Lower Your Blood Sugars by Using the Dexcom Arrows

[@HarlemLightsMD]

Love your videos! I never really paid attention to the arrows, but now I am. I usually just look at the number and move on. I’m still new to Dexcom!

[@lisadonavan6133]

My doctor switched me from Libre 2 sensor to Dexcom G6 d/t latex allergy. There was no conversation w/ me when I was placed on either CGM. Thanks to your channel I now know that there exists a dosage calculator. I’m a T2D on the cusp of T1 d/t pancreatitis & the damage it’s causing. You’ve helped me to know that I can use resources you offer as well as this great community that comments info & tips as well. Thank you so much for your guidance. It’s indispensable !

[@DiabetesStrong]

I'm glad the channel can be a resource. Thank you for watching

[@1970owie]

Thank you, excellent news. Have an excellent April 2023

[@DiabetesStrong]

Thanks, you too

[@Wheely55]

I've been a diabetic for over a year now amd just got approved for the Dexcom. I can't wait to try it. Thanks

[@jackschitt6235]

Type 1 or 2? Injecting insulin or something else?

[@Wheely55]

@@jackschitt6235 I use insulin

[@jackschitt6235]

@@Wheely55 I'm on the Medtronic system but hope to be switching when I hit the 4 year point... Less than a year to go. That's how long the insurance normally expects you to stick with something after the initial investment of thousands of dollars for the pump. I want the best possible CGM and most people seem to feel it's definitely not the Medtronic system!

[@DiabetesStrong]

That’s great! I hope you’ll find it helpful

[@dwightl5863]

@@jackschitt6235 For those on Medicare: I was on the Medtronic pump (before CGM) and Medicare would not update the pump after the four year warranty period provided by Medtronic. Medicare would update after 5 years. As a result Medtronic, did extend their warranty another year. That said my last Medtronic pump's internal battery that keeps your settings while you change your battery, was giving up the ghost towards the end of that 5 years. Not a criticism of Medtronic's pump. I'm currently on a Tandem pump and will be interesting to see how Medicare handles that pump. But that won't happen until November, 2024.

[@az.az466]

That's why I love the omnipod, it does the job for you. Less stress on how to calculate it. But nice info for MDI users.

[@jackschitt6235]

Were you ever on the pumps from either Medtronic like me or the Tandem?

[@donnatalmage6806]

Thank you for this. I wasn’t aware of how to use the arrow. Very helpful

[@DiabetesStrong]

Glad it was helpful!

[@MH55YT]

I just finished my first 3-month trial on Dexcom G6. My A1c dropped to 5.7 from 6.4. My blood sugar readings were below 80, two percent of the total time. That's because I was learning how to live with the new Dexcom G6 GCM. My Diabetic counselor said 5.7 is probably too low. She meant that 2% out-of-range could negatively affect my long-term (or short-term) memory - I can't remember which she said. She recommended that I manage it back to the mid 6's. However, I don't need a GCM to get back to 6.4. When my blood sugar dropped below 80 mg/dL, I could adjust quickly thanks to the G6, which rarely dropped far below that 80 mg/dL target. I wanted the G7. But for some reason, Dexcom initially sent me the G6 rather than the G7. The G7 was available, but Dexcom wanted to eliminate all the old G6s. Then I complained, but Dexcom didn't compensate me. Rather, the Dexcom pharmacy said I needed to pay an additional $389 to upgrade. The new $380 G7 receiver was not covered by Medicare. So if you are new to the GCM world, make sure your doctor prescribes the newest version of Dexcom, or the company will charge you unnecessarily to upgrade.

[@DiabetesStrong]

Thank you for sharing that

[@khaledalhouli8816]

This is new for me. Really helpful. Thanks 🎉

[@DiabetesStrong]

Glad it was helpful!

[@electrology]

Always Christel comes with useful info ..❤

[@DiabetesStrong]

Glad you think so!

[@davidcause9942]

Pro Tip. Thank you. Have one ordered. Very helpful information.

