Research indicates that the more a patient wears the CGM, the lower the a1c travels. This makes sense. If you see your blood sugar rising, you’re probably going to take action to stop it. If you don’t see your blood sugar risking, you’re probably not going to take action until you feel high, or test again. That’s a good 30 minutes to 2 hours saved from having a high blood sugar. Like I said, all of this makes sense. Every CDE will share this advice, as they should.
I need to backtrack first. Technology is taking considerable chunks out of our lives. I get an urgent “request” from an app, website, or social media site to install a new push notification just about daily. I know I’m not alone in this sentiment, sometimes it feels that way, but I do not like getting notifications. I do not want to be told what the score of the Thunder game is at the end of the 1st quarter. If I want to know the score of the Thunder game, I will check the score. In my experience, the conveniences offered through push notifications are rather inconvenient.
For illustration, let’s use a Father’s Day cookout with the family. It’s been a perfect summer evening. You’re sipping on a cool glass of stevia-infused lemonade. You just started playing a game of kickball with the family. After a few innings, you feel your phone vibrate in your pocket. It tells you that Jordan Spieth just made a birdie on the 17th hole of the U.S. Open. You, and the rest of your family, had totally forgot that the U.S. Open was even on T.V.! In a mad rush to catch the 18th hole drama, the whole family goes back inside the house to watch. Meanwhile, your niece was loving that game of kickball and the family insists that everyone will come back out after the conclusion of the open. Thirty minutes later, the match is over. Jordan Spieth just won his second major, and now it’s dark outside. Your family doesn’t have lights outdoors, now everyone’s pretty tired, and the kickball match is officially postponed.
You’re probably wondering who the niece is in this story? Well, I guess it’s us sometimes. Pretend that the niece is us before we get the CGM alarm saying we’re about to go high, go low, have a low sensor, need to calibrate, or are in a fall rate. Did we necessarily need to be told, right there in the middle of the game, that we needed to calibrate? Are we sure we’re not missing moments because of all those alarms? Surely we miss something is we check that number 100 times a day, right?
The inspiration to write on this topic stems from a week long CGM break. I honestly just ran out of supplies. A couple of days into the absence, I realized how pleasant it was to not be vibrated or beeped. My mind didn’t ponder when to calibrate. I didn’t have any anxiety as I watched my blood sugar rise. I just found out that I was high when I tested my sugar.
I have no plans to discontinue CGM use. The value has been enormous for me. My a1c has taken a downward path. Knowing where my blood sugar is trending is extraordinarily comforting as a test-taker and weekend endurance athlete. Having felt some freedom from this incredibly valuable technology, I am looking to reexamine the alarms I have set and possibly loosen up those reigns. Because you know what? I’d rather be playing kickball.