I went to Sacramento’s version of TCOYD yesterday for the later part of the afternoon. (By the way, if there is one near you, I highly recommend going. It was only $20 and they feed you D-friendly catering with carb counts!) I was sitting in one of the forums on CGM technology and one of the questions asked stuck with me enough to break my blogging absence and write about it. (I promise… I have plenty to share… later.)
A CDE in the audience told the story of a patient who was diagnosed at the age of 8 and her parents put her on a Dexcom by the age of 10. From that point forward, the young D-ling obsesses over the spikes and valleys of her Dexcom graph; often sitting and waiting with a cup of juice in hand if her Dex showed a downward trend with a 120 mg/dl readout. “I know it’s coming!” the CDE repeated.
Panelists suggested the young patient wasn’t ready to have a CGM, especially if it was causing obsessive behavior. But I took to heart how many times I’ve checked my Dex in an hour while I was waiting for my high blood sugar to do something. Y’know, continue to elevate so I could justify a correction or see a downward trend so I can eat once more. And sometimes I become so obsessed with a stagnant high that I give up and correct anyway… which usually has detrimental results.
It’s very much like watching the Stock Exchange. If you’ve ever seen movies about Wall Street or watched brokers on the news shouting to “buy” or “sell” on the floor because people’s retirements are at stake… you know what I’m talking about. People can drive themselves nuts if they have a very aggressive portfolio to hopefully support their livelihood as an older adult. And then that fateful day comes when the market crashes and they lose everything. Gone. What now?
I can’t watch my portfolio… but I do study my Dex. Sometimes obsessively, and the consequences are a bit more extreme than losing your life savings. Especially now that my sugars have become more erratic.
On one hand, I’m lucky to have this technology at my fingertips. Last night, for example, Dex woke me up on 4 separate occasions for falling blood sugars. They were all legit… and sadly interrupted my already limited sleep. (Curse Daylight Saving Time!) But without Dex waking me up, would I have woken up myself? And when morning did come, I could see that this trend is becoming a regular occurrence, prompting me to reduce my carb ratio for my bedtime snack. (Never thought I’d ever see a 1:7.)
On the other, I find myself clutching my Dex for answers and finding frustration in the stable arrows. Yes – trending up or down arrows can mean trouble too, but those stable, do nothing, apathetic arrows really get to me. And I will hit that power button once… twice… four times… in one hour. Just waiting for it to do something. Am I really still 63 mg/dl and holding? Should I test AGAIN and treat? Or – it’s been two hours and I’m still holding steady at 180? Why won’t you start coming down?
So which is better? Is ignorance really bliss, leaving us powerless to our body’s trends? Or are we to take in as much data to educate ourselves, but while clutching a cup of juice and waiting?
PS: I did have a lot of fun at the conference. I got to meet Kerri, Chris, and Heather. And then listened to Manny and Adam (along with Kerri) give a real good push for the DOC and digital technology for diabetes. Way to go, y’all. And based upon all the photos that were taken of them, they are quite the celebrities. 🙂
2 thoughts on “How Much Is Too Much Data?”
Data can definitely be overwhelming, but you can’t take it from just one source (and yes, I’m just as obsessive and would also contemplate treating a 120 with a downward trend). But seeing that, the next questions I would ask myself are “how much insulin do I have on-board?” and “is this a case of the pre-meal bolus waiting for the food to work?”.
While the Medtronic CGM does have “predictive alerts” (unlike Dex), it bugs the hell out of me that it doesn’t consider carbs eaten or IOB in those predictions — all of which are stored right there in that same little black (or blue, or purple…) box.