WTF is CGM Sensor Soaking?

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

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

HUGGING THE CACTUS - A T1D BLOG
Contrary to the connotation of the word “soaking”, this does not mean you’ll be submerging your CGM in any sort of liquid.

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

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

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

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

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

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

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

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

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

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I Dos and Don’ts: My Tips for Attending a Wedding with T1D

I can always count on diabetes to make life’s most joyous occasions just a bit more challenging…so I shouldn’t have been surprised when my diabetes threw several curve balls at me on my cousin’s wedding weekend.

There was the moment at the rehearsal dinner when I stood up to get something and hit my leg against a chair, literally knocking my pod off my thigh. (But I didn’t even realize it for another 20 minutes.)

There was the moment later that night, after the rehearsal dinner, that I discovered my blood sugar was high and that my mealtime dinner bolus probably was never delivered.

There was the moment the next morning that I realized my breakfast options were limited to a giant, carb-y bagel or a massive, sugary blueberry muffin.

There was the moment when I was with the bridal party – applying makeup, styling hair, and trying to calm the bride down – that it hit me that I had no idea what to do with my backpack (a.k.a., my diabetes bag) during the ceremony, as I had to be standing up there with the other bridesmaids during the vows.

There was the moment I psyched myself out big time by wondering what the hell would happen if I passed out in the middle of the ceremony in front of all of the esteemed guests.

There was the moment I went a little too overboard on drinking Prosecco at the reception…and a few more cocktails at the after party.

There was the moment I woke up the next day with a high blood sugar and hangover from hell.

Needless to say, there were quite a few diabetes “moments” over the course of an otherwise beautiful weekend. As a result of them, I’ve decided to document some wedding dos and don’ts for myself, as this won’t be the first time this year that I’m a bridesmaid in someone’s wedding. Here’s my unofficial roundup.

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Showing off my decked-out pod at the wedding reception.

Do have plenty of back-up supplies. I got lucky this time around because my parents were a phone call and short car ride away from me when my pod fell off. I should’ve been carrying insulin and a spare pod on me, but at least it was within my mother’s reach at the hotel room.

Don’t sweat the small stuff. Things happen, and I’ve got to learn to accept them more quickly so I can better adapt to a situation. It took me awhile to forgive myself for the pod snafu at the rehearsal dinner, and if I hadn’t snapped out of it, then it could’ve ruined the night for me.

Do try to plan meals when possible. I knew that I should avoid a high-carb breakfast on such a busy morning, but I can’t resist a blueberry muffin, especially when it’s one of two breakfast options I had. I wish I’d thought to bring food that had accurate carb counts on it so I could’ve had more predictable blood sugars throughout the day, but I did come back down from the sugar-induced high relatively promptly.

Don’t forget that family and friends are willing to help. My “problem” with my backpack was solved by handing it off to my boyfriend about 30 minutes before the ceremony started. I didn’t miss any photo opps with the bride and bridesmaid during the hand off and I felt better knowing it was in good care.

Do remember that time flies. I had to keep myself in context; after all, I was standing up in front of the guests for less than 30 minutes. I knew there was relatively little insulin in my system and that I was starting to level out somewhere in the 100s by the time the ceremony started. The odds of me passing out were slim, and I needed to give myself that reality check.

Don’t forget to drink plenty of water. Duh, that’s drinking rule #1! I’m embarrassed to admit that I maybe had two glasses of water during the entire reception and after party. It’s not like there wasn’t water available, so I don’t know what I was thinking. But I do know that I was incredibly lucky to hold onto stable blood sugars well into the night, despite my lack of hydration.

Do have a plan for hangovers. Sometimes, they happen, and they’ve got to be dealt with swiftly. After some consultation with my mother, I set a temp basal to fight against my high blood sugar and downed glass after glass of water. By early afternoon, I was feeling much better. And even though I had a bellyache, I didn’t yak, so I suppose that’s a silver lining.

