure when it first started, but I haven’t gotten a solid night’s sleep in I-can’t-tell-you-how-long.

I don’t know what’s causing the problems.  Although like just about everyone, I have some anxiety,but it’s not what I’m thinking about in the middle of the night.  Maybe hormone fluctuations have something to do with it, but fortunately, if hormones are a part of this, they are NOT affecting my blood sugar.  And for that, I’m grateful.  Anyway, it’s not clear to me what the problem is between me and sleep.  But lately, it hasn’t been a symbiotic relationship.

I don’t have a problem falling asleep, but staying asleep the duration of an entire night?  Forget about it.  I usually go to sleep around 11:30/midnight, and wake up feeling bright eyed and bushy tailed around 3:30am.  I toss and turn.  Finally fall back asleep after what seems like about an hour or so, and then it happens again around 5am.  And there’s just no way I’m the kind of girl that likes to start her day at 5am.  Nor am I the kind of girl that functions well on a mere 5 hours of sleep.

I’ve tried all sorts of remedies- mostly natural, and even some not natural because lately, I’ve gotten desperate!  Here’s a list, off the top of my head, of the things I’ve tried to help me stay asleep during the night.

*warm baths with epsom salt (baths have always been a ritual of mine, but lately I’ve added in epsom salt and lavender oils)

*avoid screens (tv, computer, phone) as bed time approaches

*no caffeine beyond 2pm

*ear plugs and eye mask

*sniffing/rubbing on my temples some mix of essential oils that was given to me labeled “for sleep”

*this supplement that has melatonin, l-theanine and botanicals

*a magnesium supplement

*Ambien (Yep.  I’ve heard scary stories about Ambien, but again- I’m now desperate enough to try just about anything that might help.) (And yes, I’m going to write a blog post on this, specifically, soon.)

If any of these things have helped, it’s been so subtle, I haven’t noticed.  I still wake up around 3 or 4am feeling wide awake.

I’ve been listening to podcasts, and reading articles about how to get a healthy sleep routine going.  I’m taking any and all recommendations.  The new idea I’m trying this week that I just heard some sleep doctor talking about is: get OUT of bed if I’m not sleeping.  He said we need our brain to associate the bed with SLEEP (or sex), not with tossing and turning.  So, if you wake up, his advice is to go to another room, keep the light low, and do something like read until you feel tired enough to go back into the bedroom and fall asleep.  I’ve tried that for the last few nights, and while I like getting in the extra hours of reading, I’m not sure it’s helping me change my sleep routine. In fact, I fear that it might be ingraining that 3am wakeup call even deeper into my book-loving brain.

Like I said, my sleep issues don’t seem to be directly hurting my blood sugar control or my diabetes in general.  BUT, it’s well researched how vital sleep is to our overall health.  Lately, I’ve had problems with my shoulder (supposedly tendonitus), my hand/wrist (supposedly carpel tunnel) and neck pain in general.  I’ve said out loud, “I feel like I’m falling apart all of the sudden.”  And when I think about my sleep- or lack thereof, it makes sense that this would be the case. SO: It’s important to me that I figure this out.  My goal is to start sleeping a minimum of 7 hours each night. Right now, that sounds very lofty.  But it’s just sleep I’m talking about here.  SLEEP.  Something I love.  Something I want.  Something I need. I CAN DO THIS.

Right?

I’m taking all tips, recommendations and advice if you have any to offer.

#goals

Being Patient with Type 1

I haven’t had any clearly defined complications due to having lived with Type 1 for over 20 years.  And I’m seriously grateful for that.  BUT from time to time, I have little ailments that I wonder… Is this connected to being a Type 1?

My A1c tends to be anywhere from about 5.5% to 6.3%, and as time goes by and technology improves, it tends to be lower as the years go by.  I work hard and obsess over keeping my blood sugars in range, but still, I have spikes and drops in my blood sugars on a daily basis.  So, I’m far from perfect when it comes to blood sugar control.

In the past, I’ve had to have two surgeries for trigger finger.  One, for my left pinky, and the other, for my right thumb (ouch. that one was a bitch.) Before I finally got the surgery, I tried cortizone shots.  But they only helped for a short period of time, and then the trigger finger would return. The surgery, in my opinion anyway, was actually less painful than the shots. And, once you have the surgery, the problem doesn’t return. YAY!  I have read about the correlation between diabetes and trigger finger.  It has to do with inflammation.  Who knows, maybe I would have had this problem regardless, but I suspect Type 1 played a pretty big role in it.

The surgeon I used for my finger trigger insinuated that I would heal quickly from the surgery, but both times, that was not the case.  And again, I wonder, am I a slower to heal because of my Type 1?  Even though my blood sugar control is good?

