Tag: CGM

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

mollyt1d1 Comment

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.

393F3AB0-9B48-4E65-BA9F-8EBDFB3622AD
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.

My One-Month Dexcom G6 Review

mollyt1d18 Comments

My first month on the Dexcom G6 went by so quickly. The G6 entered my life during a particular hectic period: between a trip to Vegas, my 25th birthday, family gatherings, and work obligations, May was marked by constant activities…which made me that much more grateful to have my G6.

Before I continue with this review, I’d like to note how I got priority access to the G6. Approximately one year ago, I applied on Dexcom’s website to be a “Dexcom Warrior”. Basically, this just means that I filled out a form with my information and some background on my diabetes story. I didn’t expect anything to come of this; if anything, maybe I’d be contacted for someone to write a bio piece about me.

Fast-forward to January 2018: I receive an email informing me that I’ve been selected to participate in a Dexcom marketing campaign. There weren’t too many details other than that a shoot was taking place over two days in Atlanta, Georgia in February and that Dexcom would pay for my flight and hotel if I gave them my time that weekend. I was thrilled to receive the offer and gladly accepted. And I’m grateful I got to have such a unique, fun experience.

I didn’t learn until several weeks later that my participation in the marketing campaign would allow me to receive early access to the G6. In other words, I was going to be one of the first in the world to try this technology. My head is still spinning from that fact, and it’s not something that I take lightly. I understand that I’m fortunate to have access to it, and in return for this special privilege, I am putting as much truth and transparency as possible into my reviews of it.

Onto my one-month evaluation…new observations include:

  • The whole 10-day automatic shutoff thing bothers me a little more than it did in the beginning. There’s no workaround, so I’ve got to know exactly when my sensor is going to expire so I can have a fresh one on hand. This can be irritating, especially when *life happens* and I forget about changing my sensor.
  • The adhesive seems to be one thing that has made zero improvement (but it’s not like it’s gotten worse, it’s the same). I think the surface area of it is a little smaller? But it’s held up fairly well for me for the full 10 days. I’ve only had to use OpSite FlexFix tape on it once, and that was on the ninth day.
  • I am LOVING not having to calibrate the receiver after the two-hour warmup period. My blood sugars automatically start getting recognized by the receiver after the two hours have elapsed, and it’s awesome.
9A60AC29-96C0-4DD5-98B9-5D8A501F4294
A view of the G6 mobile app.
  • I’m still experiencing an utterly painless application. I’ve yet to try a site other than my abdomen, though. I don’t think a different site will hurt more, though I’m curious to see if readings are less accurate.
  • Speaking of readings, I’d say that they’re within the ~15 point range compared to the blood sugars my meter reports. Not bad at all.
  • The battery on the receiver is kind of weak. I have to charge it at least twice per week, which is slightly annoying. But I also have the G6 app downloaded on my phone, so it’s not a huge deal if the battery on my receiver depletes completely.
  • The G6 app works well. Aesthetically speaking, it’s clean and modern looking, and very easy to read. It works better for me than the G5 app did, but I had a myriad of issues going on with it that affected my user experience.

I’m pretty satisfied with my G6 experience so far. I’m hopeful for the future – perhaps it’ll be possible to extend a sensor’s lifespan or easily recycle the chunky plastic applicators.

But I’m interested in questions you might have – are you still wondering about something regarding the G6 that I haven’t addressed? Please let me know. I’d be happy to provide insight.

Diabetes Connections: Gym Edition

mollyt1dLeave a comment

“Are you a diabetic?” Despite the fact that I was wearing earbuds, I heard the question that was undoubtedly being directed toward me.

I glanced to my right and met the gaze of the teenage girl on the treadmill next to me. I smiled, tugging an earbud out, and said, “Yes, I am. My OmniPod gave it away, didn’t it?”

She nodded eagerly. “I have a Medtronic pump, but I know what an OmniPod looks like. When I saw it, I had to say something to you.”

This marked the beginning of what wound up being a thirty minute interaction with Shae, a high school senior with bucketloads of energy and questions for me about life with diabetes. We specifically chatted about college, and I couldn’t resist telling her all about the College Diabetes Network and what a useful tool it was for me during my three and a half years at UMass. The more we spoke, the more it felt like I was looking at a mirror image of myself from seven years ago. She had just finished taking her AP Psych exam and was relieved it was done. Her senior prom was in a few days, and she described how she’d wear her pump while donning her fancy gown. She was excited about college, but a little nervous about the dreaded “Freshman 15” and whether her diabetes would adjust well to college dining halls.

