Thomas A McAtee Jr.
I have a question. I seem to be in that group that don't 'feel' when they're having a high or a low. A friend and I were talking about it and he thought odd because he can feel his lows etc.But I explained that the only way I know is when I do a test. We got to discussing something that his nephew uses. Think it's the CGM.
I'm not on insulin but do fall into that category about not feeling the symptoms. So got to wondering if that a CGM would benefit me or not. Will try to talk to the CDE on this but wanted to see what everyone thought on this as well.
Thanks
Thomas A McAtee Jr. Moderator
Did some research and noticed that Medicare's requirements states that you have to be on insulin. Could had sworn that I had seen on some site saying 'or unable to feel low symptoms'. Oh well guess will just keep going and see what happens down road. 😉
Kelly Dabel, RD Community Admin
Apologies for the delayed response Riddler. Thanks for reaching out. This is a great question. Continuous glucose monitors are a great tool for many. They are typically recommended for those who experience extreme highs and lows in their blood sugar with no clear reason, those are prone to hypoglycemia or hyperglycemia and those who use an insulin pump. Of course there are other scenarios where a CGM may be beneficial and a doctor can decide if it's indicated. Even with a CGM, a finger stick is still needed, although less often. As you said, insurance may or may not cover the expense, so that's something to consider as well. You mentioned that you aren't always able to detect your lows. Are you finding that you have dangerously low blood sugar levels and were unaware or are they lower than expected but still in a safe range?
Absolutely, have a conversation with your doctor about it and any concerns and questions you have. Good for you exploring your options and researching! Keep us posted! Best, Kelly, Type2diabetes.com Community Moderator
Thomas A McAtee Jr. Moderator
With me I never know what I have until I test. I've had lows in the 60's and 50's but no symptoms what so ever. Same when I get highs from 180 up. Then when I think I might have one or the other I'll test and will be okay. So I never know anything until I test. They're not consistent. I mean I'm not having every day or every week but when I do have them I never know anything. So was just curious on this. But when saw what Medicare's requirements and probably the secondary's requirements are then I saw that it wouldn't probably happen in getting one. 😉
Thomas A McAtee Jr. Moderator
Here's another question along these lines of thought. I was reading where when some couldn't tell their symptoms of going low or what have you that their ranges would be adjusted higher. So, when reading that I got to wondering. If low is considered anything below seventy what/how does raising the bar to above 70 so that anything below that range would be considered a low help someone to start to know the symptoms? I couldn't grasp what they were getting at for some reason. Same would go with knowing when they have a high? How does that work to help someone know when they're there if they can't feel the symptoms at the norm set by the ADA and Joslin??? Thoughts on that as well?? For some reason when reading something like this I just can't see what they're getting at. I know that the CDE I had before now having to start a new team mentioned that people w/o diabetes will also have a low/high at times. I understand that and also knew what she meant about her getting some lows when she was on a diet. But still looks like they feel it, seems like she knew. But for someone that can't feel I couldn't grasp how their doctor adjusting their range for them will help to learn how to tell when they're at a certain point.
Way I see it with the new ranges set then they'd still need to do the finger prick to see if they're low or high then. Right?? Clarification??
Kelly Dabel, RD Community Admin
Thanks for the question. In some cases a doctor may modify a patient's goal blood sugar targets. An example would be in an elderly/frail patient who is prone to hypoglycemia. The team may liberalize that patient's goal range to say that they should strive for a fasting value between 100-140 or less than 200 after meals, because for that patient to strive for the lower scale may become dangerous for them. This is of course very individualized and something that patient and doctor have to weigh the pros and cons of together. This modified scale does not teach someone how to tell when they're low or high but rather builds in a cushion to protect them from a dangerous low. Obviously, ongoing elevated blood sugar levels are not ideal either, which is why the patient and doctor need to evaluate case by case.
Hope that helps clarify! Keep striving for that tight blood sugar control and checking on a regular basis.
Best, Kelly, Type2diabetes.com Community Moderator
Thomas A McAtee Jr. Moderator
Ahhhh Thanks. For some reason the things I read led to believe that they were adjusting to help with the learning to recognize when they're having a low or high.
Then assuming that an individual had the goal of 100-140 for fasting would anything below the 100 be considered a low and be treated or would they still follow the anything below 70 is what's to be treated with the 15 min rule?
Thanks