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Dec. 16, 2021

#50 Dexcom 101 and How to Read the Dots, not the Arrows

#50 Dexcom 101 and How to Read the Dots, not the Arrows

We love our Dexcom G6 continuous glucose monitor! However, before we got on it, we had A TON of questions and were pretty nervous about how the whole thing worked. Today, I discuss all things Dexcom including terminology, calibrating, placement, pairing new transmitters, going through airport security. Plus, I share a little tip and trick that has helped us immensely to make sound treatment decisions for my daughter and avoid the type 1 diabetes rollercoaster as much as possible. Spoiler alert... it's all about reading the dots and NOT the arrows. This is episode is not sponsored by Dexcom or affiliated with them in any way. Enjoy and let me know if you have any other questions.

Find more information and answers to many commonly asked questions on the Dexcom website: https://www.dexcom.com/faqs

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Y Hello there to switch it up a little bit. This week, I'm putting the product feature of the week at the beginning of the show. Crazy. I know, but this week's product feature is a waterproof floating pouch for your cell phone. Many of us or many of our kids use their smartphone as the. Dexcom receiver. And when we are near a body of water, I do not want to take any chances with that thing, getting submerged and ruined and lost forever at the bottom of the ocean or wherever we may be a waterpark wave pool. You name it. These things are great. Check it out. I will put an Amazon affiliate link in the show notes. Please make sure it is compatible with your particular smartphone. The one featured via the. Is compatible with most, but always double check and make sure have you had a chance to check out, buy me a coffee yet? Buy me a coffee is a no strings attached way for listeners like you to support the show. Your gift can be a one-time donation or you can become a sugar mamas podcast. Buy me a coffee member. We have memberships starting at only $1 a month. Huge shout out to our most recent, buy me a coffee participant. Kate bought me two coffees. Thank you, Kate. If you want to check it out for yourself, you can go to buy me a coffee.com forward slash SugarMomma. I'll leave a link in the show notes each and every donation received, goes to making this podcast come to life each week. All right, let's get. Hey everybody. This is episode 50 of the sugar mamas podcast. I can't believe we're at episode 50. That's crazy. We're about to come up on one year of the podcast and you'll know I'm going to buy myself a cupcake and sing happy birthday to the podcast in my kitchen today, I want to talk about the Dexcom G six. First of all. I want you to know that this episode is not sponsored by Dexcom. I'm not getting paid to say these things. I just really love our Dexcom G six. And I feel like I figured out a pretty good system on how to read and analyze the Dexcom data to make the best treatment decisions for my daughter, whether we're treating a low or a high, I feel like I have a pretty good trick. On how to know what to do next as always please know that nothing you hear on this podcast should be considered medical advice and your diabetes may vary. So what works for us might not work for you. Before we go over that though. I thought I'd just take a little bit of time to answer just some commonly asked questions about the Dexcom. These were questions that I had before we even got on the Dexcom and then kind of when we were really new to the Dexcom, when we were newbies and figuring it all out. So this episode is great for anyone who's maybe looking into. Getting on a Dexcom or who's about to get on the Dexcom. Congratulations, by the way, you're going to love it. It's life changing. And for those newly diagnosed families who have a very vague idea of what a continuous glucose monitor is, and they keep hearing people talk about the Dexcom, or maybe you've been on Dexcom G six for a while now. And you just want to figure out how to avoid the diabetes rollercoaster at all costs. I am not saying we are perfect by any means. We never have been, and we never will. But the way that I have come to read, my daughter's Dexcom graph has really helped me calm the crazy that is diabetes on a lot of days. So maybe you'll find it helpful too. All right, let's do our intro and we'll get started. You're listening to the sugar mamas podcast, a show designed for moms and caregivers of type one diabetics here. You'll find a community of like-minded people who are striving daily to keep their kids safe, happy, and healthy in the ever-changing world of type one. I'm your host and fellow T one D mom, Katie Roseboro. Before we get started. I need you to know that nothing you hear on the sugar mamas podcast should be considered medical advice. Please be safe, be smart, and always consult your physician before making changes to the way you manage type one diabetes. Thanks. All right. First and foremost, let's go over some Dexcom terminology. Bless my husband's heart. He still gets these three things confused quite