Dexcom One CGM - In Review

It's been a number of years since I last used a Dexcom CGM. In 2018 and 2019, I used the Dexcom G5 followed by the G6 and my experience was "patchy" for various reasons. So, it was with hesitancy that I accepted the Dexcom One "Starter Pack" during my latest diabetes review appointment. It was offered to me following the sharing of my experiences of Freestyle Libre 2.

Firstly, how wonderful to have a choice of blood glucose tech. I know most areas in England and Wales are offering a choice of Libre 2 or Dex One yet many are still finding it difficult to access one or the other - mostly Dex One - at the time of writing this blog post.

The Starter Pack contains everything you need for 10 days CGM use - 1 transmitter and 1 sensor. You'll need to install the Dexcom app on your phone and create an account if you don't have one already. Then, you're ready to go!

You'll need to "pair" your phone with your Dexcom One transmitter. Pairing is a simple process, just follow the steps on your phone screen. Once you are paired up, you can insert the sensor using the single use applicator. By the way, be sure your phone is compatible with the CGM. Dexcom will have a list of compatible handsets on their website. 

The sensor applicator looks and feels a little like a computer mouse. There is one orange button to insert the sensor under your skin and a small protective orange strip to cover it. You'll need to snap that off before you press the orange button. You'll also need to remove the two slips of paper that cover the sensor adhesive area. Once the paper is removed, hold the applicator against your skin and press the button. Sensor inserted! Just ease away the applicator and dispose of it as best as you can. It's a pretty chunky lump, making recycling difficult. Some have suggested breaking it up with a hammer to make recycling easier. I think Dexcom could do a lot more to be planet friendly, here.

Before you go waving a hammer around, pop the transmitter into your sensor. Next, follow the app instructions to begin the warm up process. If you've never used a Dexcom CGM before, then get ready for a wait. The Dexcom One takes 2 hours to warm up so, maybe don't do this right before bed.

The warm up process was problem-free and BG values began to appear. The first few readings were pretty close to my actual blood glucose. "Great!" I thought, until my BG dropped so low that numbers became letters on the Dexcom app. However, I wasn't hypo. Things didn't get any better for a good 6 hours, throughout that time I remained outside of the hypo zone. I decided to let the CGM "bed in" and, erm, go to bed.

I don't know if it was just really tired from sitting in a box on my living room floor for a few days, but the rest seemed to do the CGM good! Fasting BG in the morning was very close to the Dex One number, which was also very close to the Libre 2 number (I'm wearing both devices at the same time). 

Heading towards 7 days with Dex One, I've become comfortable with it and I have begun to trust it. Compared to Libre 2, it has been closer to my actual BG for more of the time.... just! The difference between the two is very minimal for me. L2 is reading a little lower (it usually does) than Dex One, but not by worrying amounts. 0.5 mmol perhaps as an average.

Accuracy aside, the Dexcom One app is a very stripped out affair compared to LibreLink. It will offer some eA1c info via Clarity and some Time In Range data, but there is no place to leave notes and no way to screenshot the app. Read this in your best Nick Jonas voice - No screenshots? Really?! Some of you are going to suggest using third party apps and you're right. You can screenshot and note leave using different apps. However, I'm not a fan of unofficial apps when it comes to my data, support, security, yada yada. Also, the tech newbies don't want to be overwhelmed by having to install multiple apps to do things they could do with one app on LibreLink. I'm not a newbie, I'm just big hearted and I care about the people who are.

The app is my only gripe, really. Yet, it works and how often am I going to leave passive-aggressive notes about the sensor accuracy? Do I really need to screenshot my BG to encourage keto diet zealots to question how long I'll be keeping my toes with those numbers? Maybe not. I've drifted off track. My gripes aren't a big deal. They're little annoyances. The important thing is the CGM works well. At least, after the first 6 hours.... 8 hours if you include the warm up. Yeah, that first day is pretty annoying. I can accommodate that, though.

What else? 

- It's ergonomic. No sharp edges to catch on clothes, bed sheets, other humans, etc.

- It's simple to set up. Minimal steps and great on-screen instructions.

- Satisfactory accuracy vs Libre 2.

- 10 day wear isn't wonderful. That's 3 sensors per month vs the near 2 for Libre.

- 90 day transmitter usage is... okay... remember GlucoMen Day have rechargeable transmitters that last for 5 years.

- Waste could be better. That big lump of applicator, 3 times per month. Eeek.

That's about it. Soon, I'll need to make a choice for NHS purposes. Dexcom One or Libre 2. Which one do you use? Have you been given a choice?  

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What a Site! - Diabetes Tech Worn by Everyday Diabetics

Have you noticed the Diabetes Tech ads on your TV, lately? It seems to be a marketing avenue that a few companies are exploring. I'm happy about that. It normalises the use of the technology in day to day life and reduces stigma around Diabetes. One particular ad' caught the eye of my mother, who asked "Don't you use one of those disc things for your blood sugar?" She'd seen a Libre ad' featuring a woman, swimming. The conversation led to my explanation of how the tech works and how we both wished it was available in the 1980s when I was diagnosed. 

It also led me to think about the marketing around Diabetes technology. The images, videos and individuals used. Nick Jonas might spring to mind? Perhaps a few other names, too. Of course, the famous and the achievers deserve access to Diabetes tech as much as the rest of us but perhaps it's time to celebrate the "Everyday Diabetic" a little more in such marketing. I consider myself be a Everyday Diabetic - Just a man who talks about his condition, warts and all, on various platforms. I'm lucky to have an agreement with GlucoMen, who appreciate my content and supply me with their Day CGM. I'd love to see more individuals given similar opportunities.

