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Posts tagged ‘dexcom’

Lower Arm Real Estate.

“Rotating sites?  Hell yeah, I rotate.”

… sort of.

I’m good about rotating my pump and CGM (continuous glucose monitor) sites, but I’m decent, at best, about exploring new real estate.  Most of the time, I use my outer thigh or lower back/hips for my CGM, going back and forth between those four areas.  This sounds like proper rotating, in theory, but in practice, I am re-using and abusing the same patches of skin.

Because my skin has a persistent and scaly reaction to the sensor adhesives, it takes several weeks for parts of me to heal after they do their seven days of data due diligence.  Which means that I need to stay the eff away from my last two most recent sensor sites, or else a skin reaction blooms in a matter of hours, regardless of preventative measures.

tl;dr – My skin hates everything and I need new real estate for my diabetes devices.

I’ve seen a few of my PWD friends sporting their sensors on their arms, but until recently, I’ve never been able to keep an arm sensor stuck.  On me, the tape always comes loose and even extra adhesive goes rogue on me.  Arm sensors, up where I used to pinch up and do injections on the back of my arm, are a disaster for me.

But a few days ago, I took a crack at a lower arm sensor, placing it six inches or so above my elbow.  It’s more on the front of my arm (giving my bicep a strangely LEGO’ish look), but so far, so good.  The adhesive is staying put, the Toughpad seems fine, and no skin irritation here on day three.

Above the elbow Dexcom sensor. #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

Placement of sensor on arm. My arm. (Why does this caption sound so formal?! Over and out.) #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

I’ve been having trouble keeping sensors comfortably stuck in the last few weeks, so I’m hoping a true and proper site rotation helps heal what ails me.  Otherwise, I may scratch my skin into oblivion and will be forced to slather it with Brad Pitt lotion.

[Dexcom disclosures. And all my other disclosures, if you'd like some light reading.]


In almost ten years of using a CGM, I’ve never, ever had this happen.

This morning, when I went to insert a new Dexcom sensor, I followed all the usual protocol:  Put a Toughpad down against clean skin, place the sensor adhesive against the Toughpad, and then insert the sensor right through into my skin, allowing the giant needle to pull back into the applicator, leaving the sensor wire embedded in my skin.

Right?  So imagine my surprise when I pulled back the applicator and instead of seeing a sensor housing ready for the transmitter, I instead saw the stupid needle sticking out of my leg.


It hurt, so instead of documenting the needle in my skin (as a good diabetes blogger should – ? – in efforts to get the best grost), I pulled it the hell out and inspected it to make sure there wasn’t anything wrong with it.

The needle in my Dexcom sensor application tool. Filed under "oh hell no." #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

And you know what’s wrong with it? IT’S HUGE.


The sensor was damaged when the needle gave up on me, leaving the sensor wire poking out from the underside of the transmitter. Pointless prick. :)

Longest Dexcom Break in Six Years.

“Is it because of the skin thing?” he asked, watching me put the transmitter and receiver on the bedroom dresser.

“Yeah,” I replied, only it wasn’t exactly the truth.  Sure, my skin had some pretty irritated patches from the constant application/reapplication of my CGM sensors, but it was manageable, especially if I was more diligent about rotating my sites.  But it wasn’t just the physical itch or the bulk of another device stuck on me.

I needed to fly blind for a while.

Which sounds ridiculous, because I am lucky as hell to have access to that data insight in the first place.  Twenty-some-odd (they’ve all been odd) years ago, I would have laughed in you face if you told me I could have access to all-day streaming blood glucose data without having to prick my finger ever five minutes.  I remember putting on my first Dexcom sensor and being amazed at the trends alone (the old STS wasn’t up to G4 standards).  Using a CGM helped me corral my blood sugars in pursuit of a happy-baby-range A1C without working in a pile of low blood sugars.  And throughout my pregnancy (and the subsequent raising of my now-not-so-small Bird), the data was beyond useful.  It became indispensable.

But after six years of wearing the sensor almost all the time, feeling like the two hour booting up time frame was an eternity, I needed more than two hours off.  I needed more than two days off.  I needed to take the sensor off and put it on a shelf for a week or two in order to stop leaning on it so heavily and to help retrain my body and my mind to tune in more actively to diabetes.

Because when the sensor is on and throwing data, I trust it.  Trust to the point of crutching out on it, not testing my blood sugar often enough throughout the day and making corrections and meal doses off the CGM data.  (Do as the FDA and Dexcom say, not as I do.  Consult your doctor before ever consulting the likes of me.  See also my Dexcom disclosure.)  For years, the CGM data was making me better at the job of managing my diabetes.  I liked it that way, but in the last few weeks (admittedly, months), I haven’t been doing a good job of staying on top of my diabetes.  Instead, I’m letting the technology take control, when the one at the helm should be me.

