Looking for a walkthrough of mySugr reports? Join Molly Wagman, mySugr's US Clinical Manager and lead CDE, and Scott K. Johnson, Patient Success Manager, for a detailed overview of accessing the report and how to read it.
Scott K. Johnson - Thank you for joining us today. mySugr was founded for one reason, to simplify life for people with diabetes. Our app and care services work together to provide a powerful health management solution. We are a digital health company for people with diabetes made by people with diabetes. Welcome to mySugr. In way of introductions, my name is Scott Johnson, I'm Patient Success Manager here at mySugr.
Molly Wagman - Hi, I'm Molly Wagman, I'm the Clinical Manager here for mySugr and the lead Certified Diabetes Educator.
Scott K. Johnson - What we have in mind today is showing you a bit about the mySugr reports. To start things off the first question is, how do I get my reports? So it's very, very easy. Open your mySugr application, there is a button in the menu for report. If you're on IOS it'll be down the bottom, if you're on Android it'll be up in the navigation menu in the upper corner. And then here you can select what date range you're interested in and then press export.
Scott K. Johnson - Now while that's generating I should mention the PDF reports are a pro feature, so if you have the free version of mySugr this is not available for you, however, there are a handful of ways to get mySugr Pro:
- First and foremost you can buy it, it's a small fee per month, $2.99. So a small cost per month.
- You can subscribe to the mySugr bundle which comes with the pro version as well as coaching and unlimited strips.
- You can pair and synchronize with a supported Accu-Chek® meter. All of those will be available in your connections menu.
- You can also ask your employer or your health plan about providing mySugr as a diabetes solution for it's constituents. And if you received mySugr as part of your benefits packet you already have mySugr pro.
Scott K. Johnson - So, with that in mind let's jump right into it. So the report now is on our screen, so what's next, right? Of course, if you want to look at it you can do so right on your screen but in typical cases, you're going to be bringing this into your doctor's office or certified diabetes educator appointment and you'll want to get it off your phone. There is an export button, on IOS it's right there in the upper corner, I'm going to tap that and then from there, you'll have available all of your different options to either email it, print it or send it somewhere else. From there, now you've got the report on your screen and this is where the expert takes over.
Molly Wagman - All right, so I like to start right at the top so underneath where it says report. You can see where your date range is. So you can see the amount of time that you're looking at. So for this report, we're looking from July 7th to August 24th. And the first value that you see there is your estimated A1C. I love to look at this because I think that all of us like to know what our A1C is before going into an appointment. We don't like being surprised.
Scott K. Johnson - Yeah, no surprises, yeah.
Molly Wagman - Yeah, so again this is estimated so it may not match exactly what a lab-drawn A1C is but it's a good idea to get the approximate value of what your A1C is over these past eight weeks or so. And then to the right there, you have the average blood glucose over this time period, and then you have your blood glucose deviation.
Scott K. Johnson - So that's something I hear a lot about, but what does that mean?
Molly Wagman - So this is basically, you can see there's a plus or minus in front of it, so it's showing you in comparison to your average blood sugar, how much the range is, so how much above that average blood sugar or below it. So most of your readings will be plus or minus 83 points in this example of 188.
Scott K. Johnson - Okay, so if I'm thinking about that in terms of kind of the graph that many of us are used to seeing, it's sort of a measure of how high or low the peaks and valleys are, right? So if that number's lower that means I've got a more stable, steady blood sugar around my average?
Molly Wagman - That's exactly right, yep. So it will kinda show you how much up and down you're doing.
Scott K. Johnson - Okay, that's useful, great.
Molly Wagman - Yeah exactly. And then to the right there you have the activity time for the total of that time period and then the percentage of the hypo, so your low blood sugars and the hypers, or your high blood sugars. And these are based on the settings that you have in your app, which we'll look at. I also wanna point out that in a really small print underneath the percentage of the hypos and hypers, you have the number. So the exact amount of high or low blood sugars that you have.
Scott K. Johnson - Great, for that time range?
Molly Wagman - For that time range, that's exactly.