Lately, I’ve been having problems with my right shoulder. Not from an injury, but just over time, it’s gotten more and more sensitive, and my range of motion has become more limited.  I got an MRI, and learned that I have bursitus and tendonitus.  Again, an inflammation problem.  And again, I wonder… is this related to my Type 1?

And even more lately- just the last 2 weeks- I’ve started having numbing in my left hand.  I’ve been to a doctor about it, a physical therapist about it, and had an MRI.  It could be related to spine problems I’ve had for many years, or it could be carpel tunnel.  (More on that later, in another post- but for now, that’s enough to make my point.) Again, I’m wondering, “Dammit.  Is THIS because of my diabetes?”

So although I’m not usually pissed at diabetes, sometimes I am.  Right now, my numb left hand is so pissed that it wants to punch my diabetes in the face.

But that anger isn’t going to do me any good.  It might even cause more inflammation, which I think this is all related to anyway.  Maybe inflamed emotions lead to more inflamed body parts.

Maybe it’s a good time to just breathe.  And remember that this is just a moment in time and it’s going to pass.  And things might be stiff, and tingly and even numb, but still- everything is working. (“That’s what she said!”)

I’m writing this today to remind myself how fortunate I am.  Fortunate for good insurance.  Fortunate that I have nothing too extreme going on that I am limited from enjoying my normal happy life. Fortunate that I have the money to get the therapies I choose to help me through this.  Fortunate to have friends I can call on (or text) to bitch to. It’s all good.  I know my body is working on healing.  Maybe it takes me a little longer to do that, but I can be patient.

Ask and You Shall Receive

On my last post, I wrote about how much I want a true to-it’s-claim, FAST acting insulin.  I was pretty sure I had read about one, but when I was doing my super speedy Google search the other day, I couldn’t find anything about it.

But today on Facebook I saw a post that not only did it exist, but it just got FDA approval.  YES.

THIS.  I want this.  The moment it’s available in the US. 

RAPID Acting Insulin

Last week, I went to my local JDRF office for our monthy DADA (Dallas-Area Diabetic Adults) meeting. A couple of reps from Omnipod spoke to us briefly about that particular pump and what’s on the horizon for new developments.  They spent a little time talking about how the hybrid closed loop system would work, but weren’t quite sure- or at least weren’t able to tell us- when it would be available.

I don’t use a pump.  I use an insulin pen to deliver my insulin throughout the day instead.  I tried a pump many years ago and it was just too cumbersome.  I know they’ve come a long way from that (especially Omnipod- and seriously, IF I were leaning towards a pump, I think that is the one I would be interested in), but at this point, I haven’t been motivated to make a change to the pump.  “If it ain’t broke, why fix it?”- Hey, I’m from Texas.  Those kind of annoying phrases are common around here. 😉

Since I’m not a pumper, I’m not anxiously awaiting the hybrid closed loop idea either.  It seems that I’m having to change up my insulin ratios every few months anyway (thanks, mid-life!), and I’m pretty good about figuring out those adjustments on my own.  Would the pump be better at this stuff than I am?  I don’t know… I kind of feel like an expert at this point.  I don’t feel like being on a pump, closed loop or otherwise, would make my control better.  And I honestly just don’t feel like having to learn something new when I’m happy with the way things are currently.

So although I’m content to stick with MDI (multiple daily injections) there IS something I’ve heard is on the horizon that cannot get here soon enough, in my opinion!

And that is a true-to-its name “RAPID ACTING INSULIN”.

BRING IT.

One thing that drives me crazy is how long it takes for my “rapid” acting insulin to effect a high blood sugar when I’m making a correction.  In my experience, the higher my blood sugar is, the longer it takes my insulin to make any kind of an impact on bringing it down.  I’m always very cautious and conservative when dosing for a high blood sugar post-meal.  I watch my Dexcom, and I check with my glucometer after about 25 minutes and usually at that point, it still hasn’t moved at all.  That is not rapid. I end up waiting- sometimes nearly an hour or more!- to see if, and how much, it’s going to drop. Then, after another hour or so, if it still hasn’t dropped much, I’ll take another small dose. All this takes far too long, and if you’re not super careful, it can cause the worst kind of roller coaster.

I want to be able to take insulin and see a drop in my blood sugar within 5 minutes. I want that insulin to peak in 20-30.  And I want it cleared out of my system within 2 hours.  THAT would be the perfect rapid acting insulin, in my opinion.  That would be something I’d get more excited about than a closed loop pump.  And I bet even pumpers would love a more rapid acting insulin for their pumps!