Took a break.

A photo posted by Kerri Sparling (@sixuntilme) on

So I took off the sensor about a week and a half ago.  Defiantly, but also half-expecting to cave and put another one on right away.  For the first two days, going to bed at night was the toughest part because of my concern for overnight hypoglycemia.  But I was testing more, and I set an alarm one night to double-check, and then there was this moment when I wasn’t panicking about the lack of data because I had started re-trusting my own ability to do this myself.

Because I can do this. I have done this. This Friday marks 29 years of doing it and doing it and doing it well. I’m in control, despite the work it takes to get there and the patchy moments of “Yeah?”

This afternoon, I’ll pop a new sensor on and watch my glucose live-stream again.  But it will be different because I won’t feel like I’m along for the ride with this diabetes bullshit.  I feel a little more like I am back in the driver’s seat, with technology as my seat belt instead of my airbag.

Guest Post: Does Diabetes Tech Assist or Insist?

Several years ago, I “met” DCScribe (who remains mostly anonymous) on Twitter and he and I did not see eye-to-eye on much, aside from sharing the diagnosis of type 1 diabetes.  For a while, the lack of common ground frustrated me because I identify with and bond over experiences, but then I realized the alternative viewpoints he provided were not only important but essential to my growth as an advocate.  It is good for me to hear perspectives outside of my comfort zone; they help keep me realistic.  And when I had the chance to sit down and have lunch with DCScribe several months ago, it was really nice to confirm that two people who might butt heads constantly can still share a mutual respect … and a lunch table.

He was diagnosed with type 1 diabetes at 8 months and has lived with T1 for more than 50 years. Over the course of his career as a journalist, he has worked as a reporter in Washington for 26 years covering the White House and Congress as well as conflicts overseas, hurricanes including Andrew and Katrina, and every presidential election since 1988.  He’s recently embarked on a new career in global health that will take him to the frontlines in the battle against Ebola, malaria, AIDs and other scourges around the world.

And today, DCScribe is taking a turn here at Six Until Me to talk about diabetes technology as something that assists or insists.  Read on for more.

*   *   *

The older I get the more I’m struck by how the decisions I make in so many facets of life are deeply informed and influenced by my long career refereeing soccer at the highest levels.  It’s even shaped my relationship with diabetes technology. And yeah, I can hear the rumbling. “Holy hell. Where’s this going? That dude ought to check his ‘sugar.’”

But it does. And here’s why. Reffing has helped me understand the difference between someone (or something) who “assists” and someone (or something) who “insists.”

It’s a question every diabetic should ask when making a decision about the technology you need (and don’t), how to use it and whether it means being in control or under control. Understanding where that line falls and enforcing it is central to my D management and my easy, stress-free life with the disease.

I speak only for myself, of course, and concede there might be gaps in my perspective. After all, only two other people outside my wife and kids and my doctor knows of my condition and my identity. My wife knows I use a pump but doesn’t know the brand or really how it works. I never share my BGs with anyone, though I’ll offer vague updates at home such as, “I’m gonna wait a bit to eat dinner.” It works for me; I’ve never had a single bad day from diabetes in more than 50 years. Sure, some days are better than others but not one has been truly bad or difficult.

There are lots of reasons, but an important one is my comfortable but always skeptical relationship with technology.

I have no idea if I’m different in that respect. But from scanning the Diabetes Online Community twitter feed and beyond, I wonder if enough people asking the question about technology’s proper place and power. (Here’s one place where it was asked and discussed publicly. It’s a cautionary tale and luckily I can’t ever imagine finding myself in a similar place.)

At the same time, I’m not immune from the pull of technology. I use a pump and have for 16 years (though my current pump is 7-years-old. Let’s face it: a pump is little more than a tricked-out syringe.) It’s why I got my first blood glucose meter in the 1970s and have used one ever since (though my one-and-only meter today is 9-years-old.) It’s why I’ve never used a continuous glucose monitor and never will. I’m constantly examining that distinction and that, along with my natural skepticism keeps me from chasing the latest, often imperfect, shiny object until its use and accuracy are proven.

This also fits with my belief that too much information can be more of a burden than a savior, especially if that information is imperfect. I wonder too if a fixation on technology diverts attention from proven and powerful “human factors.” For me, the basis of my success and easy life with D is rooted in discipline when it comes to food, making sure I’m physically fit and a refusal to ever use diabetes as an excuse for anything at any time.

Which brings me back to the beginning and “the pitch.”