frequently, which I find amusing, but the Dexcom G six comes with three components. There is the sensor, the trans. And the receiver, the sensor is the part that gets stuck onto the skin. It comes in a slightly bulky packaging with an apparatus that is white with a big orange button. You can remember sensor, skin, sensor, skin. That's the part that actually sticks to the skin. You may be wondering if the sensor on the Dexcom is. It is not, I was very nervous about this before we got on the Dexcom. My daughter was terrified about this. Yes. There is a needle that initially inserts the sensor under the skin into the interstitial fluid, but that needle retracts immediately. I mean, it's gotta be half a second or less that the needle goes in and immediately comes out to insert the sensor under the skin, the sensor itself. So what stays in the body underneath the skin is actually a very, very, very thin wire looking thing. It is about the size and width of an eyelash. Just as flexible. So it's very flexible, very soft, very, very tiny, just to calm, anybody's worries or fears about what it might look like or feel like Dexcom sensors last for up to 10 days, we usually get 10 days out of ours. I know a lot of people seem to not get 10 days out of it, but we do more on that later. The Dexcom transmitter is the. Is another component. It is the little gray plastic looking piece that snaps into the sensor these last about three months. So you can usually get through for a year. The last component of the Dexcom is the receiver. So this receives the information from the sensor and the transmitter. Displays it either on the little handheld device that looks like a miniature phone that came with your Dexcom initially, or on your phone, some people only use their phone as their receiver. Some people only use the little hand handheld device that Dexcom issued you. Some people use. We used to use both, but now we just use the phone. We take the receiver with us when we go on vacations, because I just like to have a backup. And sometimes I like to have it when we're like in a lake or a boat or a pool, I'll put it in a waterproof pouch. Um, especially if I know I'm going to be near Sarah, so I won't have to rely on the follow app to see her numbers. Um, I do. If I have to lose something or drop something in a body of water, I would prefer that it's the Dexcom receiver that came with the Dexcom and not the very expensive smartphone that we pay for monthly, but that's just me. And luckily we have not dropped that in a pool or a lake or the ocean yet. Speaking of bodies of water. The Dexcom sensor and transmitter that stays on the body is waterproof. It really, really is. I was questioning it at first. I'm like, can she really take a shower with this thing on? Can she really jump in the pool with this thing on, but it is, it is for sure. Waterproof, we have worn it in a hot tub. We have warranted in the pool. We have worn it on nice long bubble bath. We have worn it in the ocean. We have worn it on a plane, on a train, in a box with socks. Can I really wear it in the water, Sam? I am. Yes, indeed. You can. You can. I've heard a lot of people ask if you really don't have to do fingerprints when you are wearing a Dexcom and for us, we really rarely do. Finger pricks. Now that we're wearing a Dexcom. I know that we did more in the beginning when we were kind of getting used to it, learning to trust it. But now we do finger pricks when we are waiting for the Dexcom to warm up, because there was a two-hour warmup when you start a new sensor. So you don't have any readings for two hours. So we will do a fingerprint every 20 or 30 minutes while we're waiting for the Dexcom to warm up. And then the other time that we do a finger prick is if the Dexcom is giving us an in rain. Number, but my daughter is saying she feels low. Sometimes I will just go ahead and treat that low with a few Skittles. Even, even though we often will do a finger prick and she's not actually low, she maybe she just, I don't know, felt a little woozy or a little off for whatever reason, but I just think it helps her give her peace of mind. Just give her three or four Skittles. That's not going to make a humongous dent in her blood sugar. Just gives her a peace of mind to know that. If she were in fact low, she would have a little bit of glucose on board. Uh, another time we do finger pricks is if she is indeed low, like if the arrow is pointing down or maybe a double arrow down and we are, we've treated a low, so we've already treated it and we're waiting for the Dexcom to catch up because, you know, there's like a 15 to 20 minute. Lag in the readings between what's actually going on in the blood sugar. So we will do fingerprints then just to ensure that we indeed have stopped the low and the blood sugar is starting to come back up when you have a double arrow down and you're at like 50 or below, which we have been there before. And your Dexcom is still screaming at you that you're low, low, low, low, and you've already treated the low, but your Dexcom is still alarming at you. That you've need to do something about it. That can be a little stressful. And so