Scott K. Johnson - Got it, okay.
Molly Wagman - And then if you scroll all the way down to the page at the bottom you have the settings that are in your profile and you have the option to edit this at any time. You likely set this up when you first downloaded your app though. And the first is what carbohydrate units we're looking at, so you have the option to select grams, which I think most people are using, but if you count exchanges then that's an option as well. And then you have your hypo, your low blood sugar setting, and in this case, we have 70.
Molly Wagman - And you can see that that's red, that's important to note so anything of hypo range 70 or less will be red, we'll get to that in a moment. And then you have your target range. So that's where you're saying, I want most of my blood sugars to be in between this range. Here we have 90 to 160, everything will be there in green. And the hyper is the high blood sugar number that you've selected. Here we have 180. But again, you can create these so that they are specific for you.
Scott K. Johnson - Sure, now there are some gaps here, right? So what happens if I'm between 70 or 90 or between 160 to 180.
Molly Wagman - Yeah, so that's where the color-coding comes in. And when we look at the graph then we'll see yellow numbers that are in between our hypo and target range and the upper range of the target range and the hypers.
Scott K. Johnson - Got it.
Molly Wagman - So I'll point those out when we see them.
Scott K. Johnson - Super.
Molly Wagman - And at the legend here on the side, you'll see that there's a solid gray line and that's your BG graph, it will connect some of the dots and there's a blue squiggly line, so if you're in an insulin pump then you can set a temporary basal rate. Basal rate is your background insulin, so if you set a temporary rate it would show you up there as a squiggle line. And then if you have a continuous glucose monitor the CGM data will be in a dotted line.
Scott K. Johnson - Gotcha, okay.
Molly Wagman - Let's see that on a graph. So let's scroll and look, you can already see, even without getting in really close, you can see green. Okay, I know that that is within my target range of 90 to 160. Yellow is going to be then in between my target range and the hyper and the hypo range. And then anything that's red is going to be at hyper, so the high or the low, the hypo.
Scott K. Johnson - So these are kind of some ways to just draw your eyes to places that might need a little bit more love and attention.
Molly Wagman - Exactly right, and we think of red as like, okay I need to pay attention there and that's exactly where we want to be here, it helps you just zone in, it let's, this is where I need to spend most of my time looking at where most of the red is.
Scott K. Johnson - So speaking of kind of zoning in, can we spend a minute talking about just the format of the page here, right? So if I'm new to this or I'm a little uncomfortable looking at blood sugar values, what am I looking at? Is this, the format of it is there for a reason, right?
Molly Wagman - Right, so you have the days stacked on top of each other so each rectangle is its own full day.
Scott K. Johnson - Yep, I've got Sunday, Monday, Tuesday, okay gotcha.
Molly Wagman - And actually, in this report, the first page of your data is actually the oldest. So if you wanted to see the most recent data you would scroll all the way down to the bottom of your report, the very last page. But you can also see the date range at the side, and if you're ever unsure of what days you're looking at and what that overall data is, just look at that top section where it says the week number, it has a date range and it also has your statistics for that whole week. So you can see the percentage of basal and bolus insulin if you're using insulin, that'll be 0% if you're not taking insulin, which is absolutely fine. And your estimated A1C for that week. Whereas before at the very top it was the whole time range.
Scott K. Johnson - Whole time range.
Molly Wagman - Whereas this one is just for this week. And again, that average blood sugar, the blood sugar deviation, your activity, your hyper and hypos.
Scott K. Johnson - So a lot of those line up the same as what we saw on the first, that's helpful.
Molly Wagman - Exactly, but this is just for this specific week. And like we just talked about, each day is stacked on top of each other so you can see Sunday the 7th and it is organized kind of like a graph. So you have on the side, you have your basal and bolus insulins.
Scott K. Johnson - So let's hold on for a second there. Let's say I'm new to insulin or I haven't heard those phrases before, what are those terms mean?
