Diabetes and Technology

This November, I participated in the #HappyDiabeticChallenge on Instagram. This challenge centered around daily prompts to respond to via an Instagram post or story. I’ve decided to spread the challenge to my blog for the last couple days of National Diabetes Awareness Month. As a result, today’s post will be about diabetes and technology.

Diabetes and technology: a pair as iconic as peanut butter and jelly, Lucy and Desi, and Han Solo and Chewbacca. I can’t imagine managing my diabetes without all the technical tools and devices I have in my arsenal.

I’m grateful for all the tools we have at our disposal these days, because I know that this wasn’t always the case. I didn’t have to experience a time without a test kit. I didn’t have to deal with checking my blood sugar only once or twice daily using a complicated urinalysis system. Though I chose to take insulin via manual injections for many years, I had the option to try an insulin pump whenever I was ready. And when the CGM came around, approximately ten years after my diagnosis, I was able to start using this new technology.

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Just a few of the key technological components in my diabetes toolkit.

So I guess that diabetes and technology makes me think of two, somewhat contradictory, concepts: privilege and freedom.

It’s a privilege that I have a wide array of technology available to me. I’m lucky that I’m able to use it, because I know that many people with diabetes in this world cannot afford it or do not have access to it. It makes me upset to think about how diabetes might be harder for these individuals due to a lack of treatment and care options, but in that way, it reinforces how freeing diabetes technology has been for me. I have the freedom to bolus quickly and easily as needed. I’m free from annoying tubing, thanks to my OmniPod pump. I’m free to live a life less interrupted by diabetes, because my technology helps me manage it with greater finesse than if I were doing it 100% on my own.

That being said, I won’t ever take my access to diabetes technology for granted.

I can only hope that, as technology innovations continue to improve the quality of life for people with diabetes, technology accessibility becomes more widespread, as well.

Can the Dexcom G6 be Restarted? (and Other FAQs)

I’ve been lucky enough to have the Dexcom G6 CGM in my life for just over six months now. In that time, many people in my life – both T1Ds and non-T1Ds – have asked me countless questions about my experience with the device. I thought it’d make sense to address some of the most commonly asked questions here, in the hopes that I can provide some insight to those who are curious about the Dexcom G6.

Question: Can the Dexcom G6 be restarted?

Answer: In my experience, no. I cannot get the G6 to restart like I could get my G5 to restart. But take my “no” with a grain of salt, here, because I know of other people who HAVE had success restarting their G6 sensor, making its life extend much longer than the 10 days guaranteed by Dexcom. I have only tried to restart the G6 once, with absolutely zero success, following the process outlined here. My advice to those who want to try to restart their G6 is to do so cautiously, and make sure you’re not trying to do so with the last sensor in your stockpile.

Question: Is it actually safe to take acetaminophen (Tylenol) on the Dexcom G6?

Answer: Yes! I’ve noticed that acetaminophen can be taken safely on the G6. I did not anticipate for it to be unsafe, seeing as it was advertised as one of the big improvements Dexcom made from the G5 to the G6. I’ve taken Tylenol a handful of times without noticing any issues with my CGM readings, but as always, be sure to monitor your blood sugar carefully and perform a manual finger stick check if your symptoms don’t match up with your CGM.

Question: I can’t get my Dexcom G6 sensor to stay put for the full ten days. How do you make it last?

Answer: There’s tons of ways you can help ensure your G6 sensor stays stuck on for the entire ten-day duration. I always make sure that my skin is completely dry before the sensor makes any contact with the site. Avoiding any excess moisture is key in helping it stay put. If I notice the sensor starting to peel around the edges after a few days of wear, then I use a Pump Peelz CGM adhesive to keep it in place. Those tend to work really well for me. In times of serious adhesive doubt, I also use Skin Tac wipes, which basically glue that sucker down. One last tip I recommend is to avoid sites that come into contact with a wide variety of surfaces. In other words, a sensor that’s placed on the abdomen may fare better than a sensor on the leg, because the odds of the sensor getting accidentally knocked off due to contact with clothing or other objects are lesser. You know your own body better than anyone, though, so trust your own judgment when it comes to CGM placement.

