Swimsuit Season is Here and My Diabetes Gadgets and I are Not Ready

A “yay”: Summer is here!!! Hooray for warm weather, beach trips, and backyard BBQs! (Not to mention VACCINES!)

A “nay”: My pods and my CGM sensors are about to bare themselves for the world to see and we are NOT READY for it.

My confidence in my appearance is rarely, if ever, high. But I like to fake it ’til I make it and act like I’m rocking my summer wardrobe instead of stressing about how my legs or arms look in the staples of the season that are designed to show more skin.

Usually, I have a lot more success in feeling good about how my medical devices appear on my body. Whether they’re hidden under my clothes or out for the world to see, I typically don’t care because these gadgets are keeping me alive!!! And that’s a lot more important than any negative body image connotations they may create.

A picture from a time during which I was very okay with PDA (public displays of my arms).

But something about this year feels different to me. I am so not looking forward to the extra stares that my diabetes technology attracts. I’m not sure if it has to do with being sheltered in the last year and a half because of the pandemic, but whatever the cause may be, this is something I’m grappling with as the temps creep up and the temptation to hit the beach grows stronger.

I know I’m not the only one dealing with this. In fact, I was in Maine for a couple of days with my parents and I was wearing my pod on my leg, whereas my mom had hers on her arm. And we had multiple people approach us about our pods! They weren’t necessarily rude in their approaches – curiosity drove them to speak with us and that’s innocent enough – but it’s still weird to know that people are looking closely enough at our bodies to see our devices and feel comfortable enough to ask us about them. Plus, I felt extra self-conscious about it because in typical Molly fashion, I had a sunburn all around my pod thigh site…when applying sunscreen, I almost always miss the area directly around my pods because I’m afraid of the sunscreen making my adhesive weaker or interfering with the pod’s functionality. So not only did I have this big chunk of plastic sitting on my leg, it was also red all around the site, drawing even more attention to it. It was a relief when I was able to put shorts on over my swimsuit and cover up both the burn and the pod.

So while I’m not loving how wary I’ve felt lately about baring my diabetes devices, I’m also coming to terms that it’s just a sort of phase that I’m going through right now. And that’s okay. I’m also trying to remind myself that I don’t have to feel obligated to go into detailed explanations when people ask me about my pod or CGM. It’s a natural tendency that I have to use it as a teaching moment and be a good diabetes advocate, but sometimes I just don’t have the energy for it. I’m keeping my fingers crossed that as the summer season goes on, my comfortability with my diabetes devices increases and I worry less about the looks they tend to draw.

Ask Yourself These 6 Questions Before Trying New Diabetes Technology

This blog post was originally published on Hugging the Cactus on May 13, 2020. I’m sharing it again today because I think it’s super important to weigh the answers to these questions before deciding to try new diabetes technology. This is coming from someone who waited 17 years before she tried her first insulin pump, and even though it has had an enormously positive influence on my life and sometimes I wish I’d tried it sooner, I’m ultimately glad that I waited that long! Read on for more details…

So you want to try your first continuous glucose monitor. Or maybe you’re ready to leave behind multiple daily injections and switch to insulin pump therapy. Whichever diabetes device you’re looking to start using, there are some questions you’ll probably want to have answers to before decide that now’s the time to introduce new diabetes technology into your daily routine.

The following is a compilation of the questions that I thought long and hard about (literally for years) and that I wish I’d thought long and hard about before I made the transition to the OmniPod insulin pump.

1. Am I ready for it? It took me 17 years before I decided that I was ready to try an insulin pump. 17 freakin’ years!!! I spent most of that time being too afraid of introducing such a drastic change to a routine I’d had down pat for such a long period of my life. There are times when I wish I’d gone onto my insulin pump sooner, but ultimately, I’m glad that I wasn’t swayed by my family or doctors to go on it before I truly felt ready. By the time I started using my OmniPod, I had the maturity, responsibility, and emotional intelligence that I felt that I needed for an insulin pump.

