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.

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.  🙂

 

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!

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?

 

 

Intermittent Fasting

Whenever I’ve heard about the benefits of a fast, or cleanse, I’ve always thought, “That is absolutely NOT for me!”  For one thing, I get pretty cranky if I go without food for too long during the day.  Then there’s my Type 1 diabetes to deal with… these fasts I’ve heard about are usually not recommended for someone like me.

Intermittent fasting, however is a whole different thing.

In a nutshell, with intermittent fasting (IF),you get most of the benefits of a longer fast, but it’s much easier, in my opinion.  You have a 8 hour window  (you can tailor it, but generally an 8-10 hour window is ideal) during the day of when you eat all of your meals and you don’t have to worry about eating the rest of the time.  There are all sorts of ways to do IF, and if you do a little research on Google, you’ll find many articles about it.  I’m only writing about the way I do it, and how it works for me.

Don’t worry about that saying “Breakfast is the most important meal of the day.”  It probably is!  Break + fast = breaking your fast.  Breakfast, also known as your first meal of the day, doesn’t have to be eaten early in the day, and it certainly doesn’t need to be pancakes, waffles or whatever you consider “breakfast” foods.  As for me, I’m much more likely to include veggies, nuts and other proteins into a mid-day meal than I am a morning meal.  In fact, for years (and years and years) my standard daily breakfast was a piece of cinnamon toast- Gluten free bread, butter, and a little cinnamon and sugar sprinkled on top.  Does anyone believe that was my most important meal of the day? It certainly wasn’t my healthiest!

I eat lunch (usually a little after noon), occasionally an afternoon snack, and an early-ish dinner.  At first, not eating a late night snack was hard, but that’s just becath-2use snacking at night while watching tv is fun!  But it’s not necessary.  And I’m not like a baby or puppy whose tummy needs to be full to sleep through the night. I’m sleeping at least as good as I was before changing my eating schedule.

The benefits of intermittent fasting for the average person is slightly different (again, you can read all about it online) but for me, here are the benefits I notice as a type 1 diabetic:

  1. I can maintain a very steady blood sugar the longer I go without food… therefore, going a solid 16 hours without eating, I don’t have to worry about the effects food will have on my blood sugar. That’s over half the day.  And that’s a good thing for my blood sugar average, and therefore my a1C.
  2. I save time in the morning not having to deal with making and eating breakfast. I no longer concern myself with how my morning shot of fast acting insulin is going to effect my workout. Now, I don’t take any fast acting insulin until right before lunchtime.
  3. Even though I’m not trying to, I end up consuming less calories. And it’s mainly empty calories that have fallen by the wayside… My morning toast and evening snacks were never anything that packed in a lot of nutrients anyway!

Occasionally, I wake up in the morning with my blood sugar a little lower than I like it before my morning workout.  Obviously, if that happens, I eat to take care of that. I find I usually don’t need more than about 5-7 grams of carbs since I don’t have any short acting insulin in the morning.

With intermittent fasting, you’re not necessarily reducing the amount of food you eat each day, just the scheduling of when you eat it.  And if you’re like me, you might see good results without making much of a change.

As a reminder, I’m not a doctor, nurse, or a nutritionist. I am just a person with type 1 diabetes that is trying to live my healthiest life and when I stumbled upon things that work well FOR ME, I like to talk about them.  Everyone is different, and different approaches work for different people. Always consult your doctor before making any changes in your diet.