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Modeling my G6.

Question: Is sensor insertion truly painless?

Answer: For me, G6 insertion has been pain-free approximately 85% of the time. It’s stung slightly a handful of times, but I’ve found that it only hurts when I choose a site that’s not particularly fatty. That’s why I generally stick with my abdomen – either side of my navel – or the back of my arms for G6 insertion.

Question: Is the G6 really that much more accurate compared to the G5, or any other CGM on the market?

Answer: Yes and no. That may not be a very satisfactory answer, but I’ll explain why that’s my belief. Overall, the G6 seems to be more accurate for me than the previous Dexcom CGM models I’ve worn. Are the number always on point compared to what appears on my meter? No. Do I wear the Dexcom CGM to have an accurate picture of what my exact number is at a given moment in time? Kind of, but I also know that this isn’t totally realistic. After all, users of the Dexcom CGMs know that it measures blood sugar levels in five-minute intervals. It can’t give me a clearer picture of what my blood sugar changes are minute-to-minute. So with that in mind, I find that the G6 is really excellent for monitoring trends – seeing how rapidly my blood sugar is falling or rising, or seeing how it changes gradually over time. The patterns are more important to me than the precise numbers; at least, that’s how I feel in my current stage of diabetes management.

I can’t really speak to other CGMs on the market, such as the Freestyle Libre or Medtronic’s CGM. But what I can say is that I’ve heard less-than-stellar reviews about both. It’s important to remember, though, that they’re not meant to be the exact same as the Dexcom CGM. The Libre itself isn’t really continuous and can’t provide users with information until they chose to wave the receiver over the sensor. And as far as I’m aware, the Medtronic CGM communicates directly with Medtronic pumps, and I’m not sure how seamlessly the systems work together.

Bear in mind that when it all comes down to it, I’m answering these questions with my experience, and my experience alone, in mind. Dexcom is and will always be the number one resource to go to with any questions regarding their CGM devices. But hopefully, the information I’ve shared here will at least help someone who is curious about the G6 feel more motivated to seek additional information. I stand by the fact that it has revolutionized my own diabetes care and management, and though it’s far from being flawless, it’s still an invaluable tool to have incorporated into my daily routine.

I Want to Love my Dexcom G6, but…

…this keeps happening on Day 9 of wear:

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I don’t understand why the sensor error occurs. But it almost ALWAYS happens on the ninth day: My sensor will work wonderfully and provide me with extremely accurate data, but then BOOM it’ll sporadically stop working and produce graphs like the one above that are virtually useless. Even worse, there’s no telling when exactly it’ll start communicating again with my receiver. The error message SAYS I’ll get data back within 3 hours, and I normally do, but there’s a big difference between going 10 minutes and going 2 hours without any readings.

This device has so many good things working in its favor: longer wear, painless insertion, increased accuracy, compatibility with acetaminophen, slimmer profile. But I’m of the opinion that if something says it will totally function for a certain length of time, then it WILL. The fact that it doesn’t, and that this has occurred more than once to me, is alarming and frustrating.

The only possible explanation I’ve come up with is that maybe the upper arm isn’t a great place to wear the G6. As we all know, Dexcom devices are FDA approved to be worn on one location, the abdomen. However, that hasn’t stopped the cheeky diabetes community from wearing it elsewhere. Besides the upper arm, I’ve seen people with it on their forearms, thighs, and calves. I even know one clever person who chooses to wear it on the upper bum during the summer months to prevent tan lines (hilarious and brilliant, IMO). I choose to wear my CGM on my upper arm most of the time because it’s comfortable there, and I like to give the sites on my belly a break. But maybe it’s time I start wearing it more frequently on my stomach, the “officially okay” site, to see if that prevents these ridiculous sensor error scenarios.

What I’d like to know in the meantime, though, is has this happened to you or anyone you know using the G6? Has anyone pinpointed a cause, and is it worth notifying Dexcom of this issue? I’d love to hear your stories and thoughts – drop a note in the comments or get in touch with me directly!

