I walked away from my third Diabetes Congress last month thinking about how damn bright the future of diabetes treatments are looking. That’s not something that I could have said so easily 24 months ago. I can’t go any further before acknowledging my privilege in being able to feel this way. Today we have new pump choices, competition on the horizon for CGM, interconnected smart pens, nasal glucagon and hybrid closed loop systems (both commercial and DIY) to name a few.
Continuous Glucose Monitoring is something that I never, ever, ever thought would be an option for me. The system is extremely expensive to use, and unfortunately I don’t qualify for any government subsidies here in Australia. But the more I thought about that bright future, the more I knew that at least trying a CGM would undoubtedly give me more options.
Thanks to Diabatteries Down Under, a community on Facebook that is helping to facilitate cheaper CGM access here in Australia, I am now up and running on the Dexcom G5 system. (If you’d like to learn more about cheaper CGM, you can join the group on Facebook). The Dexcom consists of a sensor that sits just underneath the skin on my stomach, measuring my blood sugar every five minutes. A transmitter sits on top of the sensor, and sends my blood glucose data straight to my iPhone.
Like every new piece of diabetes toolkit, the Dexcom was definitely a learning curve. I’m glad that I chose a quiet weekend where I had the time and patience to get it all set up, and equally I’m glad that I’m over the hump.
It did take me a few days to trust the accuracy of the device. The system requires one calibration every 12 hours with a finger prick. One lesson I learned the hard way was that my over-calibrating did more damage to the accuracy of my CGM. My understanding is that the system’s accuracy is formed from each and every calibration, and not just the most recent one. More calibrations do not equal greater accuracy. After I stopped and restarted my sensor on day 3, the accuracy was superb.
Another big mistake I made was integrating the CGM with my t:slim in addition to my phone while this was so new to me. With every alert, I had two devices needing my attention. Suddenly my pump had come alive with beeps and alerts, and given the nature of our attachment, it was clear that this was the one that had to go. A shutdown and restart of the pump thankfully restored my t:slim to the pump I know and love.
I’m loving the novelty of being able to see my blood glucose readings from a glance at my phone. I’m pretty lucky to come into this in a position where I already manage my blood sugars quite well that the system’s alerts don’t bother me too much. After three years of intermittently using FreeStyle Libre, I’m also confident that I feel comfortable with the continuous stream of data.
This is still very much an experiment. I’ll be looking to see how feasible this system will be to run in the long term, how much benefit I’ll be able to reap from it and of course how much I like using it. Stay tuned.
Thank you Frank for your optimism. That is one of the allowable infections!! What the glitz of the technology is distracting from is the slow gains being made in the dietary management of TID and T2D. That old curmudgeon the ADA is finally admitting that low carb diet is one of the three best ways for T2Ds to lose weight. The others being calorie restricted diets (think the Newcastle diet) and gastric stapling. Already in UK the low carb diet program (via DDM who run diabetes.co.uk and Dr David Unwin GP) for T2Ds has so impressed the NHS that they are fast tracking it with the expectation that it will save billions of UK pounds in health expenditure over the next ten years. Meanwhile the same company with Dr Unwin are launching a similar program for TIDs. Of course it is alleged that Big Food and Big Pharma are going all out to try to sabotage this endevour.
Another curmudgeon, the DAA here, has eased the restrictions of practice on prescribing low carb diets for their members it would appear. ( not entirely as children and pregnant women have been excluded from this change despite DAA producing no substantive evidence that I know of) At least that is what they write …. ( see Jennifer Elliott vs DAA, a 2015 case)
I really like my CGM and I find the arm is the place to put it. But a battery to extend the life? Yeah that might be cool.
I like using my arm too…. Doesn’t get in the way much at all! Diabatteries Downunder makes thing much more cost effective. Worth doing.