[@DiabetesStrong]

Glad it was helpful!

[@cut--]

Great info Christel, I never knew the ''math" behind the arrows! 😉

[@DiabetesStrong]

Glad it was helpful! So much math though 😑

[@jackschitt6235]

My Medtronic user guide is close to 400 pages long! I doubt many people have studied it like fundamentalist christians study the bible. Way too much unnecessary blah, blah, blah etc. They could do so much better producing something that most people might actually read, understand and remember!!!

[@thehappydiabetic5380]

Another very good video with lots of useful information. Thank you.

[@DiabetesStrong]

My pleasure. Thank you for watching

[@seanallan3042]

Awesome,where can I find the info sheet for the arrows that shows the amount it will rise or fall,I like the idea of the insulin dosage calculator where can I find that thank you

[@DiabetesStrong]

This is the link to the arrow description on Dexcom website s3-us-west-2.amazonaws.com/dexcompdf/HCP_Website/LBL015804+G6+Trend+Arrows+and+Treatment+Decisions.pdf For the bolus calculator just Google “Omni Insulin Dosing Calculator”

[@seanallan3042]

@@DiabetesStrong thank you I’m from the uk so I need it in mmol I can’t seem to find it on the website

[@DiabetesStrong]

@@seanallan3042 I don't have a conversion table (but to get from mg/dl to mmol/l you divide by 18). They used to include the meaning of the arrows in the box

[@DiabetesStrong]

or check out this page: waltzingthedragon.ca/diabetes/managing-bg/choosing-cgm-unique-features-dexcom-cgm/

[@seanallan3042]

@@DiabetesStrong thank you very much I got 1 of that website,keep up the awesome videos thank you

[@tubester444]

The arrows are definitely good for getting your attention but I supplement them by looking at the data dots to confirm the arrows and see how the dots are trending. This helps keep me from over treating because the arrows alone can be a little over dramatic at times. And confirming the CGM readings with a finger poke is always good if you have time.

[@530mnorman]

Same! I only look at the way the data dots are moving. I really wish the dexcom app graph could show the data a bit differently. I used to use the Libre sensor and I found the graph so much easier to read. The data wasn't nearly as accurate as the dexcom, but I loved the look of the app.

[@DiabetesStrong]

Thank you for sharing. Great point

[@sallyross8161]

Great info, thx

[@pM-sh4ep]

On an unrelated note but still related to Dexcom, I’m VERY please to see g7 has seemed to address their connectivity issues. All of a sudden I’m NOT constantly losing connection and I can actually go running and have readings the whole time (before it was losing connection). Anyone else noticed this or did Dexcom announce they made a modification ??

[@530mnorman]

Super interesting to learn all this background about how the math is supposed to work. From my experience, I really have never found the arrows to match up with my reality though unfortunately, so I never put all that much stock into them. 9 times out of 10 for me, the slope of the arrow matches the slope of the graph over the previous 30 minutes not the future direction I'm actually moving in. My blood sugar rises or falls and then levels out. The arrow will still show up or down for about half an hour after I can see on the graph that I've already leveled out. I rely on the trajectory of the graph itself and never pay much attention to the arrow assigned. I wonder if it works better for other people and maybe my personal biochemistry just doesn't mesh with the way the sensor determines the arrow? I still love my dexcom and find it an essential tool, but just as you say, it's only a tool and you gotta use your gut and years of experience every step of the way.

[@jackschitt6235]

You might want to read Sugar Surfing by Dr Ponder. He talks a lot about using the CGM feedback to anticipate and take action at just the right time. He's both a pediatric Endocrinologist and a type ONE diabetic for 50+ years. It was available from my library if you don't like buying books like me if I don't have to.