to help my daughter calm down while we're waiting for the numbers to catch back up in the readings to catch back up, we'll just do a couple extra finger pricks, maybe one every five minutes for 15 or 20 minutes. I don't just randomly check on a whim to see if our Dexcom is accurate. I just kind of trust it, which my personality tends to lean more towards. Being a worrier. So my mindset is I'm just going to trust this number. I feel like if I did test it more often, maybe I'd be more frustrated with it, but I don't. Ignorance is bliss. People trust the number. Speaking of trusting the number you might be wondering about calibrating, the Dexcom personally, I do not. Calibrate the Dexcom, unless we get a blood glucose meter reading that is very far from being close to what the Dexcom receiver is telling us. And when I say very far for me, that would be like 50 or more points off. So if it is 50 or more points off from the BG meter, and this is a big one and the arrow is steady. On your Dexcom graph. Hey, the arrow is important. Then I might, might with stars all around that might calibrate. Personally, I am much more likely to calibrate the Dexcom if we're on like the lower side of readings, especially at night, for example, if Sarah's low alarm goes off at night and at night, I have her low alarm set at 65, which I know is probably a lot lower than some of you would feel comfortable putting it at. But if her alarm is going off and it keeps going off. Even after we've treated the low, if it just keeps on digging and digging and digging, I'll do a finger prick. And if it's above where I have, Sarah's low alarm set at, let's say the BG meter says she's actually at 90. Then even though that is less than a 50 point difference, right? That's only 25 points difference between the two. If the arrow is steady, I still make sure the arrow is steady. I will calibrate it then. Because that might bring it up too, that might bring the Dexcom reading up to like 80 and that would stop her alarm from going off. So just keep that in mind, if you're trying to get some sleep now, not to make a liar out of myself, but I actually calibrated the Dexcom last night when Sarah was running. Hi, Sarah was running a lot higher than she normally does at night. She had had a very big meal, but going into that meal, I knew we were going to do that. With like a delayed rise. So I had given her more insulin than I normally would at the beginning of the meal and then had given her insulin after the meal as well. But even with those extra measures, she was still running way higher than normal. So I went in and I did a correction, nothing. Hour later, nothing. Absolutely. Nothing was budging did another correction. Then the third time I had to go in there, I did a finger prick. Cause I'm like, what? In the world? Like there's no way this couldn't have changed. I've been giving her so much insulin. Well, the BG meter said that she was actually sitting about 50 points lower than what the Dexcom was telling us. The arrow was steady. So I did go ahead and calibrate it and it brought that Dexcom reading down by about 30 points. So also just keep in mind that when you calibrate your Dexcom, it's not going to bring the number down to what you're seeing on your BG meter might bring it down by about half of that or by about half of the difference between the two. I would definitely recommend. Do not calibrate your Dexcom. If the arrow is anything other than a steady arrow, you can't calibrate it when your blood sugar is changing. Cause that's just going to throw everything off. You might notice that for the first 24 hours of a new sensor, the numbers do seem a little wonky and off if you're checking and comparing it to your BG meter. But I have found that if I do not calibrate it and I just let it. It will work itself out within the first 24 hours. Now I will say it is extremely rare for our Dexcom and our BG meter number to be exactly the same. It's that pretty much almost never happens, but even the Dexcom website says that they're almost never going to make. And what they consider to be a normal difference in readings. Is there 20% or 20 rule, which I can leave a link to that in the show notes, or you can find it on their website@dexcom.com forward slash FAQ's are my Dexcom readings accurate, but basically what they say is that to a certain extent, having small differences in numbers between meters and Dexcom readings is normal and to be expected. So try not to get too frustrated, but yeah. Avoid calibrating at all costs. I feel like there have been a few times where I have haphazardly calibrated, the Dexcom hand. It just seems to go totally squirrely. After that. Apparently the website says that the Dexcom will only ask you to calibrate it, like actually prompt you to calibrate it. If you don't enter a sensor code when you're starting a new sensor and it will ask you a lot. So if you feel like you are getting a lot of prompts to. Your sensor, maybe you didn't enter the code. I'm not sure, but I also feel like we've entered a sensor code every single time. And there have been a few occasions where we've been prompted to calibrate it. So I'm not