What Is That Thing?

On my recent vacation in Las Vegas I wore tank tops most of the week, which meant my continuous glucose monitor (CGM) was in full view on the back of my right arm.  2 people asked what it was, a whole lot of others tried not to get caught staring.  I notice the same thing at the Y when I’m on a treadmill; people are curious but uncomfortable asking, and throw side glances while they walk or run.  Not everyone will feel the same as I do, but my advice is this – if you see someone wearing a medical doohickey they’ll probably welcome your questions.  If I wasn’t OK with you seeing it I’d put it somewhere else or wear longer sleeves.  And while I’ll happily give you a quick lesson on the fun toy stuck to me, I promise not to bore you with a 10 minute preachy spiel.

For those who didn't see it when this picture from Vegas was on Facebook, here's the highly noticeable gizmo on my arm (and my terrible posture).  We'd stopped for a few minutes to watch the 4th quarter of the Michigan/Wisconsin game and my friend took the picture while humoring me with a game she didn't care about.  If you look close enough you can see the fireworks sticker I added to the transmitter from Pump Peelz.  

Anyway, it’s been almost 4 months since I started wearing my CGM, so I thought I'd give an update on how things are going.  As a reminder, the CGM is a device with a tiny wire inserted under my skin connected to a transmitter that provides glucose readings every 5 minutes.  I get those readings on my iPhone and 3 friends also get those readings on their phones in real time.

My overall thought?  I love it.  One of my favorite parts is being able to watch my sugar while I’m at the gym.  On one hand it’s just cool to watch the number drop as I walk.  Typically after about 20 minutes things start trending down, so it doesn’t take long.  More importantly, it tells me when my sugar is starting to get too low.  That lets me throw back some glucose without missing a beat and without worrying about the potential for some kind of catastrophic flight off the end of a treadmill if I get way too low.  Though yes, I know some of you would pay good money for that video.  Not happening!

The biggest minus of my CGM is that sometimes it’s really wrong.  An alarm on my phone goes off for any glucose reading under 55.  Four times recently a transmitter has decided I was around 50 in the middle of the night, setting off that alarm on my phone and my friends’.  That alarm is a big part of why I wanted a CGM in the first place, but more than once I’ve gotten out of bed to check manually and found my sugar was a perfectly healthy 100.  Thanks for that, Dex.  Nobody really wanted to sleep through the night anyway!  Why are the readings wrong?  Sometimes because it's time for a new site and I need to move the transmitter to somewhere else on my body.  Technically you’re supposed to move it every 7 days, though like most people I stretch that as long as I can if it’s still working and is reasonably well stuck to my skin.  Other times readings get screwed up or even temporarily cut off if I’m laying on the body part the transmitter’s in.  Since I don’t lie just in one spot all night it’s kind of hard to avoid that in my sleep.  And like everything else with T1, sometimes it’s wrong because the thing just glitches.  That’s all I can figure out, anyway.  If I drop from 90 to 50 in 5 minutes, I label that a glitch.  I don’t think that kind of dramatic change has been right yet.

Accurate or not, those low alarms in the middle of the night don’t just go off at my house.  That’s both a plus and a minus.  There are 3 people who have been willing to follow my CGM data and that’s a big deal to me.  My biggest goal with getting this was safety, and I’ve asked these friends to be my back up when I may not be able to take care of myself.  But that also means waking them up!  There have been a couple of times already where I’ve needed an adjustment to my insulin dose or my body seems to be a bit out of whack and I wind up going low multiple nights in a row.  That means we all wake up, I text them that I’m OK, and we all try to go back to sleep.  Not a big deal in the grand scheme of things, but I feel guilty when it happens.  More than once I’ve eaten some glucose or M&Ms because it looked like I was dropping and I wanted to make sure I didn’t wake anyone up.  I realized just recently though that I’m the only one of the four of us who hasn’t slept through any of the low alerts yet.  Yet.  Good thing we can all back each other up. J

Another annoyance with the Dexcom is keeping it on me.  While there’s a wire under my skin, the whole operation is kept together by adhesive that glues the CGM to the surface.  I’ve struggled with this part and haven’t found the ideal solution.  My record is now 26 days, for that site on my right arm that went skydiving in Vegas.  There’s no way to predict how well it go, and several sites lately have barely made it through the 7 days the company promises.  I’m working my way through suggestions I’ve found online (like the colorful and fun Grif Grips!) , and my next step is going to be trying to put Skin-Tac adhesive on my arm before I stick the sensor down.  After that I’m aiming for kinesio tape because I’ve heard some people have luck with using that around the edges.

As I write all this down I realize that I’ve listed a bunch of negatives that might contradict me declaring my love for this gadget.  Besides stalking my own sugar on the treadmill, one of the big advantages is keeping tighter control of my health.  I saw my endo a couple of weeks ago and was hoping for an A1c of 5.7.  I wound up hitting 5.6 and tied my all time low.  In non-T1 adults that result is considered non-diabetic.  So on average, I'm doing a decent job playing the role of my pancreas.  I can react faster to changes in my sugar now and that helps me prevent some highs and resolve others sooner than I’d know about them otherwise.  A lower A1c means I’m pulling off tighter management of my glucose and hopefully reducing my risk of complications from T1D.  Doing that with a CGM that warns me when I’m low means doing it as safely as I can, so I’m willing to accept a few false alarms.  My doctor was so pleased with my trend over the last 3 months that he joked about framing the graph I printed for him, and he cut me down to only 2 appointments a year instead of the 4 visits most T1s have.  That's a pretty good place to be!