2. Will I be able to afford it? Obviously, this isn’t a question that I wondered about when I was younger, but it’s one of the first things that comes to mind as an adult on her own health care plan. We all know that diabetes supplies are expensive, and it seems that the more technologically advanced something is, the more money that has to be forked over in order to obtain it. This isn’t right or fair, but it’s a simple truth and an important one to think about before choosing one pump or continuous glucose monitor over another.

3. Why do I want to start using it? I wanted to start using my OmniPod because my mom experienced great success when she started using it. And I decided to get a Dexcom CGM because I fell in love with the technology after undergoing a trial period with my endocrinologist. In both situations, I felt very much in control of my decision to start using these devices and I didn’t really listen to anyone else’s opinions. But I am very aware of the fact that social media and real-life friendships with other people with diabetes can often sway people in different directions. After all, if I saw a post on Instagram from a dia-influencer who was singing the praises of a Tandem T:slim pump, then I might seriously start thinking about switching to it (this has actually happened to me). But the bottom line is to think about the why – will this device enhance quality of life for me? Will diabetes be easier to manage with it? Will it help me achieve my A1c and/or blood sugar goals? Do I need to add something new to my routine because I’m feeling burnt out by doing things the same way all the time? Knowing why I wanted to use an OmniPod or a Dexcom CGM made me feel that much better during the whole process of learning how to use them – I felt like I had clear goals that would help me navigate the integration of these new technologies into my daily routine.

Did you know that Insulet/OmniPod has demo pods that you can wear? They don’t hold insulin or deploy a cannula, but they can give you a good sense of what it’s like to wear a pod on a daily basis!

4. Will I be comfortable wearing it 24/7? This is a big one! Pods, pumps, and CGMs are very visible, and it can be jarring to go from being “naked” to having bumps and lumps underneath clothes that can get caught on doorknobs, chairs, and the like. Personally, the benefits of my OmniPod and Dexcom outweigh something like this which is a bit superficial, but that doesn’t mean it’s not something to think about. But it’s also worth thinking about comfort and what is least painful when it comes to insulin delivery, so that’s why this is an important question to ask.

5. Do I know anyone else using it who can provide feedback from a patient’s perspective? I’ve talked about this before, but I’m not sure when, if ever, I would have seriously considered using the OmniPod if my mother hadn’t tried it first. The fact that we both have diabetes has probably made us a little closer and strengthened our bond, so if there’s anyone’s opinion that I’m going to trust when it comes to something like this, then it’s hers. I can actually remember her first few weeks on the OmniPod – in which she learned a lot of valuable lessons – and how pleased she was with it once a few months with it elapsed. She taught me the ins and outs of the OmniPod when started to use it, and I’d argue that her advice was more helpful than that of my diabetes educator. So I’d advocate gathering opinions from family and friends (if either is applicable) or the diabetes online community before going on a new diabetes device, in addition to the research component below…

6. Have I done enough research on it? …Like any smart shopper, it’s crucial to really consider all options and research them thoroughly, especially when it comes to the top contender. I definitely did not complete sufficient research before going onto the OmniPod or Dexcom; rather, I trusted that they were just right for me. If I were to switch to something else tomorrow, though, you can bet that’d I’d spend a lot of time scouring the web for every last bit of information on the device so I could make the most informed decision possible.

New diabetes technology can be both scary and exciting. But more than anything else, it can really make life with diabetes much more carefree, and I’m glad that in this day and age there are so many options available to people with diabetes that continue to be technologically impressive

CGM Sensor Adhesive: Not as Sticky as It Used to Be

I’ve had four CGM sensors fall off in the last six weeks or so.

Four! And they’ve all been in different locations, too – both the left and the right sides of my thighs and my stomach. I’ve worn overlay patches – at times multiple – to help keep them on, and I’ve still dealt with adhesive that just doesn’t want to lay flat against my skin.

What gives? I can’t recall a time in which I’ve had worse luck with my CGM sensors staying stuck.

I’ve gone through quite a few overlay patches in the last few weeks in an attempt to get my CGM sensors to stay stuck on my skin…with mixed success.

Normally, I’d blame it on weather, but it hasn’t exactly been warm here in New England yet. Temps have mainly stayed in the 50s and 60s, so it’s not like I can pinpoint the problem on heat.