so sure about that, but yeah, I have been known to threaten members of my family. If they have suggested that they were going to calibrate the Dexcom, I'm like, I will ninja kick that thing out of your. Do not calibrate it. Some of you may be wondering, can I go through a metal detector with my decks? Come on. Yes. Yes, you can. We have gone through metal detectors. We have been wanded. Yeah, we've done both of those things. Totally fine. No issues. So I, I wouldn't worry about that. You can even get through airport security with it, but of course at the airport, if you really just don't feel comfortable with that, you can. Talk to TSA cares, um, which I have a whole episode on that, but they would be more than happy to help you out and help you to feel as comfortable as humanly possible. Like if you don't want to go through the big body scanner with your Dexcom and maybe your insulin pump on. Okay. So I actually just hopped on Dexcom's website because I wanted to double check about that and apparently walk through metal detectors and the wanding, like the, you know, wanting to do it. Um, Security places is fine, that that has been tested and your Dexcom will easily stand up to that. But as far as the like full body scanners that sometimes they ask you to get in at the airport that has not been tested. So in those circumstances, they suggest that you explain to security that this device is actually inserted into your skin. You can't take it off and you would rather opt for the wanding or maybe a pat down. Um, if they won't let you get. Just a wandering. Also, they recommend not wearing it in MRI machines, cat scans, or like medical x-ray machines, because it just hasn't been tested in those, but you can fly with it. You can fly with it. It will, um, you will have to put your phone, like if your phone is acting as the receiver, you'll have to put that in airplane mode. But after you do that, you can make sure the Bluetooth setting is turned on and it will still communicate with the Dexcom sensor and transmitter. And if you just use the Dexcom receiver, they issue. You at the beginning, then there's no problem with that. You don't have to adjust anything without on an airplane. It will continue to get your readings. Dexcom website has a lot of great information. dexcom.com. Check it out. I just want to take a quick sec to mention the wooden spoon trick. Apparently, sometimes the sensor applicator's like the. It's actually not little, the big white handheld thing with the giant orange button on it that you have to push to insert the sensor. Apparently, sometimes that white apparatus will get stuck in it. Won't come off of the sensor after you push the orange button that has never happened. Thank goodness. So I can not speak from experience, but I have seen several moms and other parents comment in different support groups online that if that happens, if you take a wooden spoon and hit the white apparatus with the orange button. It will pop it off of the sensor and you'll be able to get it unstuck. You might want to do a little bit more research before you try that. Also, perhaps to prevent it from happening altogether. I always push the orange button pretty aggressively. Like I pushed that thing all the way down. Like, I mean it, I, my daughter still wears her Dexcom on the back of her arm. That is the only place we can get her to wear it at this time, but I take the back of her arm and I just kind of gently squeeze up pinch up. So I have a good little squishy area. And then I really push that orange button hard and then let go. And we've never had a sensor get stuck. I just want to make a comment about bleeding, Dexcom, sensors, bleeders. As I've heard people call them. We have had a few bleeders, I think three bleeders. And they're fine. As the saying goes, bleeders our readers. Once you hop in the shower or pool or bath or whatever, Blood kind of just gets washed away and they seem to. Read perfectly fine after that. So I would not worry if you put a Dexcom sensor on and it starts bleeding has never caused an issue for us. If you do have to replace your Dexcom sensor, maybe it fell off before the 10 days was over. Maybe you're getting sensor, air readings left, and right. Maybe you've gotten a sensor error and it's just never come back online. For whatever reason you can either. Dexcom support. Uh, if you do that, you're going to need to have the lot number with you, which the lot number is on the paper backing that you peel off of the sensor when you're doing a center change. So what I do is when I, as soon as I peel off that paper, it's like a rectal. About the size of the Palm of your hand has the lot number and a few other numbers on there. But I stick that in our little diabetes supply kit that we take everywhere with us. And then I immediately take the old one out. So the old one is already in there. Cause I had put it in there last time I take that one out and I put the new one in. So I'm constantly carrying it with. For the remainder of the time Sarah's wearing that sensor that way, if it feels her falls off or whatever, I've got all the information I need to call Dexcom support. Also, I have