Wednesday, February 20, 2008

Dexcom - day 5


We are dexcom day 5 with Cadence.  What a great little device, which has already paid for itself in spades after a scary low on the weekend.
We were cruising through a showhome in our 'hood looking to
 steal some decorating ideas for our little hacienda.  Cadence was ripping around the house, up and down stairs, jabbering at all the other people milling about in there on Sunday afternoon.  We heard the chirp from her Dexcom CGMS and the warning that she was dropping low.  We sort of expected her to go down a bit as a result of her activity, so we casually picked her up, went over to the kitchen table in the showhome and did a quiet fingerpoke.  The number on the blood glucose meter said 2.2 mmol/L (35 md/dL).  That is a severe low and a very dangerous one for a 15 month old.  The worst part is that she had no idea...  confirming our suspicion of "hypoglycemic unawareness".  Cadence doesn't feel her lows, where as most diabetics feel horrible during a low, it's their safety net.

So, I sprinted out of the showhome to grab whatever carbs we had from the car, while Nic put Cadence on the boob.  I grabbed fruit bars, soy milk, anything really, and ran back into the showhome to the surprise of the salespeople there.  So with about 25-30 people moving in and about the showhome we treated Cadence's second lowest glucose reading since her diagnosis.  We had carbs, a sock, and bloody test strips layed out over the kitchen table...in the middle of the showhome.  Sometimes you just have to make due LOL.  Once recovered, we continued the tour through and upon exiting she showhome manager says "that must have been some diaper change!  By the way, is that a GPS on your daughter?"  :)

Now, onto the Dexcom.  What a great little device, and proven so in the above story.  We are on day 5 and the finger stick readings comparative to the dexcom trends are very close if not bang on.  If there is a difference, it's usually as a result of taking a reading at the peak or valley of of change in glucose levels.  Otherwise, the dexcom is usually well within 10 points (mg/dL) of the meter reading, a huge plus.  With the minimed system we had values that were absolutely nowhere near what her blood glucose reading was, even at times of stable sugars.  So the question begs:  What's the point on putting a "real-time" blood glucose reading on your display if the user is amazed if and when it's accurate?  The trending bars are invaluable though.
We are still undecided as to which technology we are going to invest in but the Dexcom appears to be a better product.  If only they could pay one computer programmer for 3 hours work and make some rate of change arrows (like minimed's) and have an option to use mmol/L or mg/dL, it would be the giant killer of Minimed product.  For the price of these "next generation" units it's amazing that a handheld poker game from the airport has more display and computing capability than these devices.  We're going to give the minimed another shot next week though and see if it can stand the test.  

With Cadence's hypoglycemic unawareness, it appears that we don't have much of a choice of not going with a CGMS.

3 comments:

Bernard said...

Brad

I'm glad the Dexcom caught Cadence's low. That must have been scary.

I've seen several different people complaining about the lack of support for mmol/L units. Have you contacted Dexcom support and let them know? It seems to me that the more people who ask for this, the more likely it is to happen.

I normally use the curve over the last hour or 3 hours to help me determine the direction and rate of change for blood glucose readings.

For me, I don't think arrows would add all that much. But then I have one of those strange mathematically inclined minds.

Brad Kane said...

hey Bernard,

Yeah, wrt to Dexcom I asked a bunch of different people over there and got the "um...that's a good question" type of answer. All mentioned that they "are trying to go international, therefore they would have to have both unit measurements" type of answer. The rep seemed to think it would be available through a software update at some point. As it's only available in the US and a prescription is required I think we may be one of very few that are using one up here, but it's sure hard to imagine going back to the minimed setup after this.

I also agree on the three hour screen as it seems to show the trends a bit more accurately. It's too bad that you can't set which startup screen you would like for the unit. If I could get it to start at 3 hours, that would be awesome. Again, some of these issues would take about 3 hours at about 16 bucks an hour for someone to program in.

I appreciate the info!
brad.

k2 said...

Seems like you and your wife and doing well with Cadence.
I know it's a battle, and keeping up with all the latest and greatest technical advances can make your head spin!
As far as your Dexcom issue - keep on the rep about it & keep us posted on your progress!