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.

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.  🙂

 

One Touch Veria Meter

Every year or so, I have to switch my glucometer due to what my insurance will cover.  It’s not a huge deal, because meters are just meters- as long as they’re accurate.  I don’t care about the bells and whistles of meters that do special things with data anymore, because, well… I just don’t.  I have my Dexcom, and I feel like the bulk of important information comes from that anyway.  These days, my meter is just what I use to calibrate the Dexcom.  And as long as it’s calibrated, I trust the Dexcom’s numbers just as much or more than a glucometer.

My insurance company now only covers One Touch meters. So, it was time to move on again. My endo had two to chose from: the Verio and one other (I don’t recall the name) that looked a little flimsy, so I went with the Verio. I liked the sleek look of it.

One Touch Verio Glucometer

Instead of batteries, it has a charger.  Initially, I liked this idea.  But I just noticed last night that the charge only holds for 1-2 weeks.  So when I go on a trip that’s anything over a week, I have to remember to take yet another charging cord.  Ugh. So honestly, I think batteries are my preference.  They last for months, and double A batteries are cheap! Oh well.  Not a big deal.

Like pretty much all the meters I’ve tried in the past few years, the Verio is quick and simple.  Just a teeny bit of blood on the teeny strip, and 5 seconds later, you know what your blood sugar is.

I’m currently paying out of pocket until I meet my deductable, so this first 3 months supply of test strips cost me around $560 at my online pharmacy.  Just out of curiosity, my husband checked Amazon Prime’s pricing on the strips and they were actually CHEAPER on Amazon.  But we weren’t sure how regulated they were (when’s they’re expiration? why do the boxes look diffrent?) if I bought them through Amazon and the price difference wasn’t hugely significant. Before I order my next batch of strips, I might look into this a little more.  I guess I shouldn’t just assume that buying from my online pharmacy  (when it’s out of pocket and not a drug that needs a prescription) is always the best, most affordable option. I wonder how much the strips would be if I ordered them from Canada?