IMG_3979
It’s so funny to think how something as crappy as diabetes can introduce so many amazing people into your life.

I did my best to answer Shae’s rapid-fire questions frankly but reassuringly. As I told her about how much my CGM helped me in college (especially since I was still on multiple daily injection therapy at that time), she exclaimed that I was inspiring her to want to give her CGM another shot (pun unintended – I love spontaneous diabetes humor).

As we parted ways, we both grinned broadly and wished one another well. This is why moments like this – diabetes in the wild – are so great. Diabetes instantly bonds you to a stranger who you might not otherwise ever interact with, and the beauty in that immediate connection is priceless.

The CGM Experiment: Comparing the Dexcom G5 to the G6

mollyt1d3 Comments

I have the extremely good fortune of being one of the first people in the world to receive the Dexcom G6, the latest in continuous glucose monitoring (CGM) technology. After spending almost two years eagerly anticipating its FDA approval, I could scarcely believe that I finally had it in my hands when it first arrived a few weeks ago.

I am partway through my second-ever G6 sensor, so I’ve had enough time to come up with some initial opinions on the system as a whole compared to the G5.

Let’s start with what I knew going into the first insertion of the G6. I knew that the transmitter would have a sleeker profile than the G5. I also was aware that the insertion process would be much more streamlined – all I would need to do is push a button and it would be on my body.  Plus, the G6 required 0 finger sticks or calibrations, could be worn for 10 consecutive days, and would no longer block acetaminophen (Tylenol) like its predecessors did. So far, me and the G6 were off to a solid start.

Then, it came time for me to actually put it on. Rather then end my current session with my G5, I decided to leave it on so I could see how accurate it was compared to the G6.

5af0f7d2789dd724634597

I was amazed by how easy it was to insert the G6. All I had to do was input a 4-digit code located on the sensor into my receiver. Once the code was accepted, I peeled the adhesive off the sensor, placed the system on my abdomen, folded the orange safety clip until it snapped off, and pushed the big orange button. I cringed when I did it for the first time; truthfully, I was prepared for it to hurt. It made a ka-shunk sound as the sensor inserted itself into my skin, and I…didn’t feel a thing. I marveled at how ridiculously comfortable it felt as I snapped the sleeker transmitter into place. I pressed one more button on my receiver to get the sensor warmed up, and that was it. Once two hours elapsed, my G6 system would be fully operational and could determine my blood sugar without requiring manual calibrations.

IMG_6655

While it felt great to know that I didn’t need to worry about calibrating my new device, I was more interested in seeing how well it matched up with my G5.

And I was a little let down…at least, I was in the beginning.

Initially, I was not impressed at all by the G6’s reports. They matched pretty damn closely with my G5. I was beginning to wonder whether the technology really was that excellent, and then my G6 proved to me that it was, indeed, kind of a big deal.

That moment came when it caught a low blood sugar sooner than my G5. I was feeling the early signs of a low, so it wasn’t much of a surprise when it alarmed. But what was particularly neat to me was that it was able to tell me that a serious low blood sugar (below 55 mg/dL) was oncoming in the next 20 minuets or less. In other words, it knew that I needed to treat my blood sugar right away to prevent a more urgent hypoglycemic event. That predictive feature was definitely a pleasant surprise.

As I wore my first G6 sensor for a few more days, it seemed to adjust better and better to my body. As evidenced in the above picture, it proved to be spot on when I compared it to the blood sugar readings I got from my meter. There’s absolutely still a bit of the classic CGM lag, as it takes about 15 minutes or so to catch up to what’s actually going on in the body, but that was to be expected.

I’m already on second sensor and I think it’s safe to say that I’m sold on the G6. But I don’t think that any product comparison/review is complete without a list of pros and cons, so here’s what I’ve come up with:

Pros of the G6 (compared to the G5)

  • Slimmer transmitter profile
  • 0 fingerstick calibrations (which I really loved when I didn’t have to wake up in the middle of the night to calibrate a sensor I inserted before bed)
  • Predictive low feature
  • Modern touchscreen receiver
  • Absolutely painless and foolproof application – honestly, it was THAT good that it might win me over from the G5 if that was the sole difference between the two

Cons of the G6 (compared to the G5)

  • Clunky applicator – as many other members of the DOC have noted, the system is comprised of a lot of plastic. Probably not very environmentally friendly. I wish it was possible to recycle it somehow
  • Automatic expiration after 10 days – with the G5, you could restart a sensor after a week had elapsed, and in theory, you could use the same single sensor more than once for a few weeks in a row. The G6 automatically shuts down after 10 days, so you’re forced to put on a new sensor. This medical device is already pretty expensive, and you could at least get your money’s worth with the G5
  • No super noticeable improvement in blood sugar reporting capabilities

The bottom line is that the G6 is unquestionably an upgrade in diabetes technology. It requires fewer blood sugar checks and allows for greater discretion with its smaller size. The G6 is far from perfect, but it’s still a valued component of my diabetes toolkit. I’m excited to continue on this journey with it and discover just how much it helps me take the best possible care of myself.

So THAT’S How Long and Sharp the Dexcom G5 Insertion Needle is…

mollyt1d5 Comments

IMG_6621

Oh, I cringe just looking at that.

This is a rare photo of the Dexcom G5 insertion needle. Yikes! I only captured it because somehow, my last sensor change with the G5 went awry and I wound up being unable to use this particular sensor. Before I threw it away, though, I played with it a bit to see if I could get a closer look at the needle that helps secure the sensor to my skin.

Obviously, the mission was accomplished. Even though I was slightly horrified by the needle’s pointy length, I was also relieved to know that it would be the last time it would puncture my skin. That’s because I knew my G6 was on its way and that one of the major improvements to it was making the whole process painless. Little did I know how true that would be until I put my first G6 sensor on…

In a couple days, I’ll *finally* publish a post that reveals my initial thoughts on my brand-new Dexcom G6. I’ll compare it to my experience with the G5 and share whether I think the G6 is worthy of all the hype it’s received.

 

What It’s Like to Wear a Medical Device 24/7

mollyt1d2 Comments

A question I’m often asked is: “Can you feel your CGM or insulin pump on your body?”

The simple answer to that is: usually, no. It’s something that you just get used to. You grow accustomed to seeing a lump underneath your clothing. You adjust to putting clothes on (and taking them off) carefully to avoid accidentally ripping a site out. You acclimate to showering without being completely naked.

And, of course, you get used to the questions from strangers asking about that device stuck to you.

But the more honest answer to that question would be that there are times that I feel it more than others. For example, sometimes I forget where I’m wearing my pump until I hit it against something (I’m a major klutz who constantly runs into doorways and trip over things, almost always managing to catch my pod on whatever it is), resulting in pain at the site and a curse word or two to fly out of my mouth.

Circled Devices
My OmniPod (on my arm) and my Dexcom (on my stomach) are stuck on me 24/7.

I feel it the most, though, when people stare. Whether unconsciously or purposely, people do ogle at it in very not subtle manners. Which makes me feel extremely uncomfortable. It’s worse when they don’t even ask me what it is – I’d rather have a chance to use it as a teaching moment than to have someone walk away not knowing what the device does. This tends to make swimsuit season a little less welcome for me. Nothing will stop me from donning a bathing suit at the beach or by the pool, and I do so as much as possible in the summertime. But it’s just not as fun when I’ve got to cope with lingering looks, especially when I’m an admittedly insecure person in the first place.

So it’s a more complex question to answer than you might realize. Wearing a medical device 24/7 is humbling. It keeps me alive. I’m privileged to have access to it. I’m grateful for the ways it’s improved my life. I’m always wearing it, but it’s not at the forefront of my mind – unless it chooses to make its presence known by alarming, or I’ve got people blatantly checking it out. It’s kind of like diabetes itself. It can make you feel a gamut of emotions, but no matter what, it’s always there. It’s just a part of me, and I can deal with that.

A Good Diabetes Day

mollyt1d1 Comment

I’ve blogged plenty of times about my “bad” diabetes days – you know, those posts that I talk about stubborn blood sugar that won’t come down/up, or how technology refuses to cooperate, or how I’m feeling intense diabetes burnout.

This made me wonder about the “good” days. Besides my blood sugars looking so perfect that I question whether my pancreas has magically started to produce insulin again, what sets those days apart from the “bad” (and plain, old, ordinary days)?

 

The answer likely varies among people with diabetes, but let me describe my version of a darn good diabetes day:

  • Going to an endocrinologist appointment first thing in the morning and discovering that your A1c has dropped nearly half a point, down to 6.7. YAAAAAAS!
  • Being told by said endocrinologist that you’re doing an amazing job, and passed all other blood work tests with flying colors – I was most thrilled with my HDL cholesterol (the good kind) levels, which have gone up due to my current exercise regimen. And she said I lost a couple pounds, to boot!
  • Coming home from work to a package from Dexcom containing the brand new G6 receiver, transmitter, and sensors. I can’t remember the last time I was so excited about a delivery!
  • Topping it all off, my blood sugars throughout the day weren’t too shabby.
ezgif.com-video-to-gif.gif
Dancing excitedly with my new Dexcom G6! My puppy couldn’t understand what the hullabaloo was all about.

It’s days like that that make me feel validated – like all my hard work is worth it. It isn’t easy to manage diabetes every moment of every day, so when the diabetes stars align like this, it feels…wonderful.

My Involuntary Hiatus from the CGM

mollyt1dLeave a comment

Currently, I’m on a break from my CGM for an unknown length of time.

This temporary split wasn’t mutual; rather, it was due to a series of coincidences that occurred much to my chagrin. The short version of the story is that my CGM transmitter died a week earlier than I had anticipated. I thought it would be pointless to order a replacement since I was expecting the new Dexcom G6 to arrive at my house before the transmitter expired. When I learned there was a delay that would cause me to wait a little while longer, I realized I didn’t have much of a choice to go ahead and order a replacement G5 transmitter. After all, it was fly blind without my CGM for just a few days versus the possibility of missing out on that data for weeks.

fullsizeoutput_75dThe choice was obvious, and as I write this, my G5 replacement transmitter is on its way to me.

Though there’s comfort in that fact, I feel weird not having my CGM data available to me. It’s kind of nice to be wearing one less medical device on my body, but that’s really the only benefit of being without my CGM. The information it provides to me is invaluable, and an involuntary break from it makes me feel uneasy. I’m constantly reminding myself that I managed diabetes just fine for the first 15 years I had it without a CGM’s aid, which does offer a small amount of comfort. But it also reminds me how important the CGM has become in my daily care choices. Twenty-four hour, real-time updates of my blood sugar help me live a life less interrupted by my diabetes, something that’s extremely difficult to give up after 20 relentless years of dealing with it.

You really don’t know what you’ve got until it’s gone – even if it is only for a short period of time.

I’ll make the most of this situation. It will at least help me get in tune with my body’s signals when my blood sugar is high or low, which is definitely not a bad thing. And it makes me appreciate something that not every person with diabetes is lucky enough to have access to: serving as a humbling reminder of my fortunate circumstances.

Instagram vs. Reality

mollyt1d3 Comments

What does Instagram vs. reality mean?

It’s best explained using pictures. Take the following, for instance:

Beautiful, perfect Instagram
Cold, hard reality

The first image is basically the ideal Dexcom graph. It depicts steady, on-target blood sugars for hours.

It makes the image next to it look that much uglier. The second picture shows blood sugar that rose rapidly over a short amount of time and flattened out at a level so high that it exceeds the Dexcom maximum number.

Instagram: The social networking site that promotes flawlessness. You scroll through a feed and see images that convey society’s notions around perfection. And it’s annoying. The rational part of you knows that, surely, the stunning blonde swimsuit model on your feed probably has cellulite, only you never see it because it’s airbrushed and filtered away. That’s why it’s equally unrealistic to share nothing but the “perfect” blood sugars with the diabetes community. Diabetes is FAR from being sunshine-y and unicorn-y all the time.

The reality: Diabetes is up-and-down, mentally and physically. It’s not always going to behave the way you want it to, even if you’re doing all the right things and trying your best. That’s why I like sharing the good and the bad – it makes the victories that much sweeter, and the less-than-triumphant moments more educational.

So This Just Happened…

mollyt1d1 Comment

Capture

Whoa! It’s incredibly surreal to see myself on Dexcom’s Instagram feed, but there I am! Shout out to my T1D buddies who messaged me the day this appeared and made me feel like a rock star!

Glamour shots aside, this quote really does capture how I feel about Dexcom. It’s truly one of the most powerful tools in my diabetes care kit. In addition to helping me improve my blood sugars by giving me crucial data, my CGM also provides me peace of mind because it does a lot of extra work for me – saving me a lot of time and energy.

This just makes me even more excited to get my hands on the Dexcom G6, which is bound to make life with diabetes even easier! I have the feeling that I’ll get one sooner rather than later…