All I know for sure is that if and when such an insulin becomes available, I’ll be in a rapid hurry to jump the ship of Humalog.

Tips on Avoiding Blood Sugar Fluctuations at Night

There was a post the other day on a Facebook group I belong to that’s for type 1 diabetics. Someone had posed the question, “Do you try to get above a certain number before going to sleep to prevent lows in the middle of the night?”

There was a wide range of answers, but based on most of the people’s answers, this fear of blood sugars dropping off during sleep is a common one.  A lot of people feel comfortable and safe going to sleep with a blood sugar of 150, or even 200 to avoid the possibility of a dangerous low.

This USED to be the way I felt.  I used to have a ritual of eating a “just before bed” snack to get my blood sugar up to about 150 so that it wouldn’t crash during the night.  It often still went low anyway.  And I would wake up sweaty and confused, and have to find my way to some kind of carbohydrate in the kitchen.  And even if I didn’t go low during the night, I was definitely low most mornings when I first woke up.  And whether I was hungry or not, I had to eat something fast, as soon as I rolled out of bed.  And honestly, for me at least, that is NOT the fun or best way to start a day.

But gradually (very gradually!), since I started using a CGM (continuous glucose monitor) and am aware of my middle-of-the-night blood sugars, I’ve adjusted a couple of things and they’ve made all the difference in the world for keeping a stable blood sugar during the night. Now I’m very comfortable going to sleep with my blood sugar around 80-100mg/dL, because it stays pretty consistent during the 8 hours (give or take) of sleeping. And I’d much rather have 8 hours of my blood sugar around 100, than around 200!

TIP #1

First of all, I realized, I was taking far too much long acting insulin.  My blood sugars used to steadily fall throughout the night.  If you’re taking the correct amount of long acting insulin, that really should not be the case. A huge benefit to using a CGM (like Dexcom, for example) is being able to look at the trend line during the night. Your Dexcom (or whatever CGM you use) should have a fairly straight, horizontal line during the night, showing a steady blood sugar all night long. None of my endocrinologists ever told me this, but I learned this from reading Dr. Stephen Ponders book Sugar Surfing, which I highly recommend. I gradually cut back on my Tresiba until I started to see a consistent horizontal line during the hours I sleep.  If my trend line goes up, I’m not taking enough; if my trend line goes down, I’m taking too much.  The slightest adjustment can make a difference… Which is why I did it gradually.

TIP #2

I’ve found that the other big component to steady blood sugars during the night is to make sure I don’t have any short acting insulin on board when I go to bed.  Therefore, I eat my meals fairly early (at least 4 hours before bedtime), so that my fast insulin has time to do it’s job, and then clears out of my system.  I know for me, my short acting insulin seems to peak at about 1.5-2 hours after injection, and is pretty much done within 3-3.5 hours. This varies, but for me, I’ve tracked it for a long time, and I know how it generally works for me. (Notice, “for me” is in italics.  Your body is not my body, and things may be different for you.)

I think these consistent blood sugars during the night is a big reason why my A1C is where I want it to be.  There’s very little guess work during those 8 hours since I’m neither eating, taking insulin or working out, which are the 3 things that effect my blood sugars the most. And the less lows I’m having to treat, the less I have that whole “roller coaster” of highs and lows that nobody likes.

As I’ve mentioned a lot on this website, I’m certainly not a doctor or a nurse.  I only know what works for MYT1Diabetes.  And I’m just sharing that information.  Definitely discuss any changes you want to make with your team of health care providers.  🙂

 

The Joy of Pockets

This is my adorable niece, Abigail, who began pre-K just this past week.  Here she is, modeling her first school uniform- this little red dress:

As you can see from the photo, she was obviously  pretty stoked about the first day of school.  However, in this picture she is even MORE elated…

When her mom sent me the photos, I commented on that extreme happy face in the second picture.  And she told me, that huge smile came right after Abigail’s discovery that her dress wasn’t just cute, but also functional because it had pockets.

As a girl who loves dresses, I identified with this kind of joy over the pockets! I’m not sure why Abby cares, but I can tell you why I do.  I can put my Dexcom in that pocket and have it with me all day long without needing my purse, or worrying about misplacing it.  I can also use that pocket for a candy storage compartment. Oh yes, pockets, are a huge bonus for a girl like me.

Abby, fortunately, doesn’t have Type 1 diabetes.  But still, she knows the magic of dress pockets and seems just as overjoyed about them as I am.  It’s the little things in life sometimes.

My T1 Diabetes Blog. Reboot.

