Relying on CGM for hypo awareness while driving

Minotaur said:
I'm an newbie to diabetes, and have had a cgm, since being diagnosed (6-8 weeks ago). So I'm probably hypo unaware as some have stated, as the symptoms are sometimes the same as 'other' issues.
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If you believe you are hypo unaware then it seems that you are also relying on a CGM to warn you of an impending hypo whether you wear it on your watch or have alarms set on your phone or whatever, so you perhaps should also not be driving, unless you can clearly answer that you have not had a hypo or that you have had a hypo and you have hypo awareness.

To me you need to clarify whether you have hypo awareness or not. If, in order to answer that question, you need to experience a hypo then I think it would be important to do so without access to CGM because a low alarm going off will instill some panic symptoms and potentially compromise the experiment. And I think this is the issue with the widespread use of CGM in newly diagnosed patients which leads to uncertainty and ambiguity in this respect.
 
Lucyr said:
Most watch complications don’t update instantly, you often have to tap them to refresh the reading, or on some to wake up the screen. You definitely couldn’t do that whilst driving as you can’t interact with a device. If you happen to see it in your eye line and don’t touch it then I think that’s fine.
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Mine does every minute. No refreshing. Like the exact time, it chalks the sensor readings up. It’s just “there” when the screen is activated. Though I wouldn’t be messing with it whilst moving. Could you define “update” & how you tap to achieve this update? What smart watch you use?
 
Satan’s little helper said:
Mine does every minute. No refreshing. Like the exact time, it chalks the sensor readings up. It’s just “there” when the screen is activated. Though I wouldn’t be messing with it whilst moving. Could you define “update” & how you tap to achieve this update? What smart watch you use?
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I have an Apple Watch, on Apple Watches the complications don’t refresh every minute, you have to tap on it to refresh. It does refresh automatically just less frequently eg could be 15 minutes
 
Minotaur said:
I'm an newbie to diabetes, and have had a cgm, since being diagnosed (6-8 weeks ago). So I'm probably hypo unaware as some have stated, as the symptoms are sometimes the same as 'other' issues. Some will have notice that I've been active in the 'smart watch' thread. So my question is, I've now managed to get my cgm linked to my smart watch, does looking at my watch constitute 'driving without care and attention'? Does me being able to look at my watch, and seeing my bg (it's on the main face of the watch) making it easier for me to control my levels, by eating JB to ensure my lvls are constantly high, a danger?

I'm not suggesting 'flouting' the laws, but it might be something that should be looked at more?
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OK? At what level is your sensor set for a low?
 
CliffH said:
I've got the standard meter that I was given when I started using the Libres (five years ago). As far as I know it just shows the BS number when I scan it, whereas the app on my phone shows graphs of average BS per hour of the day and so on.
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Sounds like you are starting the sensor with the reader. Thats why you aren’t getting readings automatically on your phone and you have to scan. If you want readings on your phone without scanning then you have to start it with the phone and can’t use the reader. All the averages etc are available on the reader if you want them there though.
 
Lucyr said:
Sounds like you are starting the sensor with the reader. Thats why you aren’t getting readings automatically on your phone and you have to scan. If you want readings on your phone without scanning then you have to start it with the phone and can’t use the reader. All the averages etc are available on the reader if you want them there though.
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Yes, that's right: I always start a new sensor with the reader. It's just habit from before I had the app on my phone. I'll try what you suggest though: thanks very much :star:.
 
Lucyr said:
I have an Apple Watch, on Apple Watches the complications don’t refresh every minute, you have to tap on it to refresh. It does refresh automatically just less frequently eg could be 15 minutes
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OK? I have a Samsung watch. The app I use is every one minute. I will state within 2 or 3 minutes the arrow can be extreme (either north or south.) but I’ve learned to relax on my watch, it soon levels out. The arrow on the phone app is less pessimistic on the trend.
 