The only silver lining in this scenario is that Dexcom does have a nice replacement program. They make it really easy to submit a patient support request online that goes straight to Dexcom support for processing. Filling this form out takes me no more than five minutes and by doing so, I’ve received a replacement sensor for each one that’s fallen off in the last month and a half. And while I was starting to worry that I was submitting too many requests, Dexcom hasn’t further inquired me on the matter yet, so I feel a little better knowing that I can count on them to give me replacements for sensors that won’t stay stuck.

Until the adhesive improves, though, it looks like I’m stuck wearing at least two or more overlay patches on my sensors to ensure their 10-day lifespans.

I guess they just don’t make ’em like they used to…

Byram Healthcare: A Company That Provides Quality Customer Service

Customer service experiences are usually not overly pleasant. They can be time-consuming, frustrating, and at times even unsolvable…but when they’re the opposite of that – quick, easy, and fixable – then that should be shared. So here’s a story about a particularly positive interaction I had regarding the shipment of my Dexcom supplies.

Back in January, I was dismayed to receive a phone call notifying me that Dexcom would no longer directly provide me with my CGM supplies. My account was going to be automatically transferred to a medical supply company that I’d never heard of called Byram.

I was unhappy about this because it was just so easy to order my supplies every 90 days or so from Dexcom, and I was reluctant to switch to a company that was totally foreign to me. So I asked the Dexcom customer support person who called to tell me this news if it would be possible for me to use Express Scripts to get my supplies. I already use Express Scripts for my insulin and a few other non-diabetes-related medications, so I figured I could try to get as many of my medications as possible through one provider for the sake of keeping it simple.

And I discovered that yes, I could get my Dexcom supplies from Express Scripts. Yay! A few weeks later, my sensors and transmitters arrived in the mail, and I soon forgot all about my near-experience with Byram…

…That is, until late April.

Byram gets top marks from me.

I was startled to see an email from Byram arrive in my inbox, thanking me for my order. What order?! The email also listed account information that I never set up, so I was immediately upset and under the assumption that I was going to have to jump through all sorts of hoops just to get this order cancelled and the account shut down.

Except that’s not what happened. In reality, all it took was an 8-minute phone call and a very pleasant exchange with a customer service provider.

When I first got on the phone with the Byram rep, I’m sure she could tell from my tone that I was stressed about the situation, so she assured me that it would be taken care of right away. I was skeptical, but remained on the line when she put me on hold so she could look into the issue further. Much to my surprise and delight, she rejoined the call moments later, telling me that I would have a shipping label emailed to me so I could return the supplies and that she would start the process of closing my account right then and there. No further questions asked, no additional information needed from me – that’s how quickly and easily she set about taking care of my issue.

I spent the last minute or so of our phone call thanking her profusely for her efficiency, and this time I could tell by her tone that she was really grateful for my compliments regarding her customer service. She wrapped up the call by telling me that if I ever decided to use Byram again in the future, it wouldn’t be a problem to re-establish my account. My response? I told her that my experience with her and the company over this error was so positive that I really will consider transferring to them if I ever become dissatisfied with my current provider: This representative left such a good impression that I actually meant it when I said it.

Life with diabetes is hard enough. Unfortunately, getting necessary medical equipment to help manage it can make it even harder. So when something like this happens, I take comfort in knowing that not every customer service interaction will feel like getting a tooth pulled. Shout-out to Byram for restoring my faith in that and demonstrating that they deliver on their promise to” deliver convenience, affordability, and choice, working every day to ensure you have the best care experience and simplify the complexities of healthcare reimbursement and insurance.”

Double thumbs-up from me.

Do You Know What It Means to “Sensor Soak” Your CGM?

This post was originally published on Hugging the Cactus on September 27, 2019. I’m sharing it again today because I still find the concept of “sensor soaking” to be fascinating, though I haven’t been brave enough to try it yet. Not sure what sensor soaking is? Read on to find out…

I saw an Instagram story a few weeks back that intrigued me.

In it, a friend of mine was talking about how she “soaks” her CGM sensors. Instantly, I was confused: What the heck did she mean by that? Soaks them in what, hot water or some other liquid?

