This is the third part of a triptych of diabetes posts. The first part references the time just before my diagnosis. The second part covers the most recent year of my post-diagnosis life. Here I cover some recent developments and provide a view of the near future.
What follows is one of the few things I remember from the classical Greek class I took in my senior year at Grinnell: “᾽ͅΟμοι κακαδαιμων. Ἐγενετω τυφλως. Ω Ζεω, χαλαπως ἐστι ὁ βιος.” That pretty much means “Oh the misfortune! I have become blind. Oh Zeus, life is so hard!” As someone who fears going blind, that story in the primer had a bit of an impact. Another thing I clearly remember is the inscription I put at the top of my final exam: “᾽ͅΕγαρ μα πραχοιμι κακος.” (I hope that I don’t do badly.) Athena didn’t help me as much as I’d hoped.
What does this have to do with diabetes, or with continuous glucose monitors (CGM) for that matter? Not much really. I’ve always just loved those sentences, and any time I hear “blind” or “blinded” they instantly spring to mind.
Last week, I wore a “blind” CGM to gather data for my endocrinologist. Yes, for a week — from Thursday to Thursday — I had a small device attached to me recording close approximations of my blood glucose every five minutes. A thin filament was inserted horizontally into my skin — it didn’t hurt, honest! — and the readings were recorded in a little device about the size of two stacked quarters that was attached to the sensor. Everything was held in place by a boat-load of tape. I couldn’t see the data as it was recorded, hence “blind.”
I was told to do what I normally do with two exceptions. #1: Take at least four blood glucose finger-stick readings every day using their special meter. No problem there. I usually test 7-10x day, and I seemed to test extra knowing I had this thing gathering loads of data. #2: Record everything I did on paper. Blood glucose tests. Food. Insulin. Exercise. Infusion set and insulin changes. Everything. I made a photocopy of the log (five pages!) before sending it all back to Medtronic Minimed.
I should have the results back sometime in the next week, but here are my thoughts after a week of wearing a CGM sensor:
- I hope to finally know what’s happening overnight. Do I go low and rebound? Do I steadily climb throughout the night? Do I wake up with high readings because of dawn phenomena that I can counter with extra insulin?
- What really happens when I exercise?
- Does bolusing 10-15 minutes before I eat make any difference for me? I hope to find out.
- Wearing a CGM is totally something that I could do, and I definitely want to know when I’m going up or down too much.
- Wearing the sensor didn’t hurt at all, although I’m not sure I could put one on my own back.
- One strip of tape over the sensor was not enough, and I had to add a full metric tonne more over the week.
- Logging (or journaling or whatever) is a total pain in the ass, but I did start to notice some trends on my own.
- “Observations of daily living” (ODLs) should be as easy to make as a blood sugar test or an insulin bolus. It’s currently a pain in the ass to integrate all of the data that people with diabetes use in our heuristics for self-management, but there’s no need for it to be that way.
- I don’t eat nearly enough fruits and vegetables. I’m glad a dietitian isn’t looking at my logbook.
Hopefully, I’ll be able to glean a lot of useful information out of this week-long endeavor. And if the accuracy is there, I also hope that I can get insurance approval for CGM sensors that will send data to my insulin pump. I’ll keep y’all posted.