Tag Archives: Nightscout

Confession time: CGMs.

So with all of this talk about travel and safety and doing the right thing, I’m still not a consistent continuous glucose monitor user. Here’s my confession:

I don’t want to be a CGM user.

I hope my endocrinologist isn’t looking at this today (she does look in every once in a while). But she’s already familiar with my resistance on the subject. Let me see if I can explain this. I’m sure all of the points I’ll make here can be shot down with common sense wisdom that just about anyone living with diabetes can understand. But there are a few reasons why I haven’t made CGM use habitual.

When I first started using an insulin pump five years ago, I also started wearing a CGM all the time. The CGM I was using was horrible; it had accuracy issues, and it was always painful to insert. It was so frustrating that after about nine months, I gave up on it. I won’t go into it anymore, but I think that was where my reluctance started.

Actually, the biggest, most overriding reason for not wanting to wear a CGM is that I do not want one more thing attached to me 24/7/365. That’s not to say that showing a CGM transmitter in public, at the pool or in the shower at the gym, would cause me embarrassment. Those days are long over. I couldn’t care less about that, and I certainly didn’t have a problem with it when wearing a CGM during clinical trials.

No, the problem of “one more thing” is bigger than that. It’s not only wearing something else all the time. It’s having to plan out site changes for two devices rather than one. It’s having to pack supplies for two devices rather than one. It’s fighting with insurance profiteers over coverage of two devices (and supplies for those devices) rather than one. It’s having to carry around a receiver in my already overcrowded pockets. It’s dealing with real estate issues earlier because I’m constantly violating my body in two places at a time instead of one.

I think there might also be, hidden somewhere deep, an aversion to gathering data for my endocrinologist to go through and find fault with me. My current endo is not like that at all, and I know she would never shame me if my numbers didn’t look so great. However, old wounds take time to heal. On the other hand, this would probably be the easiest place for me to give a little. In reality, I know this would not be an issue, so why should I continue to make it one? Patients are not always perfect either.

After going over my concerns with my endo, she suggested that instead of wearing a CGM full time, maybe I use one for ten days or two weeks in between appointments. That way, she could at least get a little data on how my BGs were trending throughout each day. This seems reasonable, and not too intrusive. But has that made me start the process over again? No. Old wounds take time to heal, and old habits die hard.

I’m not sure I’m solving anything here. But this is how I deal with issues like this: I talk about them, to myself, family, and friends, and in doing so, I often talk away some of the concerns (read: fears) of change. I know that CGM technology is better, and with the rollout of Nightscout and Dexcom Share, many people are able to add an additional layer of security in the advent of a hypo away from home. Why wouldn’t I want to make that a part of my care too?

I don’t think I’m there yet. But I’m getting closer. Secretly, I’ve even made lists of who I would share my data with… even “backups”.


 
 
 

Innovation is good. Innovation WORKS.

My co-workers and I were talking the other day about our recycling, and one of them mentioned that they now put out more recycling every week than they put out actual garbage. I’ve actually lived in places where a couple of decades ago, there were people arguing that recycling pickup wasn’t worth the cost to have it picked up on a regular basis. Now many of us are throwing out less than we’re recycling. Where would we be if we were still throwing everything away?

Just like when there was no such thing as recycling newspaper, plastic and glass bottles (heck, I can remember when all bottles were glass), cardboard, and metal, there was a time when performing a blood glucose check at home was a pipe dream. There was a time when an insulin pump (no injections? get out!) was something out of a sci-fi novel.

But lo and behold, over time, those devices not only became a reality, they’ve become a fixture in our diabetes lives. New things do get developed. New technology emerges. New therapies are perfected.

That’s why I get a little sad when I hear people say bad things about the artificial or bionic pancreas. It’s disheartening to hear someone dis remote monitoring of their CGM.

The reality is that these two ideas are coming to fruition at a rapid pace. We already know that artificial/bionic pancreas technology, when filtered through an appropriate algorithm, functions far better, with far less effort, in a safer way, than the average patient does on their own. Side note: Can I just refer to it as artificial/bionic pancreas now? Even now, after years of development and testing, this technology is changing further to include a bihormonal (insulin and glucagon) solution. Can you tell me you were thinking about that ten years ago?

And what about remote monitoring of your CGM? We know that Nightscout has already rolled out a solution that can allow parents to send their children to school or to sleepovers with a little less apprehension. Adults can use the CGM In The Cloud to keep their family members in the know, on a real-time basis. Was this on your list of cool diabetes ideas six or seven years ago?

I know it takes a long, long time for products to come to market. But I know that with the help of technology and some extremely smart cookies, new diabetes devices and software are going from concept to go live faster than ever before.

I know that there is still so much about diabetes that will remain dangerous, even after the latest innovations come to our doorstep. But I also know that fear of what still exists is not worth not taking steps to erase some or all of the fear of dangerous nighttime lows.

I know that a cure is still out of our grasp. But I also know that I am willing to live with incremental improvements in care and delivery systems until a cure becomes reality. And I am not willing to wait on everything until a cure is within reach.

I don’t believe I’ve ever written this before. But for the record, I am 1000 percent behind the #WeAreNotWaiting movement. Where last year there were only a few isolated pockets of innovation and collaboration in diabetes technology, there are now visible signs that collaboration and innovation are occurring and are at work right now. And that leaves me thinking that with the speed of technology, #WeAreNotWaiting will soon go from a fringe idea of faster implementation of new ideas, to an inventive steamroller that eventually leaves non-believers thinking #WeShouldn’tHaveWaited.

I was not prompted by anyone to write anything on this subject, but I was inspired by this blog post, and this one too.
 
 
 

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