So, reader! Allow me to present to you some of my tech wearing friends from around the world. Beautiful souls, kind hearts and living their best lives while wearing Diabetes technology to help them manage their condition.

It seems that we're a diverse lot. Not just in the management of our condition but where we put our technology. Arms are popular! The Libre wearer in the photo at the top of this blog moves hers around:

"I was in need of a new spot, as the back of my arm needed a bit of rest (the sensors aren't too kind to my skin, especially then - I expect they have changed something with the adhesive). Besides this it tends to come loose quite easily, so it's a lot less of a hassle on the front."

That's Julie, she says "I wear my sensor on the side or to the front of my arm, because I can see it I’m more conscious of it so I don’t knock it off, when I wore it on the back of my arm I was always knocking it off especially at work and when strength training."

Jimmy likes to keep his sensor warm, "I wear my taped up sensor on the inside of my arm (it doesn't like the cold)"

Some sensors have a habit of coming loose and falling off! So putting a strap on could be a great idea, especially if you have a 3rd party add-on such as Bubble.

Hot weather (even in the UK) causes issues, too. That's why Richard tapes his in place.

The 3rd party add-ons are still a popular thing when it comes to turning Libre 1 into a CGM.

While arms are still popular this pump user prefers core sites too, noting "Here’s where my pump is currently sited. I also use my arms, back and backside."

And if you have two pieces of tech for your blood glucose? "My trial of Dexcom is about to expire so here’s one of the Dexcom and a new Libre soaking in before I activate it in 24 hours time. Both on my stomach."

How about a pump on one side and a CGM on the other? Tummy button piercing is an optional extra which might not be NHS funded. This tummy belongs to a Diabetes tech user who is proud to show off her gadgets, "If it helps others, I'll be happy. I'm not shy in showing it either, bring on the summer bikini shots"

How about a close up on a pump cannula in action? Textbook stuff!

That one probably isn't in many textbooks! But, do you know what? Sometimes rules are made to be broken and if it works for you?... "The readings were less than 0.5mmols different and frequently equal to blood glucose"

Chest is best?

Robert might agree, with this upper-chest Libre. "Pump on my arm, libre on my chest, I'm usually the other way around. I try to avoid my waist for pump as I over did it a bit!"

Anybody for legs?

"I started using my upper legs for my pump sites about two years ago! Mostly because my CGM had to be on my stomach (it is now also been approved for your arms so that's where mine is now)! I have a lot of stretch marks, so a bit part of my stomach is unusable. I have also noticed that since switching to my legs, I have not had one bent cannula, this was something that happened often when i still used my stomach for my pump infusion set."

Guys use their legs, too. Including this pump user.

A late entry comes from this patch pump user. What goes on around the front, goes on around the back.

So, there's a splattering of lovely people and their tech sites. What, me? Alright then. It seems only fair that I show you some of my tech sites from over the years.

GlucoMen Day CGM on my tummy.

Libre leg.

Dexcom arm

Thank you very to everybody who contributed to this blog. I think we could make a calendar from these photos. Imagine seeing my thigh on June 1st!? K, maybe not.  Also, for confirmation, all contributions to this blog agreed to me publishing their image and quoting their words.

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2nd Class Diabetes

'We'd like to invite our Upper Class Diabetics to board first.'

'Thank you for your patience. We'd like to invite our Premium Diabetics to board'

'Are you guys still here?'

'K, I guess you test strip users can get on board'

It's Super Bowl weekend! and all the talk on Diabetes Social Media is of Nick Jonas and the Dexcom ad'. That's not entirely unexpected. I remember the first diabetes tech ads on UK TV causing much discussion, so it seem natural that one of the most expensive advertising slots in the world would attract some interest when diabetes tech is featured.

I watched the ad' earlier, following a JDRF UK tweet which suggested the impossibly good-looking Jonas was bringing Type 1 Diabetes awareness to the Super Bowl. That tweet is here if you'd like to read it.

Let's watch the commercial! 

If you're using your phone and the video isn't embedded above then you can watch the video here

What do you all think? Are the unaware of Type 1 Diabetes viewers going to be woke?

Possibly! 

Firstly, type isn't mentioned here. Just 'Diabetes' which, on it's own, is fine IMO. Perhaps all types of diabetes can benefit by using tech. I have T1D. It isn't mentioned. So bringing awareness of my condition to the Super Bowl viewers isn't really happening. Indeed, it might be argued that the ad' is damaging and breeding the ignorance that all diabetes types are the same. We know they're not. That's not throwing any type of diabetic under the bus, it's simply a fact. JDRF UK is a Type 1 Diabetes charity, remember.

Next up! "Finger sticks, really?" says the heartthrob. Yes! REALLY! What a horrible piece of marketing to the US viewers who are struggling to buy their insulin, rationing their life saving drugs AND their finger sticks. Can you imagine settling down to watch the game and, after taking your second and last finger prick of the day because that's all you can afford, you're greeted by Jonas. Finger sticks, really?

Wow.

I know it isn't down to the CGM company in the ad' to reduce the prices of insulin and test sticks and everything that goes along with having diabetes (any type). But it isn't alright to openly mock those who rely on those things to get by. Not by choice, remember. Many Americans (and nationals of other countries) buy what they can afford for their health. A CGM can be a luxury which is currently unobtainable for many.

I see this "class" system in various aspects of diabetes. Fortunately, in the UK we appear to have sights on a level playing field, thanks to the likes of Prof Partha Kar OBE. But in America and other countries? I can only imagine the thoughts of "What fresh hell is this?" when you watch that commercial and you're struggling to afford the diabetes meds and tech that you need.

Finger prickers, I love you guys. Don't give up fighting for the things you need at affordable prices. You're NOT a 2nd class diabetic.