And one extra “do”…do have fun with diabetes devices! I decked out my pod in a Pump Peelz sticker that had an image of the lighthouse we were near on it. Sure, it wasn’t visible to anyone but me (and a few people I couldn’t resist showing), but it still made me feel extra special and coordinated with the wedding venue. Sometimes, its the little things in life.

So besides taking several valuable dos and don’ts away with me from this weekend, I’m also walking away with a wonderful first experience as a bridesmaid to a cousin who’s always felt more like a sister to me. When it comes down to it, my irritation with diabetes doesn’t matter – it’s the love and celebrations I felt all weekend long that do matter.

5 Tips for T1Ds Dining Out

Nothing beats home-cooked meals. But it is nice to go out to eat after a long workweek or to celebrate a special occasion. It’s a good way to unwind and socialize.

And like many other things, it’s also a little bit more complicated when you have type 1 diabetes. Not every T1D might feel the same way as I do, but there are times when I feel worried about going out to eat. Specifically, I start asking myself questions like, “Will there be a decent variety of lower-carb choices on the menu? Have I had this kind of cuisine before, and can I accurately predict how it will impact my blood sugar? Can I order what I actually want to eat without worrying about the carb content? Will the portion sizes be too small or too big? How long will it take for my meal to arrive, and does this mean I can safely pre-bolus for it?” Sadly, those are just a few of the questions that come to mind before some restaurant excursions.

5 tips for t1ds dining out

That’s why I like to remind myself of the following five tips. They’re pretty common sense, but then again, they’re also key for me to enjoy a meal out guilt-free and in a way that works best for my diabetes.

  1. Cut down on carbs, as needed. I’ve learned that one of the best ways to make sure my blood sugars cooperate during a dinner out is to try to reduce my carb intake as much as possible. After all, most restaurants don’t have nutritional information readily available for diners to consult. As a result, it’s impossible to know every single ingredient that could be in a given dish, let alone their carbohydrate content. So that’s why I cut corners where I can. If I’m craving a burger, I order it and ask for it without a bun. I substitute fries or other starchy sides for a salad or seasonal vegetables. If I notice that a pizzeria can make a cauliflower crust instead of a normal one, then I ask for it. I find that using this strategy helps me in just about any kind of restaurant. And if I find myself wanting to order something really high carb (which is rare), then I rely on tip #2.
  2. Ask for a doggy bag. Say I ordered pasta at a restaurant. At most places, there could be upwards of 80 or 90 carbs in that one dish, which is just too much for me to consume in one meal. So I make a plan to eat half of it and bring home the rest. It’s a tried-and-true technique that works for anyone who’s trying to watch what they eat, not just people with diabetes. It’s a win-win because I can still order that carb-y dish, but I don’t have to worry about potentially taking too much or too little insulin to cover it. Fewer carbs in one sitting means less room for error.
  3. Load up on veggies. I incorporate as many vegetables as I can into my meals at restaurants. In addition to subbing sides, I also will focus on eating those if they come with an appetizer. For me, it’s all about filling up on the healthy stuff so I don’t leave the restaurant with too much food guilt.
  4. Share with your table mates. Whether I’m with a large group or just part of a pair, I almost always offer to share appetizers or desserts as a subtle form of portion control for myself. Who doesn’t love splitting an order of nachos or a slice of cheesecake? It’s a great way to start off or end a meal out that involves minimal guilt or blood sugar concerns.
  5. Order drinks with care. I’m very careful when it comes to choosing drinks that have zero carbs, or at least very few carbs. More often than not, I stick with water or unsweetened iced tea with lemon to accompany my meals. But when I choose to drink alcohol at a restaurant, I try to order a glass of wine or lower carb cocktails. I tend to have better luck with those, because I can more accurately predict how they’ll affect my blood sugar, if at all. I do like beer and order it from time to time, but I limit myself to no more than two – any more than that and I push my luck by running the risk of experiencing high blood sugars.

But arguably my most important, unofficial sixth rule is to remember to enjoy myself. There’s no sense in stressing too much about what my blood sugar might or might not do (unless there’s extenuating circumstances, then I totally pay it proper attention). I like to bear in mind that no matter how my blood sugars may react to certain foods, I still have to eat. Why not appreciate every aspect of the experience?