Satan’s little helper said:
Use what you a comfortable with? I believe @rebrascora uses the reader. I use phone apps for the CGM experience. It’s how we do our own thing.
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I tried using the phone app a couple of times for about 3 months each time without the reader and each time I have been happier to go back to the reader and my TIR results have improved by as much as 10% each time, presumably because I have been more at ease using the reader although I suspect the algorithm in the reader is very slightly different. The format is much more familiar to me after 4 years of use too and that has been important on the odd occasion I have had a proper hypo where I have been confused. Once in the middle of the night when I couldn't figure out how to cancel the alarm on the phone app and it was screaming at me and that was panicking me and as a result I was trying to stop the alarm instead of eating my jelly babies. Normally nocturnal hypos don't bother me at all but that really scared me as I was on my own. I just really trust the reader and being so simple, I know what I am doing with it, even when hypo.
 
rebrascora said:
If you believe you are hypo unaware then it seems that you are also relying on a CGM to warn you of an impending hypo whether you wear it on your watch or have alarms set on your phone or whatever, so you perhaps should also not be driving, unless you can clearly answer that you have not had a hypo or that you have had a hypo and you have hypo awareness.

To me you need to clarify whether you have hypo awareness or not. If, in order to answer that question, you need to experience a hypo then I think it would be important to do so without access to CGM because a low alarm going off will instill some panic symptoms and potentially compromise the experiment. And I think this is the issue with the widespread use of CGM in newly diagnosed patients which leads to uncertainty and ambiguity in this respect.
Click to expand...

I think that’s a good point re the prescribing of CGMs to the very newly diagnosed. I get the feeling they’re prescribed for the convenience of the medical team rather than the person. I don’t think they help necessarily (although it’s a different matter for children and people with additional needs) and, as you say, experiencing a hypo (a mild one) might be a good thing.

When I was diagnosed, I was told the hypo signs and given a list but it was hard to imagine them until I’d experienced my blood sugar dropping. I then immediately recognised I was going hypo even though I couldn’t remember all the signs.

At some hospitals, they didn’t let newly diagnosed Type 1s leave until they’d experienced a hypo (in controlled conditions, of course).
 
rebrascora said:
If you believe you are hypo unaware then it seems that you are also relying on a CGM to warn you of an impending hypo whether you wear it on your watch or have alarms set on your phone or whatever, so you perhaps should also not be driving, unless you can clearly answer that you have not had a hypo or that you have had a hypo and you have hypo awareness.

To me you need to clarify whether you have hypo awareness or not. If, in order to answer that question, you need to experience a hypo then I think it would be important to do so without access to CGM because a low alarm going off will instill some panic symptoms and potentially compromise the experiment. And I think this is the issue with the widespread use of CGM in newly diagnosed patients which leads to uncertainty and ambiguity in this respect.
Click to expand...
I became diabetic after major surgery, like others have said, are we safer now we have cgm's, and being diagnosed, rather than before being diagnosed?

I don't believe I have had a 'hypo' since being diagnosed, did I have one before being diagnosed is also something I'm not sure about, but as I live alone, it is definitely, something I'm hyper aware is a possibility.
 
Satan’s little helper said:
Mine does every minute. No refreshing. Like the exact time, it chalks the sensor readings up. It’s just “there” when the screen is activated. Though I wouldn’t be messing with it whilst moving. Could you define “update” & how you tap to achieve this update? What smart watch you use?
Click to expand...
Mine updates automatically also, and is just 'there' when I look at the time, no extra steps needed.
 
Inka said:
I think that’s a good point re the prescribing of CGMs to the very newly diagnosed. I get the feeling they’re prescribed for the convenience of the medical team rather than the person. I don’t think they help necessarily (although it’s a different matter for children and people with additional needs) and, as you say, experiencing a hypo (a mild one) might be a good thing.

When I was diagnosed, I was told the hypo signs and given a list but it was hard to imagine them until I’d experienced my blood sugar dropping. I then immediately recognised I was going hypo even though I couldn’t remember all the signs.

At some hospitals, they didn’t let newly diagnosed Type 1s leave until they’d experienced a hypo (in controlled conditions, of course).
Click to expand...
I was taught how to attach my cgm sensor to my arm, and then i was taught how to inject myself with insulin, which i then had to do by myself safely, before I was allowed to be discharged from hospital, everything else was a blur of information, leaflets and booklets. I was called weekly by the DSN to regulate my insulin, and now I'm just left in the wild to cope and manage things on my own, until my next appointment.
 
When I was first diagnosed, I had a colleague with Type 1.
His advice was to make sure I had had a hypo in a controlled environment. This was with my partner at home, not the hospital (I never spent more than a couple of hours there) with lots of hypo treatment to hand.
Not only did it show me what the hypo symptoms are for me (because we are all different), it showed me I was hypo aware and l, for me, the biggest hypo fear was fear of the unknown. Knowing what a hypo felt like and knowing I can treat it and recover was an incredibly important lesson.

On the top of my hypo symptoms, I previously mentioned it is a strong desire not to eat. I did not write that I follow that desire. I recognise it and still treat my hypo with fast acting carbs even though I don't want to.
 
Minotaur said:
I don't believe I have had a 'hypo' since being diagnosed, did I have one before being diagnosed is also something I'm not sure about,
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This is the important thing when you fill in your DVLA form. If you don't think you have had a hypo then it is reasonable to say that you haven't had one because you would know if you had had one! So you mark the box to say you haven't had one and leave the question about hypo awareness blank because if you haven't had one then you can't know that you have hypo awareness. At least I am pretty sure that is how the form is worded with 2 separate questions and if you reply "no" to "Have you experienced a hypo?", then you don't answer the next question about hypo awareness. Hopefully someone will correct me if I am wrong.

You will not have had a hypo before diagnosis because you were not on insulin or other diabetic medication which could cause a hypo. It is important to remember that diabetes causes high BG levels, not low. It is an overdose of insulin which causes hypos, albeit unintentional overdosing, but all to easy to do, particularly pre CGM.
A reading below 4, if you are not taking diabetes medication, is not really considered a hypo. Below 3.5 is technically a hypo because that is when your brain starts to be affected and even after very exertive and prolonged exercise, it would be unusual for a non diabetic to drop this low and if you did, you would definitely feel it. I think it is often termed "bonking" in long distance cycling.
 
helli said:
Not only did it show me what the hypo symptoms are for me (because we are all different), it showed me I was hypo aware and l, for me, the biggest hypo fear was fear of the unknown. Knowing what a hypo felt like and knowing I can treat it and recover was an incredibly important lesson.
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I wasn't advised to do this but I wish I had been!
What I found was that having had a few hypos and learning to deal with them was empowering, because it gave me confidence that I could manage them and my jelly babies would work and that significantly reduced the everyday and particularly every night fear of it happening. As @helli says' it is the fear of the unknown which is probably more debilitating than the reality. I am now so relaxed about it that I can wake up in the middle of the night, calculate how many jelly babies I need, chew on them and be back to sleep within 2 mins and without even putting the light on..... and yes I know I should stay awake and retest after 15 mins with a finger prick to check, but I like my sleep too much and to be honest, I would really struggle to stay awake that long... unless it was a really bad hypo where I got the sweats and heart pounding and struggling to think straight, but those are few and far between.
 
rebrascora said:
This is the important thing when you fill in your DVLA form. If you don't think you have had a hypo then it is reasonable to say that you haven't had one because you would know if you had had one! So you mark the box to say you haven't had one and leave the question about hypo awareness blank because if you haven't had one then you can't know that you have hypo awareness. At least I am pretty sure that is how the form is worded with 2 separate questions and if you reply "no" to "Have you experienced a hypo?", then you don't answer the next question about hypo awareness. Hopefully someone will correct me if I am wrong.
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I think it would be unwise not to respond to the box regarding hypo awareness. As it could imply you didn’t get symptoms? Even though I rarely drop that low to get that messed up. I’m still aware of the subtle early warning.
 
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