The CGM Experiment: Comparing the Dexcom G5 to the G6

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.

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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.

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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 theoryyou 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.

TypeOneNation, Boston: A Wicked Fun Family Reunion

St. Patrick’s Day is a favorite holiday of mine because I enjoy celebrating my Irish heritage. Almost every year, I eat a traditional boiled dinner, listen to Irish music, and wear an excessive amount of green.

This year, though, was a little different. In addition to all of the above, I attended the TypeOneNation summit in Boston. The event was organized by JDRF and just about 900 people with diabetes attended, along with their families and caregivers.

There’s nothing like being in Boston on St. Paddy’s day, even if it is for an event that has nothing to do with the holiday’s shenanigans. The spirit of the day made it slightly less painful to wake up at the crack of dawn in order to catch an early morning commuter rail into the city. As I sipped an Irish cream iced coffee from Honey Dew (absolutely delicious) on the ride, I got myself pumped up for what would surely be a fun day.

Once we arrived at the Back Bay station, I was one frigid (and mercifully short) walk away from the event space: the Boston Marriott Copley hotel. I went straight to the registration table so I could receive a name tag and itinerary, then made a beeline for the vendor hall. You can never have too much free diabetes swag, am I right?

Within the hall, I recognized many familiar faces and happily made the rounds to chat with some of my T1D friends in attendance. I couldn’t help but feel like I was at a family reunion of sorts as I reconnected with people who I don’t get to see often enough.

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I was pumped to see some friends I’ve made through the CDN at the summit!

Before long, the events of the day got into full swing as the keynote speaker, Nicole Johnson, addressed the crowd. Nicole won the Miss America pageant in 1999 soon after she received her diabetes diagnosis. She’s done many incredible things since earning that accolade, and she delivered an inspiring speech about living life with diabetes to the fullest. As she spoke, I looked around the room and noticed all the little kids who were there. It warmed my heart to see how they received Nicole’s words. Many of them looked at her in absolute awe. It was obvious that they thought she was pretty great, and I bet that having diabetes in common with her helped them to feel just as cool. Nicole is definitely a wonderful role model!

The rest of the day went by much too quickly as I went to two different talks offered at the summit. One was about going to college with diabetes, and the other was about sex and drugs – the “taboo” diabetes topics. Even though I’ve already experienced what it’s like to go off to college with diabetes, I wanted to go to this talk because it was given by my friends from the CDN. I also wanted to meet the parents and children at the session because I was curious to learn about their concerns. As someone who went to a very similar talk seven (?!) years ago, I felt that I could potentially offer reassurance to these families, especially since the whole college experience was so recent for me. And it turned out that the woman seated next to me was an anxious mom who seemed receptive to the words of encouragement I spoke to her at the end of the panel. While I believe that the session could’ve lasted many more hours (everyone was so engaged in the conversation), I think that the session acted as a good launching point into future discussions for many families who are going to make this transition soon.

I wolfed down a quick lunch – I loved seeing the food labeled with carb counts – before heading to the next session. I chose it because, c’mon, a title like “Sex, Drugs, and Rock n’ Roll” can get anyone’s attention. Plus, I feel very strongly that the touchier diabetes topics SHOULD be talked about more often. They can be scary to approach, but it’s important to know what to expect in certain situations in which diabetes can play a major role. I had to duck out of this one a bit early to catch the commuter rail back home, but they were delving into some pretty juicy stuff when I got up to leave. I give major credit to all of the panelists in that one – it can’t be easy to talk about highly personal intimate matters in a room filled with strangers!

Although my time at the summit was truncated, I’m so glad that I took the time to go to it. It’s no secret that I enjoy talking with other people with diabetes. Hearing their stories and sharing experiences makes diabetes feel less isolating. And I’m thrilled that I finally got to meet a few people I knew from the DOC but had yet to see in person!

Diabetes conferences, meet-ups, summits…they’re the types of family reunions you actually get excited about and want to attend.

Wishful Thinking: A Day Without Diabetes

I’ve heard the following phrase for just about my entire life:

“There will be a cure for diabetes in the next five years, just wait!”

Uh, I’m still waiting over here. Where’s the aforementioned cure? *Taps foot impatiently*

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It’s fun to fantasize about life with diabetes, especially when you look at the numbers like this.

