Getting a sense of all of this

In my post "Type 1 is such a prick" I told you the story about moving from finger stick sugar checks to my constant glucose monitor (CGM). I had just gotten it and was still getting used to it. At that point all I really knew was that I no longer had to abuse my finger tips with lancets and I'd get way more visibility into my sugar levels.

I've now been on the CGM for 2 months and it makes a world of difference. I lift my wrist and immediately see my sugar level. Beyond that, I see one of a variety of arrows telling me which way it's trending. This is arguably more useful than the raw number itself. 150 is a good number. Not great, but good. 150 with a diagonal arrow down is better. That means it's slowly dropping. If I have some insulin in me and working from my last bolus that means things are balancing but I have to watch and make sure I don't get low. If I have an arrow straight up that means I'm on a rocket ship over 200 and I need another bolus. This thing adds so much more context. Now add in that one critical function a watch does that we almost never actually use it for - telling time. Imagine that 150 with 2 arrows straight down, which means my sugar is dropping like an anchor. Big difference between 1pm on a Saturday afternoon, 5pm when I'm about to drive home, and 11pm when I'm about to sleep. Only one of those situations leaves me comfortable. The other 2 requires Skittles.

It also helps me decide my insulin treatment plans. I think about the last bolus. Am I still processing insulin or is this just where my number is sitting? Should I give more because my sugar is high and I'm fresh out of ammo or do I need to have some patience while it works? These are all key indicators.

The last important piece is the thresholds. I have it set to alert me below 80 and above 200. If either of those happen, my phone beeps like a lunatic regardless of my volume settings. It will also beep like that regardless if I'm in line at the airport and about to board an international flight and there are 200 people staring at me awkwardly. Not that that's ever happened. If those thresholds are broken for longer than 30 minutes, it'll notify whoever I have listed in the app. But it has its own thresholds for reporting. 70-180 during the day. 80-150 at night. Tighter ranges means even better success if I'm within range. I'm proud to say that my lowest success was 92% within range during a 7 day period. That was my worst!

What does all this data, tracking, and reporting even mean? It sounds like it's lots of work to watch it all the time and make calculations. The reality is just the opposite - at least as a function of time. Week over week I obsess less and less. It started with finger sticks giving me limited information an even more limited amount of time. Then it was limited information but frequently. Then I learned how to use the arrows and put them at the intersection of the clock, dose, and food. It became lots of information with lots of context and frequently.

Now I just often know. I can look at food and know how many carbs it is and roughly what it'll do to my blood sugar. I know how much insulin I took and roughly how long it'll be in my system. Of course I know what time of day it is. I glance at my watch and check the number to confirm what's already in my head. It no longer informs my decisions. It just validates the ones I've already made. It's a sanity check. The sensor sensed what was happening. Now I sense it and the sensor confirms or vetoes. To be honest, I'm ok at it. I'm not great or even good just yet, but it's been just 4 months since the diagnosis and 2 since the CGM arrived.

And tomorrow, the game changes again when we add a new piece of tech. Stay tuned for more.