not tried this, but I have heard some people say, and I've seen a little demo video on it that now a new feature on the Dexcom app is you can actually go to customer support through the app and order a new sensor. You can like type in what's wrong, what happened? All the information and numbers they need, and you can do it that way without even having to call customer support. So check into that. That is amazing. We have had very few sensors fail on us. We have had one sensor completely fall off. Because we were doing some pretty aggressive water play on a lake trip that we did last summer. So obviously we had to get a replacement for that one. We've had one sensor just kind of completely just die on us. I think it was like day seven or eight. Just went offline, never came back after hours and hours. And then we had the very first sensor we put on Sarah. It did not fail. Call it a fail, but we, it was just, we just had the worst time with it, which was sad because it was Sarah's very first sensor. So I feel like we kind of traumatized her right out of the gate by putting it on her stomach, which I am a rule follower. And Dexcom says. They only recommend like stomach and like love handle area. And maybe another area that I can't remember right now, I'm sure it's on the website. So we had heard from somebody, I forget who, but somebody had recommended the back of the arm, but then the Dexcom booklets said these were the only recommended places and not to put it anywhere else. So being the rule follower that I was, I put it on her stomach. And when Sarah was diagnosed, she was. I mean rail thin. She was always a skinny little lady, but she was just like skin and bones, a diagnosis. So she literally had no fat to speak of on her stomach. And you know, when we did the little pinch up thing before we hit the big orange button to insert it, there was like nothing to pinch up. So we put it on her and she was just beside herself, complaining that it hurt and crying. She was wouldn't even. Bend over or sit down, cause she didn't want to like kind of fold onto the sensor. She said it was very painful. The next day seemed better. But the first day she said it was very painful. So I don't know how much of that was actual pain and, or maybe just like fear of this new, weird device that's on your body. But for whatever reason, we just had horrible readings and I think. She was so thin and there just, wasn't a whole lot of interstitial fluid for that sensor to float around in. And so it just, wasn't getting great readings. I don't know that's my theory, but I feel like the thing went offline every hour and we would have to wait 30 minutes for it to come back. And then of course, you know, in the beginning you have like every single alarm set to alert you and that was beeping all the time. It was just, that was a very frustrating experience. Luckily, we were able to talk her into putting another one on and we put it on the back of her arm that time. So we were able to like pinch up a nice little patch of squishiness and stick the sensor on her and then push the orange button. And that was much better. And now sensor changes are like drinking a glass of water for her. She's runs in from playing outside. Mom, my sensor expires. I'm like, okay, we can get that thing off. And another one on. Minutes. So it's no big thing. So hope for parents out there who might have a kid who's really scared of their sensor changes. It does get better. We would do all sorts of distraction techniques. In the beginning, we would let Sarah watch watch little shows on her phone or TV, or she would put earbuds in and listen to music just to kind of like be distracted while the change was going on. Um, since her changes used to take us like an hour, no joke, because she would be so worked up over it and would not want to do it. So I feel like we just, it just takes. And repetition. And, you know, the sensor has always been non-negotiable. I will negotiate whether or not Sarah is going to wear an insulin pump all day long, but for us, the Dexcom CGM is non-negotiable. So just repetition over time. What do they call that? Cognitive behavioral therapy, no exposure therapy, where you're being exposed to something over and over again. And eventually you realize, okay, it's not going to kill me. I'm going to survive. It's not that bad. Okay. Two more things. That I want to mention before we start to talk about how I read the Dexcom graphs to make treatment decisions. Number one, pairing a new transmitter. Remember the transmitter is the little gray thing that gets clipped into the sensor. And the transmitter lasts about three months when it is time when that three months is up and it is time to pair a new transmitter. I would watch the video that Dexcom has on their website. Again, you can find that@dexcom.com forward slash FAQ. I will leave a link in the show notes, watch the video a few times just to make sure you know what you're doing, because we, we have had a lot of trouble pairing new transmitters in the past. It's taken us like hours at a time where it should take like five minutes, but what has helped. And what has helped transmit or changes