Oooookay, while I sit here and wait for another 20 years of diabetes to come and go, I’ll daydream. Ooh! I’ll daydream about a day without diabetes. What would it look like for me? I have some ideas…

  • In the morning: I’d wake up feeling incredibly well-rested. That’s because I’d sleep through the night without my CGM going off. After rolling out of bed with a head of perfectly-mussed hair (this is MY fantasy here, so just go with it), I’d head down into the kitchen to indulge in a ginormous cinnamon bun slathered in cream cheese frosting for my breakfast. I’d savor every bite and relish in not having to poke myself with needles multiple times in order to eat the tasty treat.
  • In the afternoon: After actually enjoying a workout at the gym (cue my Anna from Frozen singing voice) for the first time in foreverrrrrr, I’d probably treat myself to a massage/spa day. But a shower first because a masseuse should never have to deal with a smelly and stinky person. You know what would be awesome about that experience? I wouldn’t be worried about my blood sugar all throughout it and I could just appreciate the act of self-care. And for lunch? I’m not a TOTAL junk food junkie – I’d eat a healthy, balanced lunch that day. Perhaps a smoothie bowl laden with fabulous fructose-filled fruits that WOULDN’T spike me? Maybe a massive salad topped with carb-y croutons? The possibilities are endless.
  • In the evening: The day would wind down with a sense of accomplishment, because I would’ve been able to run errands without a single diabetes-related complication slowing me down. I’d glam myself up for a night on the town in which I’d consume one or four cocktails, free from wild swings due to alcohol’s effects on blood sugar. And then I’d run into Kit Harrington (Jon Snow from Game of Thrones, A.K.A. an extraordinary man) and he’d sweep me off my feet and we’d take off into a sunset sans diabetes.

Okay, yeah, I’m definitely stretching my imagination as I picture a couple parts of this day…but it sure is fun to think about life without diabetes.

Undeterred by a Broken Ulna

The morning of Tuesday, January 23rd, I took a bit of a tumble. I fell on some black ice in my driveway and managed to fracture a bone in the process: my ulna, which is the longer and thinner bone located in the forearm. I broke the one located in my dominant arm and have spent the past few days in a brace. I’ll get a real cast put on it early next week.

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Please enjoy this gratuitous shot of my arm in a brace, featuring the sleeve of my dinosaur sweatshirt.

I waited a few days before writing a blog post about it for several reasons. For starters, I struggled with teaching myself how to type with limited range of motion in one hand. Actually, I struggled doing most things with just one hand. Brushing my hair, putting clothes on, feeding myself…every mundane task has become a challenge. It’s been especially difficult to accept that I need to allot myself twice the amount of time to do just about anything because I have no choice but to move slowly. I’m an incredibly impatient person, so this has been a hard truth to come to terms with. But I’m getting there.

Taking care of my diabetes is also included on the list of everyday tasks that are now tricky. I dislike having to rely on others for help, but I’ve got to say that changing my pod with one hand is far from easy. It feels like I’d be flirting with disaster if I were to hold a precious vial of insulin in an awkward grip as I made an attempt to fill a syringe, then a pod, with my shaky left hand. Fortunately, my parents are more than willing to help me when I need it – thanks guys – and I’m able to do other things, like check my blood sugar, on my own.

The healing process is expected to be about six weeks, so it won’t be too bad. I’m just going to have to adapt to life with one functioning arm/hand. There’s one thing that’s certain, though: I’m not going to let this stop me from doing anything I want to do! (Within reason, of course. Let’s just say I won’t be taking a boxing class any time soon, even though I’d really like to.) Just like diabetes, a broken bone can’t stop me. I’ve even managed to get 10,000 or more steps each day since the injury happened – including the day of the fracture! I could’ve chosen to pardon myself from exercise and stew over the pain, but I wanted to prove to myself that I’m both physically and mentally stronger than my excuses. After all, the rest of my body is in perfect working order. I’ve just got to keep it that way!

Does Cold Weather Affect Diabetes?

Shout-out to Diabetes Social Media Advocacy (DSMA) for prompting me to write a post about this!

Often, I tell people that anything can affect diabetes. Factors like exercise and stress may seem obvious, but more subtle variables include the weather.

The winter season began less than a month ago, but it’s already been a brutal one for much of the country. In New England, we’ve had more than a foot of snow, subzero temperatures, bitter wind chill, and a surplus of ice glazing over all outdoor surfaces.

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Winter weather looks pretty, but it sure can be a pain in the ass.

