The CGM: so much to love

“There’s so much to love in this undoing.”
-from “Late September” by Barbara Crooker

Fall leaves

Change is funny. For me, it’s mostly hard. The first Reiki master I ever visited told me that change- too much change- seems to disrupt my energy flow. I guess that’s because when I think of change, sad things come to my mind first. Saying goodbye. Relationships ending. Moving away. People dying.

The idea of change is so pervasive this time of year: the days grow shorter; sticky, hot air is replaced with air that is cool and crisp, the leaves turn from green and lush to brown and rustling.  These changes are not bad; in fact, they are beautiful, instinctive, rhythmic.

This is one of the unique abilities of the Fall season: the highlighting of that which is beautiful though perhaps tufted with difficulty and loss.

This beautiful Fall day in Cincinnati has me thinking about change and the way that Kevin’s CGM (Continuous Glucose Monitor) has changed- no, transformed- the way he manages his T1D.  He wears a Dexcom G5.  It is one of my favorite things.

As you probably know, insurance companies typically cover the use of four test strips per day if a patient is using insulin. People with diabetes typically use this allotment of strips to test before meals and before bed. This regimen is both inadequate (blood sugar changes constantly and is affected by numerous factors beyond what we eat, like how physically active we are or our stress levels) and cumbersome (pricking fingers is no walk in the park nor is schlepping around a glucometer, test strips, a lancet device and needles when you are away from home). Further, a person who is prone to low blood sugar probably has to test more frequently in the context of a hypoglycemic episode to ensure their corrective action has been effective in stabilizing their blood

Enter the CGM. It’s a small device- slightly larger than a quarter- that is affixed to the body (Kevin wears his on his stomach) with a thin, flexible needle that inserts into the skin. The CGM has 3 parts: a sensor, a transmitter and a receiver that work together to provide insight into blood glucose levels, direction, and speed. This amazing little pod checks blood sugar every five minutes, providing constant information that helps a person make timely, informed treatment decisions. To put it simply, the CGM blows 4 checks a day out of the water.  You know what else it has blown out of the water? Me nagging Kevin to bring his glucometer with him when we go out. Checking blood sugar before every meal or snack. A check after meals to make sure he didn’t underestimate an insulin to carb ratio. Me nagging Kevin to check his blood sugar if I think he’s low. Super scary nocturnal hypoglycemia. Me nagging Kevin to check his blood sugar before we go for a walk. Kevin resenting me because I’m worrisome and annoying. Me resenting Kevin for not checking when I think he should.

This change, like so many changes, came with a bit of difficulty. Kevin had to adjust to wearing a device all the time (this has been his opposition to getting a pump- not wanting something on him all the time). I had to learn to not call him at every low blood sugar notification I received on my Dexcom “follow” app. He had to learn how to handle and respond appropriately to the constant flow of information.

But the benefits. Oh, the benefits. No more scary lows. A glance at his Apple Watch (which syncs with the CGM) before dinner instead of running upstairs to use his glucometer. Our 3-year-old knowing when Daddy needs a juice box because she can see an alert on his watch or hear a ping from his phone. Yes, you are reading that right- our 3-year-old knows how to treat hypoglycemia! All thanks to this brilliant, transformational device. How amazing is that?

There is so much to love in the undoing of stale practices. There is so much to love in embracing health technology. There is so much to love in learning and growing and changing, at any time.

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