[@530mnorman]

​@@jackschitt6235 I know that book, and it's solid. I'm pretty happy with my current level of control of about 80% time in range. I just don't really pay much attention to the trend arrows since for me, they always align with the past instead of the future slope of the graph. Super interesting that Christel calls out the recommendation NOT to use them for 4 hours after eating. That's the specific time when I'm going up or down when I want to know where I'm going. The rest of the time, I'm pretty stable so there's not much trend to track. The saying "your diabetes may vary" is super true and all these products definitely perform differently for different people, so just curious how meaningful the trend arrows are for others.

[@DiabetesStrong]

Thank you for sharing that. It’s so interesting to hear about other experiences

[@hezvandermeij]

Same! The only time I do pay attention is when I know I'm gonna be walking or biking a long time, in that case I turn on "fall alert" with the alert only on 2 arrows as I don't have the time or space of mind to watch my graph a lot then But more often then not 1 and 2 arrows have gotten confused especially when I've been high or low a lot Glad to know I'm not alone in this! 😅

[@rfrancoi]

Thank you, very useful information. QQ: Is it normal for the level have high fluctuation while sleeping?

[@DiabetesStrong]

I generally don’t have significant raises or drops while sleeping. Except if I’ve eaten close to bedtime and the food doesn’t hit my bloodstream until early AM

[@jackschitt6235]

Any thoughts on some diabetics saying their doc has given them negative feedback about being very aggressive with shooting for truly non-diabetic A1C versus being happy just being one notch under 7?

[@DiabetesStrong]

I think a good doc should go for an individualized A1c approach. But in general, if a low A1c isn’t due to too many lows and the person's quality of life is still good I personally don’t see an issue. However, there can be other considerations of course, so it’s a little hard to generalize

[@dwightl5863]

My endo is satisfied with an A1C in the 6.5 range. He is concerned with low's more so than high's in my case. My A1C over the last 9 month period has been 5.8 and 5.8 and he has been OK with that being my low's have not been that frequent and my high's have been less. Just got my A1C today for my appointment tomorrow and it is 5.5. I can credit that to less high's again. Guessing he will be happy with the readings but more comfortable with it be higher. I'll let you know. Note that I am retired and "not in the real world" having to be out and about earning a living.

[@jackschitt6235]

@@dwightl5863 Have you ever passed out from low blood sugar? It's happened to me twice since 1998. My diagnosis and treatment story though is probably more complicated than most. For 20 years I was told I had type 2 diabetes. A few years back I had to start with a new Endocrinologist and he changed my diagnosis to type 1. I'm on the Medtronic system. My last A1C was 5.3! I spent a long time a lot higher than that unfortunately.

[@dwightl5863]

@@jackschitt6235 I have been type 1 since 1970. And have passed out, or so out of it I couldn't help myself that I have lost track. 10's of times. Three times I lost my driving privileges. On a pump without CGM helped a little but still had lows a lot of lows. I have been on Dexcom for 7 years and have not had a low I could not handle on my own. The low warnings are a total blessing. Been on closed loop with Tandem with Control IQ and haven't had a low warning at night in over 3 years. Otherwise I was awaken with low alarms a couple of times a week. I don't recall ever having an A1C over 7 but that was because of all the lows cancelling out the highs. You are to be commended on a 5.3. Great job. Makes going to the doctor less stressful when your numbers are good.

[@jackschitt6235]

@@DiabetesStrong What A1C do you strive for?

[@andrewwilliams522]

You stated the highs..what about the lowest

[@PeterKeep-q9d]

I have literally thousands of readings that show the arrows are inaccurate.

[@richardforster4429]

I have the receiver. What does the circle with no arrows mean? Ha! I should get off my but and go look it up in the manual for myself.

[@richardforster4429]

It means no trend detectable. How typical for me. Story of my life.

[@DiabetesStrong]

Glad you figured it out. And it’s a great addition to the video. Hopefully, this can also help others

[@richardforster4429]

@@DiabetesStrong limbo, limbo, limbo

[@bestlifeatlarge]

Love your channel and the way you handle Diabetes. I recently launched a video about obesity and diabetes in case anybody feels it might help. Keep doing what you doing 🙌🙌

[@DiabetesStrong]

🙌🏽