In soccer, most games have three refs (though in a lot of my games there’s also a Fourth Official.) The Center Ref is the only one with a whistle. He or she prowls the entire field and is the one person responsible for fair play and safety; for keeping the official game clock and chaos to a manageable level. The Center Ref is the ultimate and singular authority. All decisions start and end with him or her.

The Center Ref uses his or her experience, training, knowledge and physical fitness to manage the game, navigate nuances and the many “gray areas” woven into the Laws of the Game and to ensure the rules are applied in a fair and consistent way.

But the Center isn’t alone. Along for the ride are two Assistant Referees, one on each sideline. Without ARs, the Center’s job is difficult if not impossible, especially on a regulation field that measures 120 yards by 80 yards.
The ref crew is a team in the truest sense, but to work well, everyone understands this: Good assistant referees never “insist.” Their job is to “assist.” That means there are times when the Center Ref will wave down a flag (or tell an AR through the headset) because the Center Ref is in a better position or has more experience or a different understanding of the larger picture.

Replace “AR” with “diabetes technology” and you get the idea.

That’s why I seldom follow the number my bolus “wizard” spits out. Its why, when my meter says I’m 70 mg/dL and I’m getting ready to ref a game that will require running upwards of seven miles and demand thousands of decisions, including a few that are game critical, I don’t hesitate. I appreciate my meter’s “assistance,” jam a granola bar in my mouth, wash down with a gulp of sports drink and go. But not always. Sometimes I simply walk on the field and start the game.

I seek assistance in carefully chosen places. That makes perfect sense to me. It doesn’t mean I’m anti-technology.

I’m a guy, so I’m hard-wired to get all tingly from even most dubious technological “innovation.” It should be no surprise that I would have instantly given up insulin before surrendering my satellite phone or the solar charger for my up-armored laptop when I was reporting overseas. In the early 1980s I had a very public and very serious relationship with my 30-pound Teleram “portable” computer that I happily lugged from one corner of the country to the next so I could transmit stories to the Mothership at the wondrous rate of 1,200 baud per minute.

And yet, I still use a 5-year-old iPhone and have zero urge to change because … it works.

Technology is great. I love it. I use it – a lot of it. But skepticism is more useful for me, as is enough patience to make sure the latest, greatest bit of technology works as advertised, and that whatever tech I use in my ride with diabetes knows its place, no matter how hyped or magical or shiny.

*   *   *

Thanks for your perspectives, DCScribe.  And for the link to the oldest computer ever. 

OMG Nick Jonas … with a Sizeable Shout-Out to Dexcom.

I can’t hear the name “Nick Jonas” without immediately hearing the then-teenaged cousins in my family clutching their invisible pearls and screaming, “OMGNICKJONAS” as if it was one word. In my mind, I think of Nick Jonas as a kind and smart … not because I have any personal experience to base that assumption off of, but because he’s also living with type 1 diabetes and I tend to be somewhat (read: entirely) biased towards people hosting broken pancreases.

Nick was diagnosed with type 1 diabetes about ten years ago and has recently joined Dexcom as a Dexcom Warrior.  He’s been talking with members of the media about his new partnership and how CGM has changed the way he manages his diabetes, and somehow I managed to sneak in as a member of media.  I missed the scheduled call with OMGNICKJONAS but his team was kind enough to carve out some time one-on-one while Nick was traveling.  (And, for the record, this whole phone call took place with my daughter skipping by my office door, a giant inflatable stegosaurus being kicked around like a soccer ball.  Such media.)

Kerri:  You’ve been part of the diabetes community for ten years now, and have been an advocate for this disease almost since your diagnosis, right? Can you talk a little bit about what made you want to go public with your diabetes, and how that’s influenced how you feel about it?

Nick Jonas:  I went public with my diabetes story six months after my diagnosis. The thing for me was about being as open and transparent as I could be to find support.  I didn’t know any other diabetics.  By sharing my story, I wanted to seek out and encourage people that this can be okay.

Kerri:  So upon diagnosis you weren’t immediately greeted with stories about people’s Great Aunt Ethel who was mostly dead?

Nick Jonas:  (Laughs.)  No.  Soon after diagnosis, I actually befriended a nurse whose son was a diabetic. For my mom and I both it was nice to have someone to talk with who had a better understanding of diabetes. People try not to overwhelm you with all of the information, but this friendship helped.  I was encouraged.

Kerri:  I’ve been wearing a Dexcom CGM system since 2006 and the data is incredible to see. How about you – has CGM technology influenced the way you manage your diabetes?

Nick Jonas:  It’s one of those things that, for me, I feel like I have a best friend looking out for me. Which is the best thing. I manage my diabetes kind of by myself.  I’m kind of personal about it.  I like to have control over it, and I’m independent. With my CGM, I know what’s coming, and that makes thing so much more simple.