go more smoothly for us is that I have to manually go in my phone to the Bluetooth settings and disconnect the old transmitter, or I'm sorry, I have to manually go into Sarah's phone because her phone is the one that's acting as the receiver. For the Dexcom. My phone is just following her information with the Dexcom follow app. So I have to go into Sarah's phone, into her Bluetooth settings and I have to unpair and totally disregard the old transmitter before it will allow us to pair a. Transmitter. I also find that putting the old transmitter like any trash can outside of your home, far, far, far away from wherever you are pairing, the new transmitter helps things go more smoothly and much, much quicker. So toss that thing across the street. And unpaired the old transmitter in the Bluetooth settings of whatever device is acting as the receiver. All right. Last thing, before we talk about the graphs, compression lows are. If your child is laying directly on the sensor slash transmitter, they can get what is called a compression low, where all of a sudden they're at like 1 20, 1 10, whatever it might be. And now they're at 50 with an arrows pointing straight down that has happened to us. Maybe three times. Two of them have been at night and. It's definitely scary. When all of a sudden you're woken up in a cold sweat with your Dexcom alarm going off saying there's an urgent low, and it's really just a compression low. So the, the way I feel like these are pretty obvious when you look at the graph, because you'll have these dots wherever they may be, whether they're at 300 or 200 or 100, you'll have a nice line of dots. And then all of a sudden, there's this one dot way down, farther below. All the other dots. It's like, it's like that one dot decided to jump off a cliff. So you have readings at a hundred, hundred hundred, a hundred, 150. So it's like a drastic change all of a sudden. And then I just, when that happens, I've just gone in and I've have Sarah rollover off of her sensor and that fixes it. And yes, I do do a finger prick in the. Situations just to double-check and make sure everything's okay. Okay. So let's talk about reading the Dexcom graph to make treatment decisions. In the beginning, when we first got our Dexcom, I would look at the arrows to make treatment decisions, but now, after having done this for a while, when I am going to make a treatment decision, I look at the dots and the way in which the line is trending. So really start to pay attention to this. For instance, if you're. Has a arrow pointing straight down or maybe they have double arrows pointing straight down. It is very tempting to panic and overtreat the low and in some situations, some circumstances that is what you need to do, but I try to take a split second. To look past the arrows and look at the dots to kind of see what direction the line is moving in. Cause sometimes your Dex com might say a hundred double arrows down, but the line is clearly getting ready to flatten out. You can see it, it's gone down and now it's making a curve. And maybe another reading or two, it's going to be a nice straight line and flatten outs. So in those situations, I will wait that takes a lot of practice to be able to wait and not panic, but I will wait another five minutes, maybe 10 minutes to see if the arrow starts to change. 'cause really like 75 80. Those are normal blood sugars for people without diabetes. Those are not numbers we should be scared of. So if that 100 double arrows down is getting ready to turn and flatten out and maybe be like a 90 and steady. That's beautiful. I will take that. And I do not want to give my kid a juice box in that situation, because then it's going to send them up to like 200 again and now we're on the diabetes rollercoaster. And as always, you might not feel comfortable doing that. Or it might take you a lot of times of doing that and then realizing that, oh great. Now we're dealing with a two 50 and we've got to treat a high, it might take a lot of those situations for you to realize like, okay, maybe I need to take a deep breath, waited out for another five or 10 minutes and see where this line goes. However, there are certain circumstances where I do not mess around, like if the. If it's double arrows down and we're at like 60, I don't, I don't really care where that line's going. I'm going to make her drink a juice box and we'll deal with the highlighter if we need to. Also, I do not argue with Sarah. If she, if like, even if the Dexcom says, you know, one 20 and steady, if she tells me she feels low, I'm like, okay, well let's do a finger brick and check. Cause right now you're, you know, you're in range. If you feel low let's, let's definitely check. I don't ever, I don't ever argue with her. Like, that's not a situation. That's not a hill. I wanna die on, you know, make your feel, make your kid feel better. Double-check with a fingerprint and maybe even give them a little piece of hard candy to suck on in the meantime, just to give them peace of mind. Cause that can be a very scary thing for a kid to think that they're getting ready to crash. So this can go the other way too. I don't