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Hypo Unawareness.

There are times when I think that maybe my hypoglycemia unawareness is made up, or all in my mind, or that it’s overblown and exaggerated.  “Pfffft, you can go without a Dexcom for a few hours, because you’ll totally feel any lows that crop up,” is the mantra that runs through my head when I pull a sensor off and see scaly skin, knowing I should wait before even going near the skin with another sensor.  (The Dexcom adhesive/sensor rash isn’t entirely better, but mostly better. The Toughpad underneath the sensor holds it for at least seven days, and more often than not, I’m able to go approximately ten days per sensor.)

But the thing is, I shouldn’t let things go that long.  I should be pulling the sensors at the seven day mark, to avoid mangling my skin and forcing myself into brief CGM hiatuses.

I tend to wear my sensors in the same region of my body (outer thigh), where there is enough real estate to work with, but not enough to work with exclusively.  The time between sensor reapplications, whether it’s a week or more, isn’t enough time for my skin to fully heal.  Sometimes a skin reaction doesn’t occur and the skin that was trapped underneath the Toughpad for a week is still unmarked and supple, so I can stick another sensor in whenever I’m ready.  Usually, regardless of how the skin looks when I pull off a sensor, I rotate to the other thigh and try to pick a different insertion spot, just to keep things on the up and up.  And sometimes, even when the skin looks good after I pull a site, it sometimes turns red, prickly, bumpy, and scaly a day or two afterwards, and remains scaly for several days.  (I apply this Curel lotion to my scaly skin and it helps quite a bit.)


I have trouble – lots of it – pulling a sensor off simply because it’s hit the seven day mark.  If that sensor is stuck, and the results are good, I want to leave it on as long as possible.  I feel like the longer a sensor is on, the more accurate and precise it becomes.  Days 8, 9, and 10 are always spot-on and I feel confident in the results because they not only match up with my meter for spot-checks, but they consistently match up.  Seeing more than a 15 point spread between my Dexcom number and my blood sugar meter check is a rarity in those date ranges.

Frustrating, to say the least, to pull of a sensor that seems to be working just effing fine, thank you very much.

I need to take better care of my sites, because for every long sensor shelf (leg?) life, I’m paying for it on the other side with scaly, un-useable skin.  Which equals out to needing to let the sites breathe for even 18 hours or so every few weeks.

Which ends up resulting in moments like this today:  Sitting in the parking lot at the bank, chewing and swallowing glucose tabs as fast as I can because the blood sugar of 41 mg/dL came out of no where and the only reason I even tested my blood sugar before driving home was because Birdy asked me if she could have a snack and I wanted to have a snack, too.  I had no idea my blood sugar was tanking.  Even in retrospect, the only symptom I had was a clumsy fumble for my meter in my purse, but I initially blamed the fumbles on cold hands.

I chomped the hell out of those glucose tabs – not out of shaky, panicky hypoglycemic symptoms, but the lack thereof.

 

13 Comments Post a comment
  1. Kim #

    I had a Dexcom sensor on the outside of my right upper thigh several weeks back, and the skin is STILL scaly. Might have to track down some of that lotion!

    03/11/14; 11:23 am
    • It’s so weird how sometimes the scales crop up days later, you know? (I got that lotion at CVS.)

      03/11/14; 11:39 am
  2. I both love and hate the Dexcom. LOVE it, because it has saved my life on many occasions, warning me of crashing lows I was completely oblivious to. Hate it, because I hate being tied to and relying so much on this expensive piece of technology. I honestly don’t think I could live without it. (and I thank my lucky stars everyday that I don’t have a skin allergy issue to the sensors adhesive/skin tac/opsite flexifix tape.)

    03/11/14; 12:27 pm
  3. Michelle S #

    I would have thought my hypo awareness would be better after almost a year of wearing the CGM 90% of the time, and reducing my lows so much. But no. Lately I have been hit with a few terrible lows. My CGM missed one yesterday, said I was just barely normal but I totally tanked by myself in a store…. panicky to find my way back to the parking lot and my family. Moments like that confirm that I need all the help I can get to stay on top of the lows. No warning signs but lots of danger.

    03/11/14; 1:24 pm
  4. Lynn H. #

    I’ll check out that lotion, too. I finally found a tape that actually helps the Medtronic CGM stick only to discover that my skin hates it. I pulled yesterday’s because it wouldn’t stop alerting that my sugar was low when it wasn’t. It seems the Dexcom is much more reliable or is the graph just always prettier (and accurate!) on the other side?

    03/11/14; 1:49 pm
  5. Dan #

    Hi Kerri,
    I took a close look at the position of the your Low Alert setting. My suggestion would be to raise the Low Alert setting. This could give you additional signals to check the receiver and your bg. This could allow you to catch the lowering of your bg before it is too late. I have set mine at a Low Alert of 90 and this brings a quicker response by me to the directional position of the arrows and the ability to minimize the quick falling of bgs. Hope this helps and as always have a great day.
    Dan

    03/11/14; 4:26 pm
  6. I, too am very dependent on my DexCom, but like to take a day off when I change my site, just to have one less item attached to my body for a mental break more than anything! It always amazes me how fast I drop when I am on my way down, one arrow can quickly turn into two and I am suddenly in trouble and I am great at denial, I’m not low, don’t need any help! My husband is very patient! 🙂 I also feel like as years go by and especially after pregnancies, hypoglycemic unawareness is a very real part of my life. I get the love/hate thing completely w the DexCom!!!

    03/11/14; 9:32 pm
  7. Christine #

    I have a dexcom however, mine turns off at the seven day mark. How are you using your sensor longer??

    03/12/14; 12:59 am
    • Kristine V. #

      Hi Christine,

      The Dexcom is set to last for 7 days, however, you do not necessarily have to change your sensor after the 7 days mark, you can just keep the sensor on and then click Start on your CGM receiver. It will take 2 hours for your blood glucose to calibrate and then you are good to go again 🙂

      Best,
      Kristine

      03/12/14; 9:55 am
  8. Joe White #

    Have you ever thought of going to a dermatologist? They might be able to help you avoid the skin problem, or give you a creme that clears it up faster.

    03/13/14; 1:10 pm
    • I’ve seen two different derms, and my endo and PCP have seen me, as well. Lots of suggestions, no magic bullet yet. But we keep trying, as a team.

      03/13/14; 3:43 pm
  9. Katie #

    I just got re-attached to the Dexcom after a hiatus for a little over a year when I lost my Dex7 transponder due to pregnancy brain. I didn’t realize that I couldn’t recognize my lows anymore until recently when I (think) I had a hypoglycemic seizure overnight. Nothing like that had ever happened to me before, but it left me really out of whack and I needed to go to the ER because I couldn’t speak when I woke up and I thought I was having a stroke. Needless to say, now I am hooked up to my insulin pump, my new G4, and an EEG machine for the next three days. Diabetes sure does stink some times.

    03/18/14; 11:53 am

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