Molly Wagman - That's a great question, it's a very common question. The basal insulin is your background insulin. I always remember it BA basal, background BA. And that is just your baseline insulin needs, if you just took your basal insulin and you weren't eating anything throughout the day, we would like to see your blood sugars stay pretty steady. So that's a once a day injection or if you're on an insulin pump. Sorry, let me back up, it could be twice a day for some basal insulins.
Scott K. Johnson - But they're longer?
Molly Wagman - But it's longer-acting insulin and if you're on an insulin pump it would be as a basal rate that could be adjusted.
Scott K. Johnson - Gotcha, okay.
Molly Wagman - And then your bolus insulin is a large amount of insulin that you would give at one time. This is usually what we call mealtime insulin or fast-acting insulin. So usually used to cover carbohydrates or blood sugars that are above your target to bring them down to your target range.
Scott K. Johnson - And it's taken kind of as needed. When you say a large amount though, if I'm taking a basal insulin, like a long-lasting insulin, that dose could be--
Molly Wagman - That's true, that's true. So the basal insulin might be a large dose but it's over time it's kind of secreted in.
Scott K. Johnson - because that insulin is spread out and it takes longer to, okay.
Molly Wagman - Exactly.
Scott K. Johnson - I'm tracking now.
Molly Wagman - Yes, perfect, great questions. All right, so if you are taking a bolus insulin or a basal insulin, then you can track it in your app and it will show up here in your report. So you can see exactly what time you took a certain amount of insulin. And then right below the bolus insulin is your blood sugar and that's where you see the numbers that are in the background of their color to match that if it's in your target range or outside your target range. And then it will be carbohydrates are right below it. So if you've entered the amount of carbohydrates for your meals or snacks they'll show up there, and any activity that you manually enter or that is pulled in from a connected Apple Health or Google Fit device.
Scott K. Johnson - Gotcha.
Molly Wagman - That'll show up there. And as you move to the right, across the page, that's the time. And you can see at the very top, if we zoom in, you can see that it starts at midnight and then it goes to early morning, in the middle you'll have noontime, and then again, it ends at midnight. And then at very end there you have the summary for the day. So whenever you see, next to a glucose value, that circle with a little line through it, that's an average, so that's your average blood sugar for your whole day.
Scott K. Johnson - Interesting. And then these are some, okay.
Molly Wagman - Right, and so for the next day, the second day there at the bottom, the sum, that's for the bolus insulin. So this person took 20 units total of bolus insulin for the day.
Scott K. Johnson - All right. And can you talk to me about the benefit for you as an educator trying to spot patterns in trends of having the days stacked on top of each other like this.
Molly Wagman - Yes, just like looking for the pattern of a certain color of blood sugar, it helps you really narrow in. So you can see, okay, at certain times of the day I can see all my blood sugars are in my target range, or, at a certain time they're above my target range, and then pairing that back to see what's my insulin dose at that previous time or what activity did I do, or how many carbohydrates did I eat? Did I sleep well? Any kind of notes that you're taking in your logbook will show up here and then that helps you correlate those notes to your blood sugar and maybe make a decision for what's happening.
Scott K. Johnson - So if I was, for example, if I was green everywhere except breakfast, then we would see that, maybe not an exact line down my report but a pretty consistent line and then that would enable you to have a powerful conversation with me focused on my breakfast behaviors or breakfast doses or breakfast whatever. Like it would help us to get to the bottom of what is going on, right?
Molly Wagman - Exactly, and that's where you said, maybe it's not every day but if it's most of the days, the point that is it a pattern? And we decide that it's a pattern if it's at least three days out of the seven days. So about half of the time. You never really wanna make a decision off of one day. Like in this instance where we see, if we're gonna focus on breakfast, I see red only on one day at the breakfast time, so I'm not going to really focus there, we wanna focus elsewhere where was seeing more of the areas where we're outside of our target range and we wanna adjust.
Scott K. Johnson - Gotcha. What about some of stuff, maybe I should, I'm gonna zoom in again, like some of the numbers have little superscript notes and then some stuff below the days. What is that all about?
Molly Wagman - This is one of my favorite things about the logbook too, is that we have so much detail that you can enter and you can see in this example here there's a little number one to the side of the bolus insulin which was six units and that little one is showing that there's a note there at the bottom. So all of the extra notes, anything that couldn't fit into the graph will show up below and this, the note here for this six units of insulin, we want to be sure that we are differentiating between how much did I take for my food, for carbohydrates and how much was, what we call a correction dose for bringing your blood sugar back down into your target range.
Scott K. Johnson - Gotcha, great, let's look at what else can be logged here. A lot of different food and correction, but this would also be if I were to make any notes or add any of the contextual tags or anything like that, basically any of the extra stuff that I'm adding to my record to help you help me make better decisions, they would show up down here.
Molly Wagman - Right, like notes about the details of your food. So you have your meals and you can put in details about your activity because it's really different, it helps us give us context, right? So it's really different if you're going out for a 30-minute walk with the dog or a 30-minute jog, or a 30-minute surf session. So having those extra details are really nice and there are, you'll see in your logbook when you press the plus on your app, there are so many different things that you can log like even sleep, or your mood.
Scott K. Johnson - Let's take a quick look at that just as an example.
Molly Wagman - And all that shows up here.
Scott K. Johnson - So if I'm making a new entry, so these are the kinds of things here. The tags or if I want to add a description, that kind of thing, or even just make a note.
Molly Wagman - Yeah exactly.
Scott K. Johnson - So that kind of stuff shows up?
Molly Wagman - Yes.
Scott K. Johnson - Great.
Molly Wagman - And as someone with diabetes if I'm looking at my log later then I can go, okay, here where the details rather than just if it's just a number you don't have any context with it and I think that's, as a person with diabetes, I feel most annoyed if I've been with a physician and it's like, what happened here. And well.
Scott K. Johnson - I always like to say, every piece of our data has a story around it.
Molly Wagman - It does, yeah.
Scott K. Johnson - And if you are able to use the tools that we have to help tell that story when we're looking at reports and trying to unravel the mystery, there's nothing but good that can come out of that.
Molly Wagman - Exactly.
Scott K. Johnson - Yeah. Is there anything else that we want to cover around the reports, I feel like we've covered quite a bit.
Molly Wagman - I just wanted to point out that, how we mentioned earlier, that gray solid line that shows your BG graph, it's connecting the dots to the different blood sugar data points and you can see that it's shaded red and that means that it is above your target for that time. So that is related to your blood sugar, I just wanted to mention that shading.
Scott K. Johnson - Gotcha, great, that's very helpful.
Molly Wagman - And there's one section that shaded purple. So if you ever see that on your graph at the bottom, it'll be like a little cone. So that is the exercise data that is pulled in from your Google Fit or your Apple Health.
Scott K. Johnson - And that's actually great-- So there's a tag before a meal there.
Molly Wagman - That's super helpful, right? Isn't it always good to be, oh yeah that was before the meal that was after, it really matters, like you said it tells the whole story.
Scott K. Johnson - So you've got before the meal tag, the carb entry with a meal description. Here you've got insulin dose information and then you've got some exercise information. Very, very helpful.
Molly Wagman - I love all this information. As a clinician, as a diabetes educator, again, if we have all of the chapters in the story it makes it a lot easier to keep that full picture and really focus on what's, honestly what's really happening because sometimes I feel like if we have just data points, just numbers, then we can get lost in it and we actually aren't solving the actual problem and having all of the details really helps us.
Scott K. Johnson - I can definitely see why. I have also, as someone living with diabetes, I've been on the receiving end of very, very helpful conversations when I have this story around my data, versus ones where I've had mutually agreeable conversations where I just don't have what you need to help me make great decisions or adjustments.
Molly Wagman - So use your logbook and log as many details as you find helpful for you and your diabetes educator or your doctor and maybe it's just for a short amount of time maybe you're only doing it for a week or two, or maybe you love all of that data and that's what helps keep you focused and helps you take care of yourself, and maybe you do that all the time. But just use this for whatever works for you, it's completely customizable.
Scott K. Johnson - Yeah, great point