Besides being unpleasant to experience, harsh cold weather like this also has a bit of a negative impact on my diabetes. How? There’s a few different ways.

Cold weather limits (or increases) the types of physical activity I can do. Snowstorms make it difficult to travel, so more often than not, I’m stuck at home during wintry weather events. This means I get less movement in, which has an adverse affect on my blood sugars. I rely on getting a certain level of exercise daily, so I have to be creative when it’s snowing in order to meet these requirements. On the flip side, depending on how much snow falls, I need to shovel the driveway. This is a highly strenuous activity that can make my blood sugar drop in 15 minutes or less. As a result, I’ve got to be careful and plan accordingly when a blizzard is in the forecast.

Cold weather impacts the foods I consume. Let’s be real, when it’s freezing outside and you can’t go anywhere, healthy eating isn’t really a priority. Nothing is as comforting as a home cooked meal, whether it’s chili or chicken pot pie. And a hot chocolate is a wonderful pick-me-up post-shoveling. But the problem is these foods are heavy, rich, and laden with carbs. I have to work harder in the cold weather to attain balance with my eating and resist the temptation to fill up on starchy, satisfying food.

Cold weather affects my insulin intake. This ties into the aforementioned points, because if I’m moving less and eating more, then I naturally need to compensate for this with higher insulin dosages. I get frustrated, because it seems like I have to deal with more high blood sugars this time of year. But I know if I keep these factors in mind, it’ll help keep the highs at bay and prevent me from under-dosing.

Cold weather can sway my mood. The winter blues is a real feeling this time of year. It’s much harder to feel motivated to keep up with exercise routines or other healthy habits when the weather’s got me stranded at home. I combat it by staying busy and keeping a routine as much as I can. And when I fall off the wagon, I acknowledge that it’s okay, dust myself off, and get right back on it.

Even though cold weather brings additional challenges with it, the season is fleeting. Before I know it, spring will be here along with better blood sugar.

Diabetes in the Wild

Diabetes in the wild refers to a random encounter with another T1D when out and about. My favorite recent occurrence of this happened when I was in Disney World with my mom (also a T1D). We had just entered Animal Kingdom. I was sporting my pod on the back of my upper arm.

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I don’t think Timon noticed my pod, but another T1D in the park sure did!

“Hey, Podder!” I heard someone yell. For a split second, I thought someone was saying, “hey, Potter,” you know, like the Harry Potter kind of Potter.

I looked around and saw a girl a few years younger than me waving her arms in my direction. When we made eye contact, she smiled and pointed at her pod. I gave her a thumbs up and the moment was over as quickly as it happened.

But it puts a smile on my face when I think about it, because it goes to show how awesome these chance meetings are – they serve as little reminders that even when I may feel like the odd duck in a crowd due to my pod, I’m not as alone as I think I am when it comes to diabetes.

Sun Salutations and Stable BG: Yoga Does the Trick for my Diabetes

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Whoa, who’s that dork doing a high-speed yoga routine up there?

Hi, it’s me!!

It’s kind of weird to watch a video of yourself doing yoga – especially when you see how awkward you look because the time-lapse feature on your iPhone sped it up so much.

So why did I film myself doing a yoga routine? Once I get past my self-consciousness, I look at the video to see what needs adjusting; for instance, I could sink a little deeper when I’m in my chair pose. I could also stand to slide my foot a bit higher up my leg, perhaps balance it on my thigh, when I’m in the tree pose.

Aside from looking for what needs to be improved, filming the routine also helps me understand why I do yoga. It shows me how my flexibility has increased, as well as my balance. I also realize that it shouldn’t be a surprise to me that I worked up a sweat during this practice – I’m constantly shifting from the ground to standing to various other poses. My muscles are stretching out and getting warm from the movements, so of course I’m giving my body a workout in the process.

And in turn, I’m also keeping my blood sugar stable. The yoga poses combined with controlled breathing and mind wandering does wonders for both my diabetes and my mental health. More often than not, I ride a straight line on my CGM throughout a yoga practice. It’s a great way to get in the right frame of mind at the start of a day, or unwind at the end of a long one.

Plus, there’s nothing like sinking into child’s pose (lying face down on the mat with your arms extended, your knees apart, and your rear in contact with your heels) or taking a nice long savasana (or corpse pose, in which you lie face up with your eyes closed, arms at your side, with fingers and toes spread open – without letting your muscles tense up) at the end of a practice to reset the mind.