Kerri:  Do you know the high and low alarms from the receiver by heart?

Nick Jonas:  I do. (Laughs.) I’ve been totally in range for the last few days, though, so I haven’t heard the alarms in a while. One of the directors on KINGDOM, Michael Morris, is also on the Dexcom and we are always comparing our numbers.

Kerri:  When I travel for work, I make use of the Share application for Dexcom so that my family can keep an eyeball on me. What are your thoughts on being able to SHARE data, and do you SHARE?

Nick Jonas:  It depends on the situation. I don’t like my mom to be stressed about my diabetes so I don’t share with her, but my brother has looked in. We were recently in Las Vegas and when we woke up the next day, he knocked on my door and said that he received an alarm, and that I had been a little bit low.

Kerri:  That’s like the ultimate “big brother” moment.  So for those moments when you do SHARE, are there ground rules for the people who can see your data?  Like “Don’t ever call me when I’m high, but call when I’m low” sort of thing?

Nick Jonas:  Yes, we set those rules.  Don’t stress if it’s a number like 200 mg/dL, but if I’m below 60 mg/dL you can call me.

Kerri:  You’ve mentioned the perspective gained from life with type 1 diabetes. How has that perspective shaped you as an artist?

Nick Jonas:  It comes down to responsibility. At an early age, I had to learn to live with a disease and how it affects how I live my life.  I don’t want the things I’m able to do or not do be dictated by diabetes.  It’s not perfect; days can be unpredictable. But at 22, almost 23 years old, I’m aware of what kind of a person I want to be as a result of diabetes.

There’s always a way to see something in a positive light. You’ll live a miserable life if everything that’s challenging is a disappointment.

Kerri:  I’m glad you brought up the idea of perfection, because whether you want to be or not, you’re in the “role model” position in the diabetes community. How do you feel about having people looking to you for inspiration, diabetes-wise, and how do you stay inspired yourself?

Nick Jonas:  I think it’s a two-way street. In moments when I’ve had tough days and needed a pickup, someone mentions that their child or friend has diabetes and that my story helped them.  Hearing that keeps me doing what I’m doing.

Kerri:  And you feel like you can be honest about the good and bad days with diabetes?

Nick Jonas:  Yes, definitely. In the past, I’ve been hyper-insecure about admitting that I had really tough days because I want to stay positive. But without a doubt, anyone that lives with diabetes has tough days.

Kerri:  I appreciate all of your honesty about diabetes.  But diabetes can’t be the only thing we talk about.  People want to know the life that diabetes is a part of, right?  Like what bands are on your playlists these days?

Nick Jonas:  Right now?  I just made a playlist on Spotify, actually.  I’m listening to a band called Purity Ring, this song by Melanie Martinez called Pity Party, and this song by Haim.

Kerri:  Did you know that one of the girls in Haim has type 1?

Nick Jonas:  Yeah, actually.  My brother met those girls at Coachella and told me that one of them was diabetic.  That was pretty cool.

Kerri:  Did that make you like their band more?

Nick Jonas:  I definitely liked them already, but finding that out didn’t hurt.

Thanks to Nick for candidly talking shop, and to Dexcom for supplying media photos that make me feel slightly uncomfortable for posting, but I’m going to do it in the name of science.  For more information on Dexcom, you can visit their website.  And for my personal Dexcom disclosures, you can read my disclosure page.


Yesterday, my daughter and I went to the beach (with my mom and my aunts and half of the state of Rhode Island) and I wore a bathing suit.  I also wore a CGM sensor on my thigh and an insulin pump infusion set on my arm, connecting to the insulin pump clipped to my bathing suit.

There were a few glances, but nothing too awkward.  (Except the older kid who was sitting on the steps heading up to the bathrooms who, after staring at my diabetes cyborg stuff, nudged his sister in the shoulder and said, “What’s wrong with her?”  To which I replied, “Plenty,” and kept walking because honestly, I had to pee.)  It always surprises me, though, that I’ve never seen another pump or sensor on the beach.  All these people who are supposedly living with type 1 diabetes – where the hell are they?

It reminded me of the lady who was so concerned about the cell phone she thought I was about to ruin at the beach … hey, there happens to be a video discussing that very topic right here!

I’m rarely self-conscious about diabetes, and thankfully I have a small child who doesn’t leave much room or time for me to be stressed out about beach-borging.  But I am reminded regularly throughout the summer that my tan lines are a little different from that of my insulin-producing counterparts.

(Yes, I’m ready for Friends for Life, where borgs are the norm.)



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