Dexcom Tells Me More Than My A1C

Last week, as I was driving to my appointment with my endocrinologist, fighting horrible traffic to get there I started to question, really, why was this appointment even necessary. My last appointment was only 3 months ago.

My main reasons for these appointments have always been:

  1. to find out my A1C and
  2. to get prescription refills.

That’s pretty much it. But now, I have a Dexcom, and I look at the Clarity app often enough that I know what my “predicted” A1C is.  Besides that, I think my trend graph is way more important than that A1c number anyway.  An A1C could spit out an impressive number, even if someone didn’t have very tight control on their blood sugars.  As long as the average works out to be something within a good range, the A1C might deceivingly seem “good”even if your control isn’t.

One thing I love about my endocrinologists office is that you get an immediate result of your A1c test.  Last week, mine came back as .5% higher than what the Dexcom Clarity app predicted.  When I told my doctor, he said “we pay more attention to Dexcom results than the lab work.”  I didn’t ask why or for any further explanation, but it’s how I’ve felt about it all along and I’m happy with how things have been going so, I’m just sticking with what my Dexcom is telling me.

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The Dexcom Clarity App on my iPhone.

It seems like an A1C result isn’t as important as it used to be now that we have more advanced technology.  I can see graphs of what my blood sugar is doing every 5 minutes of the day with my Dexcom CGM.  I can get a predicted A1c for a 7 day, 14 day, 30 day, or 90 day period with the Dexcom Clarity app.  Even better, if I access Clarity from my computer, I can see all sorts of trend graphs to see where where and when my “problem” blood sugars are. I pay a lot more attention to whether or not my blood sugars are staying within my target range than anything else.  The actual A1C or average of those readings is far less important to me than simply staying in my ideal range as often as possible.

I’ve tightened that range little by little.  I think when I first had a Dexcom, I had an alarm set for a high of 180- maybe even 200.  Now I keep my low alarm set for 65 (that hasn’t changed), and my high at 150.  These days, it’s a rarity for me to have a blood sugar that ever gets (or at least stays for long) above 170.  Of course, it still happens from time to time, but thanks to having the alarm set for 150, I can be proactive and avoid those highs I use to battle. Treating a slightly elevated blood sugar is a lot more manageable than treating one that gets way up there.

My endo told me to make my next appointment in 4 to 6 months.  Of course, I chose 6 months.  Unless something new comes up, there’s no reason for me to go any sooner than that. I get more meaningful information about my blood sugars from my Dexcom than an A1c result is ever going to tell me.

 

Comparing the Dexcom G5 to G4

(*This post originally appeared on my now defunct Blogger blog, but because this article still gets a lot of traffic, I wanted to move it to this current blog in the hopes that readers could find me!)

 

DEXCOM G5

I got mine last week.

I was uber excited that:

1. All of the data from my sensor would go directly to my iPhone, and cut out the middle man, aka, the receiver. I misplace that stupid little thing often, and cannot tell you how much time I’ve wasted looking for it.  At least if I misplace my phone, I can call it from another phone and it will ring. Also, one less thing to carry around?! Sign me up!

2. I was told that if I was out of range from my iPhone, once I was back in range, it would upload the data.  This would be a big improvement, since sometimes I’ll forget my receiver when I go somewhere and will lose hours of data that will forever remain a mystery.

3. There is a phone app called “Clarity” that goes along with the G5. I have an older Mac and couldn’t use the other software that analyzed the data of the Dexcom G4. I had heard Clarity was very easy to read, and had lots of valuable info, including a predicted A1C.

After having had the new Dexcom for about a week now, my opinion is- it’s really not that different or improved than my previous G4 version. I am not blown away by any means.

1.  Yep, it goes directly to my iPhone. BUT I actually prefer a few things about the receiver, which is surprising to me.  It’s smaller than my ultra huge iPhone 6 Plus- I can’t even fit my mega phone into most of my pockets I’m now discovering.  Also, with the receiver, I just touch one button, and voila~I can see my blood sugar reading!  With the iPhone however, I have to hit a button to light up my screen, then hit my 4 key code to unlock (because just my thumbprint pretty much never works), and then hit the Dexcom icon.  That’s between 3-7 button pushes compared to 1.  It’s a small complaint, but it is a complaint.  (And neither of these problems are Dexcom’s fault, I realize.) If I’m somewhere like my yoga class, it’s one thing to press one button on a little meter, but it looks pretty obnoxious to have my iPhone in class and press several buttons to see what my blood sugar is– I might look like some asshole texting a friend during yoga. OH NO!

One advantage the iPhone has over the receiver is that I can set my alerts to different sounds, and I can adjust the volume.  BUT- and it’s sorta a big but- BUT, often the alarm only comes by way of a text alert, but not the sound. Maybe it’s a software glitch that will be cleared up soon, but for now, that’s not working consistently for me. Also, I have to remember to keep the volume on and up or I don’t hear the alerts anyway.

Another positive- I like the display on the iPhone- it looks like this:

Dexcom G5 quick glance graphic

And if you turn it to landscape, you can view it over the past 1 hour, 3 hours, 6 hours, 12 hours or 24 hours.

my last 12 hours graphed on the Dexcom app

If you run your finger over the little dots, it tells you your blood sugar for each individual dot.

(specific blood sugar readings for each dot on the graph as you move your finger along the line)

2. If I’m out of range, that missed data does NOT upload once I’m back in range.  It’s just blank areas of the graph. (You can see that in the above graph- I was out of range for a while around 11am and so it’s blank.) The Dexcom rep who told me that was either wrong, or mine doesn’t work right. So in this regard, the G5 and the G4 are the same.  Out of range is lost data and one of life’s great mysteries.

3.  The Clarity app makes no sense to me. For one, I can’t turn my phone and see it in landscape mode, so I can only see an unreadable version that looks like this:

I’ve got great eyesight, but I need a magnifying lens to have any idea what this says.

I have no idea what that graph is all about, and it’s such a small amount of information, helpful or otherwise even if I could read it.  However, that could change once it’s collected 14 days of data.  But so far, 6 days in, this is ALL it shows me.  And it’s not impressive at all.

So maybe I set the bar a little too high for the G5 before I got it.  It’s more or less the same as the previous model. Having the blood sugar data come directly to my phone hasn’t made a big difference in my life, like I thought it might.  Don’t get me wrong, I LOVE my Dexcom, and at this point, can’t even figure out how I had decent blood sugar control without it- and how I avoided daily severe low blood sugars, especially during the night.  I’m just saying, the G5 hasn’t made me fall any deeper in love.

But I’m only 6 days in…