Contrary to the connotation of the word “soaking”, this does not mean you’ll be submerging your CGM in any sort of liquid.

Within seconds, her definition of “soaking” became much clearer. “Soaking” a CGM sensor means inserting a fresh sensor hours before you intend to activate it. Rather than giving your sensor just two hours to warm-up, you’re giving it 4-6 hours so it can supposedly provide much more accurate readings immediately after the warm-up period has ended.

I was interested in this practice because I’ve definitely experienced sensors that were off for several hours post-insertion/warm-up. Sometimes, it even takes a full day for a sensor to start reporting accurate numbers, and I wouldn’t exactly call that efficient.

While I haven’t had the guts to actually try sensor soaking yet – I’d like to sometime in the near future – I’ve been doing some research on it so I’m fully prepared to try it whenever I’d like. Here are some questions I had about the process, and the answers I’ve found to them:

Q: Doesn’t this mean that you’re wearing two sensors at once?
A: Yes. But it’s only for a short window of time, until the old sensor expires and it’s time to activate the new one; in other words, for the full soaking period.

Q: How long should I let a new sensor soak?
A: According to what I’ve found online, it seems that 4 to 6 hours is the sweet spot for soaking. It’s basically doubling or tripling the built-in warm-up period that all sensors must go through, so I can see how this might contribute to improving immediate accuracy.

Q: How do I protect the new sensor if it doesn’t have a transmitter snapped in it for several hours?
A: The reason why I haven’t tried soaking yet is because I was worried about wearing a sensor that didn’t have a transmitter snapped in it. But I found some photos online of people who wore transmitter-less sensors with stretchy, self-adhesive wrap tape to protect the nook in which transmitters rest for the soaking period. It’s smart to protect that space, because in theory, it could be vulnerable to catching on clothing or other surfaces. Plus, tape like that is really easy to remove without damaging the sensor in the process.

Q: What changes about the sensor activation process when it’s finally time to start the new soaked sensor?
A: My research leads me to believe that nothing really changes at the end of the soaking period/when it’s time to activate the soaked sensor. All that will be needed is the sensor code so it can be properly activated within the receiver/Dexcom app. So the most important thing you can do at the very start of the soaking period is hold onto your sensor code/store it somewhere safe so you’ll be able to enter it at the end.

Q: So…why would anyone bother trying this again?
A: My understanding is that it all relates back to making sure a fresh sensor is as accurate as possible once it’s activated. I can’t tell you how many times I’ve put on a new sensor, only to discover a few hours after it has warmed up that it’s off by 40 or 50 points – and that just doesn’t cut it. So I don’t think there’s any harm in me giving sensor soaking a shot one of these days. I just have to remember to do it, and have the patience to wear three devices at once (my pod, the soon-to-expire sensor, and the new soaking sensor).

Have you tried soaking? If so, please drop a comment and let me know your thoughts on it – and be sure to tell me if I missed any key steps in my research!

I Forgot About Fingerstick Checks

It was just after 4:30 P.M. on a Thursday afternoon. I’d spent the last hour and a half at my work desk in my bedroom, checking email and dialing into a video conference call. I’d deliberately left my cell phone downstairs, wanting to resist the temptation to scroll idly through social media or check my blood sugar, which had been misbehaving most of the day.

At the conclusion of my virtual meeting, I lamented that my cell phone was downstairs. I wanted to know what my blood sugar was doing (especially if it was high so I could get some insulin pumping), but I didn’t want to walk that oh-so long distance down the stairs to retrieve it.

I sighed, resigning myself to the fact that I wouldn’t be able to check my blood sugar any time soon.

Then…I remembered.

I have a blood sugar meter mere feet away from me.

I could do a fingerstick check and actually know my blood sugar! I wouldn’t have to wait for my workday to end in order to check it, after all!

I still can’t believe that I momentarily forgot that I could check my blood sugar by pricking my finger…

As I ambled over to my nightstand where my blood sugar meter is always perched, I chuckled to myself, marveling over how I could forget that this was an option readily available to me.

Of course, I had the option to not be a lazy Susan and walk downstairs to get my phone, but that’s not the point! (Plus, I was trying to give myself a much-needed break from it!)

It just struck me as funny – I used blood sugar meters for two decades of my life. And bear in mind here, I haven’t even been alive for a full three decades yet, so blood sugar meters are just something I’ve grown up with. How could I forget about them? Have I really become so reliant on the 24/7 reporting from my Dexcom that I’ve shunted aside my only other device that can tell me what my blood sugars are?

I think that this incident indicates that I have. And that scares me a bit.

When I first became a Dexcom user in my late teenage years, I was told that my CGM wasn’t a replacement for fingerstick checks. So up until 3 years ago (when the Dexcom G6 came out), I tested my blood sugar with my meter at least 3-4 times per day, sometimes even more.

But then the Dexcom G6 came out, and the exciting news that the technology was so advanced that it meant that people with diabetes wouldn’t have to do fingerstick checks. Gone were the days of making diabetes treatment decisions only with confirmatory fingersticks or calibration. This was huge, but I was so untrusting of the technology for the first year or so that I continued on with regular fingerstick checks…

…Until one day I just kinda stopped. My multiple-times-per-day checks turned into maybe once or twice a day, then once or twice a week, and now…really, just once or twice a month. And now I’m facing the reality that I don’t exactly feel that this decision suits me because I am the type of person who craves as much data as possible so I can make the best-informed diabetes choices for myself.

So forgetting about fingerstick checks may just be my remembering again to do them. Because when I did check my level and saw that 140 mg/dL flash up on the screen, I felt reassured and thankful for this data point on my blood sugar graph. It was nice to see this number alone, without the reminder of the yucky numbers I experienced earlier in the day…

And best of all…I didn’t have to go downstairs in order to get this snippet of information.

The Dexcom Site I’d Never Recommend Trying

I don’t usually regret trying new sites for my Dexcom and OmniPod.

But recently, I discovered the one area that I wish I hadn’t tried…and that is my forearm.

For a couple years now, I’ve seen forearm Dexcom sites all across social media. People lauded the location for how comfortable it is and the accurate readings it produces, so I figured, why not give it a shot? (LOL diabetes humor.)

Plus, I wanted to give my stomach and the backs of my arms a break. I put both pods and sensors in those locations and while I like them a lot, I’m wary of scar tissue building up.

So with little fanfare, I tried putting my Dexcom on my left forearm (my non-dominant arm). And I knew immediately after hitting the orange button to insert the sensor that it was a bad choice because it STUNG. It stung something fierce! I remember wincing the moment it pierced my skin, and fortunately, the pain did go away…but resurged with a vengeance about half the time I made any arm motions. It didn’t matter if I was flexing it up or down or twisting it to reach for something – any movement could trigger varying degrees of pain. Nothing incredibly intolerable, but enough to make this site uncomfortable.

My face says exactly how I feel about this site: It’s not a winner.

And this pain didn’t altogether disappear one day: I still felt stings 24 hours after I put the sensor on. Maybe I hit precisely the wrong spot (I noticed a very small amount of blood discoloring the white adhesive of the sensor), but I asked the diabetes online community and it seems that the general consensus is that this location sucks. The half-dozen or so people who messaged me said that either the pain was too much and they took the sensor off early, or they toughed it out for a full 10 days and never used the site again.

What’s more is that this site wasn’t as out-of-the-way as I wanted it to be. I roll up my sleeves dozens of times each day for different tasks, and each time I went to roll up my left sleeve, I had to go about it gingerly so I didn’t risk bumping into the site and prompting ripples of pain. This was straight-up annoying because my diabetes devices don’t usually inhibit my movements so much.

The one plus-side of trying the new site, and the only thing that motivated me to keep it on for the full 10 days, is that it was just as accurate as any other Dexcom site I’ve tried. My readings matched up pretty closely with how I felt and with what my blood sugar meter reported, so that was a saving grace. And I have to admit that even though I was worried that sleep would be impossible with the sensor in such a tender spot, it really didn’t interfere with my slumbers, which was a relief.

All in all, though, the accuracy wasn’t enough to convince me to want to keep forearm sites in my regular rotation. I’ll stick with abdomen and upper arm sites for now, with the occasional thigh site to further prevent scar tissue.

Dexcom G6: Available to Who? A Post by Tracy Ramey

This post was originally published on the T1International blog on February 17, 2021. I wanted to post it here on Hugging the Cactus because it was incredibly well-written and eye-opening. Thank you to Tracy Ramey for sharing her perspective and prompting me to really think about diabetes technology and who it is available to you. I couldn’t agree more with your closing thoughts. Read on to learn about Tracy’s thoughts on the Dexcom G6, its availability, and the problems with the commercial that aired during Super Bowl LV.

Celebrity. Celebrity in a filter. Technology. Sleek. Celebrity showcasing a device that many people with diabetes can’t afford and telling said people with diabetes that they should get with the times. That’s it. That’s the entire commercial for Dexcom G6, a continuous glucose monitor (CGM), that aired during Super Bowl LV Sunday. To the world outside of the diabetes community, it presents an easy solution to the problem of diabetes management, a quick aside they can tell that person with diabetes they know in the office on Monday.

“Hey I saw Nick Jonas in that commercial. He said you don’t have to prick your finger anymore! Ya know, he doesn’t even look like he has diabetes.”

As a mother of a child that has type 1 diabetes, managing this condition is always on my mind. I am my child’s “pancreas momager,” if you will. For the past three years I have endured well meaning people giving advice, offering empty platitudes, and not understanding the tightrope we walk as a family attempting to raise a well rounded human that is growing physically and emotionally while course correcting a disease that is never the same day to day. I hear often how diabetes is manageable, an understanding that is as true as it is nuanced. Managing diabetes is not a one size fits all leather jacket. Said person with diabetes will assuredly be giving Diabetes Splainin’ Danny an immense amount of side eye.

With this ad, Dexcom and Nick Jonas had an immense opportunity to truly advocate for all insulin dependent people on the world’s stage. Instead of dispelling hurtful myths such as diabetes being caused by eating too much sugar, or insulin being “so cheap, it’s like water”, they created new ones like people with diabetes do not need to prick their fingers. The ad conveyed that there is an easy solution to diabetes management, which is a huge blow to everyone that has been fighting with insurance companies, pharmaceutical companies and device companies just to get basic insulin and other vital supplies covered, including glucose monitors.

Dexcom’s ad conveyed that there is an easy solution to diabetes management, which is a huge blow to everyone that has been fighting with insurance companies, pharmaceutical companies and device companies just to get basic insulin and other vital supplies covered, including glucose monitors.

Most people with diabetes know about Dexcom and the other major continuous CGM company, FreeStyle Libre by Abbott. Assuredly, if they don’t have one of these devices, in most cases it’s not for lack of understanding – it’s due to high cost. For many uninsured or underinsured insulin dependent people who are already struggling to afford their insulin, the Dexcom (with an initial out-of-pocket price tag for receiver, transmitter, and pack of 3 sensors that exceeds $1,000) is technology that remains out of reach. The ad boldly proclaimed “It looks like the future, but it’s available now.” Available to who? I know people that have had to plead with their insurer to keep their Dexcom if coverage changes occur. Many can’t get it covered in the first place, even though being able to have CGM technology is a gamechanger in the life of people living with diabetes. IT affords a level of control that is hard to think of giving up once you experience it.

But again, we must ask: who is this available to? This technology requires a prescription, and we know that Black and Brown communities are being offered access at much lower rates than their white peers. I am a Black woman with a family history of type 2 that puts me at greater risk of developing it. Interestingly, despite having several family members with type 2 diabetes, my child with type 1 is the first person that has CGM technology, and that was because I pushed for it.

You know what I’m getting at. The elephant in the room is medical racism and implicit bias. When cries for justice rang out for Ahmaud Arbery, George Floyd, and Breonna Taylor, many companies found themselves scrambling to make sure they appeared to sympathize with Black people and the systemic disregard for our lives. But here we are, almost a year into the pandemic, with a January 8th, 2021 headline from Endocrine.org that reads “Black people with type 1 diabetes, COVID-19 are four times more likely to be hospitalized for diabetic ketoacidosis.”