only use this method when. I'm treating lows. Like if Sarah is going up, like we, we, not every day, but we sometimes see some pretty bad breakfast spikes. It almost, almost always comes back down to an in-range number, usually around a hundred, about two hours after she eats. But there have been some days where I've really questioned whether or not I got the bolus, right. Especially for breakfast, but I always look at the. I always look at the dots and not the arrows, because if she says, if it's saying like one 90 double arrow up, a lot of times I'll be like, you know, thinking to myself, we got to get more insulin. This is not going to stop, but I'll look at those dots and the dots have already come up and they're starting to curve. And maybe even sometimes they've started to come back down, but the arrow is still saying straight up, we're still double arrows up. So always double check and look at that line. And if that line is telling me that she's getting ready to make a turn and start to come back down, I definitely don't give any more insulin because I just waited out at that point. Cause I don't want to have to deal with a low, especially when she's at school. Plus now, if you are dealing with a low, because maybe you jumped the gun and gave more insulin, then you're more likely to over-treat the low and repeat. The diabetes rollercoaster. So I would highly encourage you to really analyze those dots. I would also highly encourage you to look at things in a one in the one hour window on your Dexcom app. If you look at things in the 24 hour window on the Dexcom app, it's always going to look. The line is going to look like some sort of Alpine peak that's coming down fast and furious, like some sort of a freight train. So I always, I always flip my phone horizontal and I click on the one hour view because then you have a much better. Idea of how fast those dots are falling. What looked absolutely terrifying in the 24 hour view or even the 12 or six hour view might look, okay. Things are starting to calm down in the one hour view, and then you can have a little bit more of a level head and maybe make a little bit more of a sound treatment decision based on those dots. And you can follow it with your finger. You know, you can take your finger and run it along the line and see, well, there's really only, you know, the line looks steep, but really it only fell. You know, five points in between this dot and the next dot. So that's not too bad if it continued at that speed, you know, in the next 25 minutes, you're dealing with a 25 point drop in blood sugar. Of course, if you're at 50, a 25 point drop in blood sugar would be huge. But if you're at 1 25, a 25 point drop in blood sugar would be great. Right? So flip that puppy on over to the one hour view, it'll make you feel so much better about yourself. Okay. Last example of how I read the dot. And not the arrows is sometimes when my daughter's Dexcom arrow says that things are steady. I can look at the line and see that that is getting ready to change. Like the arrow might say steady, but if you kind of. Take a step back and look at the line as a whole. You can see that it is trending up and pretty soon you're probably going to have a diagonal arrow up. And then possibly soon after that, you're going to have an arrow straight up. This happens often after we have a big heavy meal, like pizza or fettuccine, Alfredo, or a lasagna, something with a lot of fat and protein in it. My daughter is currently on MDI or injections because she's taking a little bit of a break from her pump. So with MDI. If I see that trend in the line, even though the arrow says steady, I will go ahead and give her another bolus of insulin. And it is hard to know how much to give at that time. Especially if she's sitting at like a hundred, but that air, that line is trending up. But what I do is I will give her what would equal a juice box for us. And I'm not even going to tell you what that number is. Because I don't want you to think that that's gonna work for everybody, because again, your diabetes may vary and what your kid might need is different than what my kid needs, but I give her a bolus of insulin that would equal the carbs in a juice box that we have on hand. That way, if I'm wrong in the line, doesn't start to trend up. Then it's nothing a juice box cannot fix. I can count on half of one hand the times I have been wrong. We pretty much never need that juice box. And oftentimes we have to end up giving her even more insulin again. That's what works for us or has worked for us. If we start to see that line trending up those dots, trending up. Even if the arrow is steady, that took me a while to get comfortable doing that. I would have never done that in the beginning. Never. I can't even tell you at what point I started realizing like, oh, maybe to avoid this high blood sugar later, we should do something about it now. And then actually feeling confident enough to act on it. I don't know, month seven, eight. I have no clue, but it's been very helpful ever since. So definitely something to consider, keep in mind and you certainly have to be smart. Like I would never push more insulin. If she was getting ready to be active, like swimming or running around with friends, jumping on a trampoline, whatever it might be riding her bike. I would just let that play out in that situation. No, typically I use this little trick after big heavy meals, like I said, pizza, lasagna, Chinese food, something along those. In the evening, right. When we're kind of getting ready for bed. When I know she's getting ready to be sedentary anyway, when we were on a pump, which we will probably be back on shortly, I would try to get ahead of this altogether anyway, by using an extended bolus. So giving like a hefty amount of the bolus upfront and then extending the rest over 3, 4, 5, sometimes. 