Managing Diabetes with a Continuous Glucose Monitoring System
As my second pregnancy draws near, I'm still struggling with the decision whether to use a continuous glucose monitoring system (CGMS). These systems have helped countless diabetics manage their blood sugar and they have become more reliable and accurate as the second generation models enter the market.
The overachieving, type-A side of me wants to use every available tool and resource to achieve optimum blood glucose levels while pregnant. However, the other option, not using a CGMS, appeals to my desire for simplicity and routine.
As I mentioned previously, pregnancy the second time around means that I have two main priorities to juggle: the new baby and my daughter Sienna. I want to ensure that I keep my blood sugars in tight control but also remain available for my toddler who wants lots of mommy's attention.
Upon reflection, it would have been prudent to start using a CGMS several months ago, so that I'd be familiar with it before the next pregnancy. However, since I didn't make those arrangements during that window of opportunity, I'm left with the decision whether to start using something entirely new just as we're trying to conceive.
Here's the thought process that lead to my decision:
Since CGMS are not reliable enough to replace regular finger stick glucose tests, I would still be testing my blood several times a day. As far as efficiency and simplicity, the CGMS seems to duplicate much of the information I can obtain through a finger stick test.
Therefore, the biggest benefit is catching trends high or low before my blood sugar gets too far out of range. Since fortunately I continue to feel my lows quite well (and did throughout my first pregnancy), the safety feature of catching dangerous lows isn't very important to me at this stage. Also, highs are not a significant concern since I'll test my blood about 18 times per day while pregnant. That works out to about once an hour during the waking hours, and once or twice during the night. When you're testing and adjusting that often, it's difficult for a severe high blood sugar to sneak up on you.
I suppose another advantage of a CGMS is that I could avoid waking at night to test, since the alarm would alert me if I was out of range. However, I usually wake once a night on my own, and don't find this nuisance to be worth the added effort of maintaining the CGMS.
So, my decision is pretty clear. I won't be using a CGMS during my next pregnancy. I'll stick with the routine that helped me achieve a healthy pregnancy the first time, tools and tricks that I know and trust. I'd prefer to spend my time playing with Sienna, preparing my low carb meals, testing my blood the old fashioned way, using my Cozmo pump, and swimming as much as possible then spend many hours learning and maintaining a new tool.
I know that CGMS technology is the future of diabetes management and I'm eager to embrace it when the technology is more perfected and I'm not juggling quite so many balls in the air. For me, CGMS will have to wait.