The Sounds of a Blood Sugar Check

What does a blood sugar check sound like, exactly? And why would I want to capture those sounds in words?

I was thinking about it the other day – the precise ritual that is a blood sugar check. It involves very distinct sounds from start to finish.

The ziiiiiiiiiip of opening up the meter case. The soft pop from flipping the cap off a vial of test strips. The pulling back of the lancing device to get it ready – click – and choosing a finger to draw blood from before pressing the button to prick it, a sound that’s a bit like a pow that ends in a dull thud.

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These three things make very distinct sounds.

I’ve been in rooms filled with other T1Ds checking blood sugars all at the same time. It’s a chorus of the aforementioned sounds that are so recognizable to anyone with diabetes that they can’t be mistaken.

Sounds that punctuate our lives multiple times each day.

Sounds that help us make so many decisions – from mealtime boluses to deciding whether to have a snack before a workout or not.

Sounds that are a constant reminder of diabetes and its perpetual presence.

Sounds that will be there, always…until there’s a cure.

Favorite Things Friday: My Verio IQ Meter

One Friday per month, I’ll write about my favorite diabetes products. These items make the cut because they’re functional, fashionable, or fun – but usually, all three at once!

One of the most crucial components of a T1D toolkit is the glucometer, also known more simply as the meter. This little device instantly measures blood sugar levels in a person with diabetes: stick a test strip in the meter, poke a finger, and wipe a drop of blood on the test strip in order to get a blood sugar check within seconds from the meter.

Ideally, a meter is used multiple times a day by a person with diabetes – the exact number depends on how often they prefer to check their levels. Personally, I check my blood sugar five or six times each day, so I’m using my meter fairly frequently. As such, it’s always been important to me that I have a meter that is accurate, user-friendly, and compact.

Fortunately, I found all of that with my Verio IQ meter.

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I can’t imagine checking my blood sugar with any other meter.

The slim, bright white device fits nicely into my Myabetic case, making it easy to tote around with me everywhere. It’s pretty trusty and generates results commensurate with my CGM. It doesn’t run on batteries; rather, it can conveniently be recharged every 10 days or so. But my favorite feature of my meter is the back light: If I need to wake up in the middle of the night to check my blood sugar, I don’t have to switch on the lamp that sits on my nightstand. Rather, I merely stick a strip into the meter and it lights up on its own, making it easy for me to see where to wipe my drop of blood. After five seconds elapse, bam, my blood sugar reading pops up on the screen in bold numbers.

I can’t remember exactly when I started using my Verio IQ – definitely prior to college – but I’ve stuck with it for at least eight years now because it works so well for me. When I got onto the OmniPod three years ago, it never even crossed my mind to give up my Verio in favor of using the PDM to check my sugars. It might seem crazy to others that I carry around one superfluous device, but it’s what works for me.

Dexcom Delivered When I Needed it Most

Last week, I received not one, not two, but FIVE packages in the mail. No, I didn’t go overboard with some online shopping – it was all deliveries from Dexcom to help me get my CGM up and running again.

You might be wondering: Why were there so many packages? In theory, I just needed a couple of replacement sensors and a new transmitter – couldn’t it all go in one box? Well, I wound up getting a little more than just the aforementioned supplies…

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Not pictured: another two boxes I received from Dexcom. Not sure why they couldn’t send everything in one large box, but beggars can’t be choosers.

That’s because I had the stupendously (emphasis on the STUPID-sounding part of that word) great idea to power up my old G5 CGM while I waited for my G6 materials. I had a few G5 sensors leftover from before I made the transition to the G6, and to my knowledge, I had a working G5 transmitter. So I followed the procedure to get my G5 going: I inserted a G5 sensor (ouch!), snapped the transmitter into place, and started the warm-up on my G5 transmitter.

But something was…off. The Bluetooth icon was blinking in the upper left-hand corner, and I couldn’t see how much time had elapsed in the two-hour warm-up period. At a loss as to what to do next, I left the receiver on overnight to see if it would ever pick up a signal from my G5 sensor/transmitter, to no avail.

That’s when I made the “fatal error” of shutting the system down and trying to restart it. This triggered the G5 receiver to enter a reboot cycle that wouldn’t stop. Any time I pressed the circular home button, the system would buzz and the screen would light up, as if it was about to start working. After 45 seconds or so, the screen would go black again. There was no way to interrupt this reboot loop – even sticking a paper clip into the tiny hole in the back of the receiver wouldn’t correct the faulty software.

So now, not only was my G6 out of commission, but my G5 was a goner, too.

After a few phone calls to Dexcom technical support, I had answers as well as supplies sent my way. I learned that there’s a known error with the G5 system that causes the reboot cycle to launch. I should have waited longer for the G5 transmitter to connect with the Bluetooth on my receiver (i.e., I should’ve waited for the Bluetooth icon to stop blinking), but it wasn’t necessarily my fault for having a device with a known software issue. I would receive a new G5 receiver because my old one was still under warranty, as well as a G5 replacement sensor. I would NOT get a G5 transmitter, because I’m convinced the battery on the current one is still good, but I was informed that once a transmitter is activated, the battery keeps going until it runs out of juice. Interesting. That means that it could, in theory, stop working any day now, because the transmitter was activated and last used in April 2018.

Hopefully, I’ll never have to get another G5 transmitter because I’ll be able to rely on my G6 from here on out. It gives me comfort to know I have backup G5 supplies, but I’m pretty much married to my G6 at this point. Dexcom kindly sent me the required new transmitter for the G6 system, which arrived on Thursday of last week. I got a return kit for the old G6 transmitter the previous day, and on Friday, my new sensors came in along with a return kit for my defunct G5 receiver.

Sure, it was a lot of packages to sort through in the mail. And it was mildly frustrating that I had to wait two days between getting my new G6 transmitter and compatible sensors. But the most important thing is that I’m now reconnected to my G6 and feeling thankful that Dexcom delivered when I needed it most.

 

What to do When Diabetes Technology Fails (at the Worst Possible Time)

This past Saturday afternoon, my Dexcom G6 sensor stopped working. It wasn’t sending data to my smartphone app or my transmitter, so I was forced to fly blind…at a party with tons of people I’d never met before, an impressive food spread, and few beverage options other than beer from a keg or spiked punch.

Definitely not a good time for my Dexcom sensor to go kaput, especially considering I was getting on a plane the next day and didn’t have a backup. And I wouldn’t get my hands on a fresh sensor for a couple more days, when I would return home from my adventures in Washington, D.C. and Nashville, Tennessee.

So yeah, it was pretty much the worst timing ever for my heavily-relied-upon diabetes technology to fail.

How did I handle it? It might sound incredibly obvious, but…I just reverted back to life before a CGM, meaning that I tested my blood sugar much more often than I do when the ol’ Dexcom is up and running. At the aforementioned party, I sucked it up and pulled myself away from conversations to check my numbers every so often with my meter. I still participated in barbecue and beer consumption, but I dialed it back because I couldn’t be sure of what direction it would send my blood sugar in, or how quickly it would happen.

As for the rest of my trip, and my travel days, I remained diligent. I’d test and correct as needed approximately every two hours. I set alarms for the middle of the night so I could be certain that I wasn’t too high or too low. I went back to relying on sensation – was I feeling thirsty because my blood sugar was high? Was my shakiness a sign of an oncoming low? It surprised me how easily I slid back into those routines, but I guess that after so many years of practicing them, it makes sense that I was still in tune with my body.

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No data…no problem.

And, perhaps most shocking of all, I remained pretty calm about the whole situation. Normally, it’d send me into a panic and I’d chide myself over and over for not having a backup sensor. But, really, I carry around enough diabetes junk – adding a clunky sensor insertion device into the mix sounds excessive. After all, the sensors are supposed to WORK for the full ten days that they guarantee. It gets exhausting, having to anticipate technology failures when they should never happen, so I shouldn’t be upset with myself for not carrying more than the essentials.

The lesson in this experience, I think, is to be unafraid to depend on my intuition. I literally grew up managing my diabetes with hardly any technological aid, and I can do it again now in a heartbeat as long as I trust myself and the process.