When I first began this blog about Type 1 Diabetes, although it had the same title, it was a Blogger blog.  I got a good amount of traffic in the beginning, and I felt like what I was writing was helping some people, and creating some great conversation among fellow Type 1 diabetics.  And that was my whole intention.

I thought switching to my own domain, and using the WordPress.org blog would give me better ownership of my content, and seem more legit.  But something got lost along the way during that transition.

boo hoo

I guess I just lost the momentum I had at the beginning. I started getting a lot of bogus comments from robots in the middle of the night. (Apparently, that’s a common problem for WordPress users) I got less feedback from real people than I did at my previous blog address.  I wasn’t sure how to promote my blog and get the readers that had found me the first time around to jump over to this new blog address with me.

I also started to feel like there were only so many posts I could write about insulin and glucometers and my beloved Dexcom. I felt like maybe I had said all I had to say on the topic of diabetes management.

I became frustrated and I decided this blog didn’t really matter to anyone anyway.

Actually, I’ve been re-thinking my pity party.

I’ve had diabetes for most of my adult life.  Something like 22 years.  And I think I have a pretty good handle on how to keep it under control, most of the time.  It’s a lot more complicated than just taking insulin and counting carbs to keep things in balance.  It’s recognizing patterns, it’s dealing with hormones, and emotions, and sleep, and workouts, and!, and!, and the list goes on. All of the things I do for my health- my physical, emotion, mental and even spiritual health- ALL OF IT, has at least some effect on my diabetes.

So I feel rejuvenated to begin again with this blog. I realize now that I can broaden the scope. I won’t just be writing about insulin and blood sugars.  I hope by posting regularly, I can find consistent readers who are also interested in choosing to live a happy and healthy lifestyle with an auto-immune disease like Type 1 Diabetes. Whether it’s in the comment section, or in sharing posts with friends, or in directly emailing me, I appreciate any and all conversation with you!

I’ll be posting on a regular weekly basis. Please subscribe so you won’t miss anything.  Thank you SO MUCH for visiting My Type 1 Diabetes Blog.

Needless Excuses for my A1c

I was suppose to go see my endocrinologist a couple of months ago.  No fault of my doctor, but the place he used to practice shut down.  With no notice!  Diabetes America, no more!

Because there was some lapse in time between Diabetes America unexpectedly closing down and Dr. Mora opening up in a new spot, I haven’t been in to get my A1c checked since December.

I figured it would be pretty good because I have a Dexcom, so I have that information available.  But the last month has been pretty challenging because we were out of town during the entire month of June. We were eating out more than usual, and at places that I didn’t know how long the wait time was, so my insulin doses were often “off”, and my blood sugars suffered because of it.  I saw way more spikes than I like to, or than I normally do.

As I drove to my appointment yesterday, I said a little prayer hoping that this new place Dr. Mora is practicing out of will have the “finger stick method” rather than the from the “vein method” for my lab work. It’s ridiculous that I’m so squeamish with veins, but I am.  I could never be an intravenous drug user- I would never be tempted to shoot drugs up for sure! So, that’s a bonus.  Anyway… Praise Hallelujah!!!  It was just a finger prick.

But even more Praise Hallelujah than that- My A1c came back lower than ever.  5.5%. So even though the last month has been a challenge, I worked hard enough that it didn’t screw things up.

I hadn’t checked the Dexcom Clarity app lately, but I did check after I got my lab results back from my doctor yesterday.  Although Clarity no longer gives a predicted A1c, it does tell your blood sugar average over a 90 day period (which is essentially what the A1c result refers to), and mine was 115.  According to the chart below, my A1c should be 5.4% based on that… That’s pretty close! And I’m very happy.  And proud!  My OCD behaviors are paying off.

As I drove to my appointment, besides saying my prayers about the blood draw via finger prick, I also mulled over my excuses I would give to Dr. Mora in case my A1C was higher than it had been at my last appointment. It’s funny that I feel I owe him excuses.  As if I’m being graded and my lab tests are something I either did or didn’t study for. As if it’s him I’m trying to impress. But I think it’s a common patient behavior. I know I’m not alone in this.

I’m not quite sure if the last month’s blood sugar average has more impact than the previous two months on the A1C, so I was a bit worried.  I was going to tell my doctor, “Traveling gave me an added challenge.” Paired up with, “Also, I’m a woman of a certain age, and I’m sort of going through “puberty” and it’s messing with my blood sugars.”  I will always have an excuse, because life always throws us little challenges, and sometimes big challenges.  But, we keep plugging away, and we keep trying our best.  And sometimes, you end up rewarded for all that trying. And this time, I was definitely rewarded!

And that’s the greatest motivation for me to keep trying my best. Not for my doctor.  But for me.

Yay, ME!