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.

 

Sugary or Sugar-Free Soda? Find out Using This Trick!

Have you ever ordered a diet soda, sipped it, and immediately doubted whether it was truly diet? Then you might find this little tip useful.

Whenever you’re not certain that your drink is diet or regular, try grabbing your glucometer, putting a test strip in it, dipping your finger in the drink, and wiping it onto the strip – just like you would do when checking your blood sugar. If the drink is diet, then you’ll know because your meter will display an “extreme low” result, or something to that effect. The key is to not panic and remember that it isn’t your blood sugar you’re looking at, it’s the sugar levels in the drink! It’s just the opposite in the case that your drink is regular/sugary – you’ll get a “high” reading that’ll make it obvious that your beverage isn’t what you ordered.

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Photographic evidence of my soda test results.

This trick has come in handy several times for me. Most recently, I was doing some Christmas shopping at the mall with my boyfriend when we decided to stop at the food court for some lunch. We split a chicken tender meal from Arby’s, which came with a medium soda that we could fill on our own.

I took on the task while he waited for our food, and was excited to see that they had Diet Dr. Pepper on tap (seriously, that’s rare for most fast food joints). I filled up the cup, fitted a lid on top, stuck a straw in, and took a sip. Hmm…it tasted sweeter than I thought it should. I mentioned this to my boyfriend as he picked up our food and we made our way to a table. I told him that I definitely got it from a tap that was labeled “diet”, but we both knew that just because the label says it is, it doesn’t guarantee that the right soda bib is hooked up to the proper line. (Our shared experience working at a movie theater several years ago clued us in to the fact that employees can make mistakes with this.)

He expressed his doubts, as well, and then it occurred to me to do the old soda test strip check. So I did, snapping a picture of the results and feeling reassured by the factual evidence that I was drinking a sugar-free – not sugary – beverage.

Favorite Things Friday: My Secret Snack Stash at Work

One Friday per month, I’ll write about my favorite things that make life with diabetes a little easier for me.

So, I’m going to cross my fingers and hope that none of my coworkers read my blog…because then my secret snack stash at work will become not-so-secret, and that could mean trouble for me when dealing with future low blood sugars. That being said, if you’re reading this and you work with me…stay away from the stash!!!

As I was saying…

I love having a snack stash stored away in one of the drawers at my cubicle. I like to stock it with snacks that have varying carbohydrate counts: more carbs for lower lows, and fewer carbs for the not-urgent lows. The items may vary from time to time, but usually, I keep the drawer filled with the following snacks:

  • Mini Lara bars (10 carbs)
  • Mini boxes of raisins (11 carbs)
  • Fruit snacks (all kinds, ranging from 10 carbs to 21 carbs)
  • Peanut butter crackers (15 carbs)

Sometimes, I’ll even add a jar of glucose tablets (which contains 50-60 tabs) to the lot. Glucose tablets are far less tempting to munch on then, say, a cracker pack, so when I’m dealing with a raging-hunger kind of low, it helps to have the tabs within reach because they prevent me from over-treating.

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In order to throw off coworkers (who are most definitely, probably not reading this post), I’ll share an image of my old snack CORNER. I’ve upgraded to a drawer now.

And when all else fails and my snack stash is depleted, at least I’ve got access to a fully-stocked Coca-Cola machine in my office suite, as well as a vending machine filled with all sorts of confections in the building’s basement.

But let’s be real here…who can possibly exercise enough self-control to stop eating a package of Skittles when low blood sugar comes ’round?

Disclosing Diabetes in the Workplace

Almost two years ago, my friends from the College Diabetes Network asked me to discuss diabetes in the workplace at their annual student retreat. The prospect of bringing diabetes into a new career and encountering new sets of challenges can seem daunting, so I was happy to talk about my positive experiences thus far as a young adult who has already made the transition from college to “the real world”.

Diabetes in the workplace – how do I navigate it? Here’s a little snippet in which I explain how I’ve decided to disclose my diabetes with my coworkers: