That Time Low BG Made Me Mad at the Moon

Low blood sugars in the middle of the night are far from pleasant. But they’re especially grating when you’re just trying to have a sleepover with your best friends and your CGM alarms loudly and urgently, rousing more than just me from a peaceful slumber.

Dammit, diabetes…you’ve done it again.

I don’t know how or why the low happened. I went to bed around 1 A.M. – we had stayed up late talking, drinking wine, and eating snacks – and at that time, my blood sugar was 156. You can’t get much better than that, and it felt even sweeter because we’d eaten pizza for dinner earlier in the evening.

I thought I’d be fine overnight. I might come down a smidgen due to the unit and a half I took to cover a slice of fabulous flour-less chocolate cake (utterly heavenly), but I made the assumption that I wouldn’t come crashing down.

I should know by now…never assume with diabetes.

So it happened at about a quarter of four in the morning – a witching hour, in my mind. I woke to the frantic buzz buzz buzzing of my CGM and quickly acknowledged it, then reached for my tube of glucose tablets. I did it as silently as I could, seeing as I was sharing the room space with my three gal pals. From what I could tell, my super slow glucose tablet chewing didn’t even cause my friends to stir. It seemed that I’d successfully managed to avoid waking anyone up, thank goodness.

I was just starting to fall back into a doze when the frantic low CGM alarm blared – BEEP beep BEEP beep BEEEEEEEEEEEP. Ugh! Upon hearing the first beep I snatched up my receiver, silenced the alarm, and scooped up my test kit and my phone. I tiptoed out of the bedroom from which we were all nesting to the living room, where I searched through my backpack for the Skittles I’d purchased earlier in the day…because that’s right, this 3:45 low blood sugar hadn’t been my first in the last twelve-hour window of time.

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Low blood sugar in the middle of the night can make you feel weird things…such as anger towards the moon.

I plopped myself on the couch and started furiously chewing Skittles. I remember looking out to the sliding glass doors and to the balcony and to the parking lot and then finally up to the sky to see the moon shining brightly at me. It was positively dazzling, yet infuriating with its cheerful gleam. I wanted to yell at it to stop looking so happy. I muttered to myself, “this sucks,” and reclined a bit on the couch while I waited to come up from the low.

Everything was fine within 15 minutes. I was on my way up and could safely go back to bed. And again, I congratulated myself for not waking anyone up.

Or so I thought.

“Did anyone hear my CGM go off in the middle of the night?” I asked my girlfriends, approximately six hours after the incident when we were all awake and about to head out to breakfast.

“Yes! I was wondering what that loud, aggressive noise was,” said one. I cringed, an apology lingering on the tip of my tongue, when she continued with an “are you okay? Don’t worry about the noise, I fell back asleep soon after.”

I was grateful for her reassurance, but also for her concern. It felt good to know that ultimately, she didn’t give (apologies for language) two shits about the actual sound that my low blood sugar caused, she was just worried that I recovered from it okay and could get back to sleep soon after.

I smiled to myself. Hours before, I’d been cursing the moon for merely existing and dealing with an annoying, random low blood sugar. But now, I was cruising at a great morning BG and I was on my way to get a delicious breakfast with my gal pals. Diabetes has its moments, but I sure as heck appreciate it when it cooperates during the ones that matter most. So in hindsight, the 3:45 A.M. low was nothing more than a temporary annoyance, and I was just glad that the worst thing it did was interrupt my sleep (and mine alone) for 10 minutes rather than ruin actual precious time spent with my friends.

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Is a Bleeder a Reader? My Take on a Bloody Dexcom G6 Insertion

This blog post probably shouldn’t be read by anyone who gets squeamish when discussing blood or when viewing photos that show any amount of it…my apologies in advance for a bloody gross blog post, but I thought this was a good topic for discussion. 

I placed the new Dexcom G6 sensor on my abdomen, hovering my index finger above the large orange insertion button. I pressed it, exhaling as I felt the minute needle pierce my skin’s surface. I looked down, and started to rub the adhesive in circles to make sure it was stuck, when I saw blood. Not just a drop, but a decent-sized pool forming beneath the sensor. Before long, just about the entire surface of the white adhesive was soaked in red.

Yeah, this was going to be a no-go.

It’s pretty rare for me to experience blood at the site of a Dexcom sensor. If I had to put a number on it, I would say less than 10% of my insertions draw blood. An even smaller amount – like, 2% – have caused me to bleed as much I did in the scenario described above. But I know I’m not alone in my bloody sensor experiences – it’s something that many other T1Ds who use a Dexcom have gone through.

There’s a bit of debate, though, that I’ve noticed in the past on Twitter threads and Instagram posts. What to do with a bleeder? Keep it and assume that it’ll read blood sugars normally? Or change it immediately and call Dexcom for a replacement?

Are bleeders readers? Or does it depend?

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Do you think that bleeders are readers?

I’m going to go with…it depends.

Obviously, in that situation I described in the opening of this post, I decided that it wasn’t a good idea to keep the sensor on my body. There was too much blood and I didn’t trust that it would adhere well to my body. I didn’t know how long it would take for the blood to stop (only a few minutes, but still), and I couldn’t be sure that it wouldn’t mess up my readings. On top of that, I wasn’t trying to stain my clothing, if I could help it.

So in that circumstance, I did change my sensor right away, and was glad that the second try resulted in a much cleaner, blood-free insertion. I called Dexcom, explained what happened to the customer support representative, and got a replacement sensor mailed to me.

However, just about any other time I bleed upon a sensor insertion, it tends to be a minuscule amount of blood. I usually don’t even notice until it’s time to replace the sensor, and there’s a bit of dried blood left on the site. Other times, I’ll see small beads of blood forming underneath the spot where the transmitter snaps in. And there’s been a couple of occasions that I’ve bled a fair amount and been totally unaware of it until I caught my reflection in the mirror and noticed the blood staining the white adhesive. And in all of those cases, I’ve kept the sensor on for the full ten days, without noticing any discrepancies in my readings.

All that considered, in my inexpert opinion, I think that bleeders usually are readers and that they’re safe to continue wearing. Of course, there will be exceptions, like when there’s just too much blood to salvage the sensor. But every time I’ve kept using a bloody sensor, I’ve had the same amount of success with its functionality…so yes, I think that for me, bleeders are indeed readers.

 

Third Time’s the Charm: Here’s How I Restarted My Dexcom G6

You GUYS! I finally did it! I managed to restart my Dexcom G6. Sometimes, a little bit of trial and error pays off.

I restarted it by following the exact same steps that I linked to in my post from a few weeks ago. It involved five simple things:

  1. Allowing my sensor to expire and remain on my body
  2. Starting a new sensor session and choosing “no code” when prompted
  3. Running the 2-hour warm-up session for only 15 minutes, then stopping it
  4. Starting a new sensor session again, without a code (if you still have the code, though, that you used when you first inserted the sensor, then enter that into your receiver/app. But don’t make up a code or enter one from another sensor – just say “no code” if you don’t have it)
  5. Allowing the 2-hour warm-up session to take place and receiving readings once it’s complete

The only thing that was different between this time and last time was the steps leading up to the restart. What do I mean by that? Well, for starters, I made sure I was attempting to restart a sensor that was giving steady, reliable readings – it seems as though it’s impossible to restart a sensor if it’s experienced any sort of error in the 10 days it’s been worn. So this means that when the sensor expired, I’d been receiving readings consistently up until the moment it expired.

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That gap represents the sensor’s second round of two-hour warm-up.

That was the main difference. The location of the sensor I restarted was the back of my arm, which may or may not have affected the restart. I also restarted without using the sensor code, which I had set aside to use but somehow misplaced prior to the attempt. I have no idea if having or not having the code makes the restart more or less successful, but I do know for sure that I got three more full days of use out of my sensor. Cumulatively, that means that I was able to wear the same sensor for almost two full weeks! It might not seem like a lot to the marathoners who are able to make older G5 sensors last 3-4 weeks (I’ve even heard of people keeping the same one on and working for 6 weeks), but it’s exciting to me to have confirmation that it IS at least possible to restart a G6 sensor.

In terms of the sensor accuracy, dare I say that it was even MORE accurate on the second go?! I don’t have proof to really back that up, but honestly, it seemed that it was right on point with all my blood sugar readings (within 5-10 mg/dL). I don’t know how to explain that, but no complaints about it here.

The only other difference that was noticeable during the sensor extension was that I was prompted to calibrate at least every 12 hours. No big deal, since I had to do that when I was on the G5. But it caught me off-guard a bit at first, because on both my receiver and within the Dexcom app, a small blood drop icon was always visible onscreen (when actively checking the app or the receiver). Initally, it wasn’t too alarming because it was merely a reminder to calibrate twice daily. But then it became an absolute nuisance when weird “calibrate after __ A.M./P.M.” messages occurred multiple times per day. I would check my blood sugar at the appropriate time and enter the result into my app/receiver, only for it to be rejected and trigger another specific time-calibration message.

To me, that indicated that my sensor’s second go-around ought to come to anend sooner rather than later. It was getting obnoxious to have to wait and check my blood sugar manually in order to appease the Dexcom messages that kept popping up. Plus, it came down to my comfort levels with wearing a sensor for a certain length of time – I just don’t love the idea of keeping the same one on for ages.

But this was my first taste of success with restarting a sensor, so naturally, I want more of the same! I’ll definitely continue to try to extend the life of future sensors, but remember, follow the steps above at your own risk. When in doubt, simply follow protocols as outlined by Dexcom. If I experience an even more successful sensor extension, you can bet that I’ll have all the details to share with you all here.

 

 

Restarting the Dexcom G6: Attempt #2

“If there’s a will, there’s a way.” This statement totally describes the Diabetes Online Community (DOC) and its collective determination to find workarounds when it comes to extending the life of certain diabetes devices.

In November, I briefly wrote about my first stab at restarting my Dexcom G6, which was completely unsuccessful. So why bother going through with a second attempt at it? Two reasons: 1) I know that other T1Ds have been able to triumphantly restart the G6, and 2) I know that there are multiple methods out there that people have used in order to do so.

I wasn’t necessarily on the hunt for a method I hadn’t tried yet, but I stumbled across one when I was scrolling through my Instagram feed a few weeks ago. Shout-out to Leah (Instagram handle: @the.insulin.type) for sharing her technique, which you can view for yourself by clicking this link.

You’re probably wondering whether it worked for me, so let me cut to the chase and give you a super annoying answer: yes and no. I restarted the G6 according to Leah’s process, but received the “Sensor Error: Temporary issue. Wait up to 3 hours.” message, which resulted in graphs with sporadic gaps created by a lack of readings. That message popped up at least three or four times over the next 48 hours, before the “sensor failed” message notified me that I had to put a brand new sensor on and finally get rid of the restarted one.

This means that attempt #2 went better than my first try at restarting a sensor, but it was far from the flawless restarts that I know other people have experienced.

I haven’t given up hope, though. I do think that I’ll achieve success, eventually, after some more trial-and-error. I do have my theories that might explain why this didn’t go as well as I wanted it to, and it has to do with the following factors:

  • I restarted my sensor on day eight of wear
  • The sensor error message was on my receiver when I began the restart process

Next time I try this method, I want to see if it makes any difference to let the sensor expire naturally on the tenth day of wear. And if that doesn’t work, I want to at least give it another shot when the sensor and receiver are communicating properly and there are no error messages causing interference.

All in all, the experiment wasn’t a total failure. I did manage to extend the sensor’s life by about six hours – it was due to expire at 2 o’clock in the afternoon on the tenth day of wear, but the sensor didn’t fail completely until about eight o’clock that night. So TECHNICALLY speaking, I got a bit more usage out of it…but then again, those six hours (and probably slightly more than that) got wiped out by those stretches of time that I was dealing with sensor errors.

As I work through more restart attempts, rest assured that I’ll post about them so hopefully someone else will learn a method that works for them, too. But remember…restart your Dexcom G6 at your own risk. It’s not guaranteed to restart or, even if it does, to be accurate.

 

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.

No More Fingerpricks Campaign

Diabetes Awareness Month may have only started a few days ago, but boy, has it been jam-packed with advocacy and awareness efforts so far! In fact, I think this is the most active year yet for most social media platforms. I’ve seen tons of different campaigns, hashtags, and posts that were all created especially for this month, and it’s absolutely wonderful to see such inspired content as well as high participation rates.

And I hope to keep the ball rolling on this! That’s why I’m sharing my #NoMoreFingerpricks post today. This campaign was launched by Dexcom and Beyond Type 1. Participants are encouraged to take a picture or video wearing the foam finger from Dexcom, or to draw an “X” on an actual finger (if they don’t have a foam finger). For every photo or video posted on Facebook/Instagram with an @Dexcom and #NoMoreFingerpricks, Dexcom will donate $1 to Beyond Type 1.

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Here’s my #NoMoreFingerpricks campaign photo! And yes, I deliberately wore blue – the color of diabetes awareness.

Yup, it’s that easy to do! And it’s exactly the kind of social media campaign that can catch on quickly. Recruit your family and friends to take photos and get posting! And be sure to teach them a couple of diabetes facts and what the whole #NoMoreFingerpricks hashtag is all about. For instance, you could mention that:

  • 34% of people with T1D know nothing or little about CGM
  • 80% of people with T1D still prick their fingers more than 3 times a day
  • 96% of CGM users would recommend CGM

You could even direct inquiring minds to visit nomorefingerpricks.com to learn more about continuous glucose monitoring technology and this campaign.

So…what are you waiting for?! Draw an “X” or grab that foam finger and post your photo to educate, advocate, and celebrate living beyond!