Can’t beat the benefits of yoga.

What it Feels Like to Have Low Blood Sugar

Diabetes evokes curiosity for those who are not familiar with it. I’ve been asked many questions over the years – can you eat sweets, does it hurt when you give yourself shots, do you have to protect your pump from water, just to name a few – all relatively easy-to-answer, yes-or-no questions. But every now and then, someone will ask harder questions. And one that I’ve struggled to answer in a succinct manner is: What does it feel like to have low blood sugar?

There isn’t really a simple answer. I guess my textbook response is to rattle off a list of common hypoglycemic symptoms: shakiness, dizziness, sweating, slurred speech, weakness. But I know that other PWD experience slightly different symptoms, such as feeling cold instead of sweaty, or drastic changes in personality. And there are even some PWD who don’t experience any symptoms due to hypoglycemia unawareness.

So how exactly do I response to a question like that, one that’s more loaded than it appears?

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A graphical representation of a sudden low – I guarantee I was not feeling great when this one hit.

I could tell the asker to imagine feeling simultaneously ravenous and disoriented. I could tell them to picture walking into the kitchen and feeling like inhaling the entire contents of the pantry – that’s how intensely your body craves sugar.

I could tell them to think about what it’s like to wake up in the middle of the night drenched in sweat. It might seem like a reaction to a nightmare, but it’s the body trying to convey a message that is, by some miracle, supposed to be grasped by someone who was just trying to get a solid night’s sleep.

I could tell them to envision feeling like energy is sapped out of every pore in the body abruptly, with little warning.

I could tell them that sometimes, it results in pure panic, particularly when no fast-acting carbohydrates are on hand or when no one is around to help you.

I could tell them that low blood sugar is one of the biggest sources of anxiety for many PWD, that it causes a deeply rooted fear. That it can sometimes lead to a PWD making unhealthy choices just to avoid a low from happening in the first place.

I could say all of this to anyone who asked me this question – and I still don’t think it would completely convey what it’s like to have low blood sugar.

How would you describe it to someone asking you about it? Would you use the terse medical explanation, or would you try to talk about how it really feels?

Leave your responses in the comments – I’d like to know how you handle this. And if you thought this was an interesting post, let me know. I’m thinking of doing a series about how I answer the more complicated diabetes-related questions I’m asked.

Memory Monday: Log Books

One Monday per month, I’ll take a trip down memory lane and reflect on how much diabetes technology, education, and stigma has changed over the years. Remember when…

…log books were a THING that PWD used to track blood sugars?

Log books were pocket-size diaries (of a sort) designed for PWD to keep track of blood sugars, insulin and carb intake, mealtimes, etc. Basically, it was the old-fashioned way of recording blood sugars so that you could bring it with you to your endo appointments so your doctor could review the book for patterns.

I remember HATING having to write down my numbers. I felt like those little log books were contraptions put in place to judge me and my numbers. Imagine an eight year old who felt judged by something like that? It’s just wrong. But I get that they had a purpose to serve, and even when I was little, I knew it was important to write everything down even if I resented doing it.

That’s why I made it more fun by drawing doodles next to certain blood sugars – a frowning face would appear when I was high, and a mini burst of fireworks would find their way next to a blood sugar of 100 (which I now refer to as a unicorn bg, along with much of the rest of the DOC). I also distinctly remember using the log book to keep track of where I was injecting my insulin: “RL” would appear on the page if I was due to give a shot into my right leg, or “LA” for my left arm. These days, I’m really good about swapping sites, mainly because it’s easy to remember, thanks to my pods. But as a kid, it was more challenging, so writing it down helped.

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Thankful that my meter tracks my blood sugars for me now (also, that 230 mg/dL would’ve totally gotten a frown-y face back in the day).

Thank goodness for modern meters and insulin pumps that keep track of my blood sugars for me now. It’s so much easier to show up to an endo appointment and hand over my meter for the nurses to download. Plus, doing so means that my doctor and I get to review all sorts of colorful charts showing my blood sugars over a certain period of time, which is more telling and helpful than a doctor thumbing through my log book and murmuring, “I see,” every few moments.

Log books are such an archaic artifact of my diabetes history that I don’t even own any nowadays. I trashed them all, years ago, when I realized that my blood sugars from 2001 were sort of irrelevant to now. Do you still have any of your log books lying around?