6 7, 8 hours just depends on what we eat. You got to play around with it. It really just takes a ton of patients and practice and trial and error to analyze these graphs. Look at the way lines, moving, look at the dots to kind of get comfortable with making decisions like this, but just, I just wanted to make you guys aware if you weren't already that sometimes those arrows are. Or they haven't had time to catch up anyway, that's it? That's what I do sounds easy enough, but it really does take a lot of practice and patience and it has really helped us to stay off of the diabetes rollercoaster. That is one amusement park ride that I do not want to buy a ticket for. No, thank you. I'll stay down here on the little wiggle worm, you know, that little baby roller coaster, that just goes up and down and up and down. Nice and smooth. I did want to say one more thing that I thought of about the Dexcom being in water. Yes. It's water. No question about it, but I still have not figured out the magical solution to get great readings. While Sarah is swimming, we do seem to lose signal quite a bit in the pool. What has helped us the most is to put our Dexcom receiver or Sarah's smartphone in a waterproof pouch, and I can leave. In the show notes to the one that we have used and really like, but we just put it as close to the edge of the pool as we can get it. And that way, if it falls in, it's not going to get wet because it's in a waterproof pouch. And that seems to help the most with. Being able to get readings consistently while she's swimming. But I mean, pretty much without fail. It goes in and out, in and out, in and out every time she's in the pool. So you just have to monitor them a little bit more closely when they're swimming, do a few more finger pricks, if you need to, you know, and how closely I monitor Sarah while she's in the pool, depends on how much insulin she has on board when she gets in the water. Because if it's been three hours since she's eaten and. Three hours and some change since her last bolus of insulin, then I'm pretty confident that most of that insulin is out of her system. And maybe what she has going on now is just like her Bazell rate on her pump or maybe her long acting insulin, if she's on MDI. So if it's just that I know she's not. Too quickly. And I might be a little bit more relaxed with how frequently I look at the Dexcom or do a finger prick if I'm not getting any readings. But if like, you know, kids are unpredictable. So in the summertime we have a pool in our backyard and she might eat breakfast, which is the meal where she gets the most insulin because she's so sensitive to carbs in the morning or her insulin resistance. So high or a combination of both. I don't really know, but that is definitely her carb, insulin to carb ratio is drastically different than her insulin to carb ratio for lunch and then dinner. So yeah, if she went swimming right after breakfast, I would be watching her like a Hawk. I'd probably give her an extra snack and totally shut off her basil rate on the pump. If you can do that, if you're on MDI, you can't do that. Right. You can't take that long acting out of their system. So just keep that in mind. That Dexcom doesn't always give you great readings while they're in the pool. You don't sometimes don't get any readings at all. So keep an extra close eye on them when they are in the water. Okay, guys, that is it for our show. Today, episode 50 is in the books. If you haven't. Come follow me on social media. On Instagram. My handle is at sugar mommas podcast. We're having a lot of fun over there. My Facebook page is also at sugar mamas podcast and there is a Facebook group, which is a little bit more interactive. People can ask questions, vent, share, tips, and tricks. So come join the Instagram community. Come join the Facebook group. We'd love to have. And can I just really quickly say a huge, thank you to those of you who have left a review, whether that's on the website, because you can easily do that on the website or through the platform that you listen to podcasts. It means so much to me. When you take the time out of your day to leave a review and tell others how much this podcast has helped you and encouraged you, it just makes my heart sing. You really have no idea. And I appreciate you. And I just want to thank you so much. And if you haven't done it. There is always time. Have no fear. 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