Companies that make a profit off of medical devices as life altering as Dexcom owe it to their consumers to look at the data and adjust to get their technology onto the bodies that need it most. Instead of addressing how they are going to provide a solution to inequities that black, Indigenous and people of color (BIPOC) face – especially Black patients – in comparison to their white peers, Dexcom paid $5 million plus for a Super Bowl ad that ignores barriers to access completely. This is chump change when, according to Yahoo!Finance, they earned $1.93 billion in 2020.

Dexcom offers a life saving product that I am fortunate enough to be able to use for my child because of my health insurance. I am acutely aware that many who look like us and need it the most don’t have access to CGMs like Dexcom’s G6. The Black and Brown people that are experiencing medical systemic racism deserve better. All insulin dependent people deserve better than a 30 second ad that wags it’s finger at all of us silly Billy gumdrops that are still pricking our fingers. Don’t spit on me and tell me it’s raining.

My Thoughts on Nick Jonas and His Dexcom Super Bowl Commercial

On February 2nd, Dexcom announced some major news: Nick Jonas – yes, the famous guy from that band – is starring in a Dexcom commercial that will be airing in a coveted Super Bowl Sunday advertisement slot.

This is pretty big for a couple of reasons, one being that Nick Jonas is now an official paid Dexcom spokesperson. In addition, this represents the first time that a diabetes company like Dexcom will be airing an ad that will be delivered to millions of Americans at the same time, which is definitely a big deal.

Upon hearing this news, the diabetes online community and I had some intense and justified reactions.

Nick Jonas is officially a Dexcom spokesperson, which generated some strong reactions from the diabetes community.

A lot of people expressed frustration that a superstar like Nick Jonas only ever seems to talk about his type 1 diabetes when he’s being paid to do so.

And listen, that frustration is warranted. It’s like the guy is trying to monetize his diabetes and it’s a little gross. There’s collective annoyance that Nick Jonas doesn’t use his (massive) platform and following on a more regular basis to advocate for diabetes. That’s a hard pill to swallow for a lot of us who have created blogs, podcasts, social media profiles, and more in order to help the diabetes community and beyond by doing things like raising awareness and talking about real issues regarding access to necessary diabetes care and medication (and so much more). So when Nick Jonas finally opens up about it, apparently it’s to advertise an expensive piece of technology that isn’t available to all people with diabetes. (And here’s my disclaimer: Yes, I use a Dexcom G6 CGM and I love it. But I’m very aware that I’m fortunate to be able to afford it because others cannot.)

It’s a little difficult for me to sympathize much with Nick Jonas here. Of course, I don’t know him (though I’m sure he’s a lovely guy and obviously he’s quite talented). I have no idea what it’s like to be a celebrity. He’s been in the limelight since he was a teenager. Many of us grew up with him. I can’t imagine what kinds of pressure he’s faced, so something like diabetes (a deeply personal condition) might be tough for him to talk about in a candid manner in front of the mass media. Or maybe he simply doesn’t know how to frame discussions around it. Who knows, but his acceptance of this sponsorship deal warrants the conversations that it has generated. Moreover, I can’t ignore his involvement with a non-profit that’s become infamous for accepting money from big pharma, which is massively problematic in the fight to make insulin affordable for all.

Let me end that line of thought by pointing out that he’s not the only person with diabetes featured in this commercial. There are two other “real-life”, non-celebrities living with diabetes who got this incredible opportunity to be featured in a freakin’ Super Bowl commercial. As someone who has participated in Dexcom ads in the past*, I can understand how exciting this time must be for these two people, and I hope that it isn’t diminished by the diabetes online community’s reaction to Nick Jonas’s appearance and sponsorship deal.

Now let’s pivot to the fact that Dexcom has dropped (probably) millions of dollars to appear in this Super Bowl ad slot…and signing a high-profile celeb like Nick Jonas as a company spokesperson likely wasn’t cheap, either.

It definitely leaves me feeling unsettled. Why did the company feel it was necessary to spend so much on this new advertising campaign? As my friend Stacey put it, Dexcom is putting corporate and celebrity money before patient needs. The reality here is that not everyone can afford insulin, let alone a “gratuitous” piece of diabetes technology like a Dexcom continuous glucose monitor. Elevating diabetes to the national spotlight only does good when it can do something about insulin access and affordability, or to raise awareness about it, or to explain how to recognize the symptoms of diabetes.

To sum it all up, I’ll share a thought from another person I’ve come to know from the diabetes online community: @miss__diabetes. The day that Dexcom announced the commercial, she tweeted:

Nick Jonas is the advocate of a privileged life with #type1diabetes. Doing super bowl ads tells the rest of the world that diabetics are living their best life with diabetes technology when the reality is diabetics are dying because they can’t afford insulin. #Insulin4all

@miss__diabetes

A nicely phrased sentiment as well as a reminder that we’ve got a long way to go in the fight for affordable insulin, don’t you think?

*When I appeared in Dexcom advertisements, I was not compensated beyond the company paying for my transportation, on-set meals, and hotel. If you want to learn more about the experience, I wrote this blog post about it, and I am always open to answering questions.

How to Make Medical Adhesive for CGMs and Pumps Last Longer

Something that all people with diabetes that I know – myself included – struggle with from time to time is the adhesive that keeps our diabetes devices stuck to our bodies.

Real talk? Both the adhesives for my pods and my Dexcom sensors can be lackluster. About half the time, the adhesives that secure them to my body begin to peel around the edges when I’m only partway through the wear time of both devices. And another (much smaller, though far more infuriating) part of the time, the adhesives lose their stickiness entirely, causing the device to fall off my body.

When the adhesive is the reason why a sensor or a pod doesn’t last the full 10 and 7 days, respectively, it’s practically like experiencing a slap in the face because at least a technology error or failure feels more out of my control…the adhesive, though, feels like something that should never be a real issue, and I can’t help but blame myself for not making a pod or sensor more secure when the glue completely fades.

On the bright side, my experience with less-than-sticky pods and sensors forced me to think of ways to get them to last their full lifecycles on my body. Here’s how I make them last as long as possible:

Protective barrier wipes: I use these wipes each time I do a pod change. When my new pod is priming, I wipe whichever site I’m about to place it on with a protective barrier wipe. (I use an alcohol wipe earlier on in my pod change process.) These seem to help with adhesion without adding a ton of stickiness like regular SkinTac wipes tend to do. They literally do what they say they’ll do, which is make a protective barrier for a piece of medical equipment to stick to easily.

Dry my skin: This seems incredibly obvious, but I make sure that new pod and sensor sites are as dry as possible before I apply a device. This is much more of a problem for me in the summertime when weather causes me to sweat more, but I’ve been able to navigate that by wiping my skin with a clean towel and making sure air is circulating well in the room in which I’m applying the pod or sensor so any excess moisture evaporates off my skin.

I may or may not have tried using Scotch tape in the past to get my devices to stick better…(Spoiler alert: It did not work and I do not recommend.)

Specially designed stickers: Both Dexcom and OmniPod produce stickers that customers can request for free. I get them mailed straight to me and I find that they are most useful when a pod or a sensor is hanging precariously off my body. The stickers are shaped exactly to fit around both, so I never have to worry about missing a spot, and they’ve definitely helped me save more than one pod and sensor in the past. I don’t like wearing them unless I have to, though, because sometimes the extra adhesive seems to make the underlying adhesive weaker (not sure how that’s possible, but I’ve always had more luck waiting to add a sticker on top of a loose pod/sensor that’s in its last couple days of wear than adding the sticker on top in the beginning).

The “circle and press” technique: Most people probably already do this, but I actively have to remind myself that when I apply a new pod or sensor, I need to take my finger and circle it around the adhesive firmly three times in order to make sure it’s pressing up against my skin as securely as possible. This method also sort of irons out any wrinkles that might have appeared when the pod or sensor was initially stuck on, so it’s a simple yet effective thing to do…which is absolutely something we could all use more of when it comes to handling diabetes.