Why people with diabetes are still pricking their fingers
Updated: Jun 22, 2021
This year's Super Bowl was a while ago, but ever since I have been thinking about the Nick Jonas Dexcom ad that played, and have continued to see play on TV. The line that sticks in my brain is, "And people with Diabetes are still pricking their fingers?!" when referencing many of the technology advances we’ve made to date. This statement makes it seem as if a Dexcom is not only easy to access, but also a foolproof solution. I am lucky to be able to have access to a Dexcom Continuous Glucose Monitor (CGM) which is an issue for MANY, but in this post I'm going to unpack the technology “foolproof solution” piece a bit and why access to a CGM doesn't mean that your glucose monitor can go in the trash. If you're interested in reading a bit more on why access to CGMs is so critically important, I’ll touch on it a bit here, but you can also take a read through this past post which dives into that topic a bit more.
I had quite the day with my Dexcom CGM over the weekend while attending a wedding as a bridesmaid, and that’s the inspiration for this post. Before I get into the CGM saga that happened on the actual wedding day, I'll start at the beginning of our road trip to New Jersey. The ability to wear my CGM allows me to feel more confident driving long distances knowing that I can remain in touch with what my blood sugar is and where it's trending. We stopped in Connecticut on the way as we often do if we're driving to NY, NJ, or PA and after eating a quick brunch, I had a breakfast sandwich and tater tots, we got ice cream from one of my favorite spots Milkcraft (photographed here) before hitting the road again.
It may sound like a carb heavy meal, and it was! We had three hours left in our drive and I wanted to make sure I was properly fueled. I actually was worried that I took too much insulin because I didn't have as much of my ice cream as I had planned. To my surprise, the opposite was true and my blood sugar started to rise steadily during the drive. Because Jake could see my blood sugar on his phone (through the Dexcom Follow app) and I could see it on my Apple Watch, I knew to take some correction doses once we got into traffic and I could "safely" inject while driving, and I was able to reduce my blood sugar before we were off to the rehearsal dinner.
Going into the weekend, I knew I was due to change my CGM sensor on Saturday. Instead of just bringing one sensor with me, I brought three to be safe even though they were my last three remaining as I was awaiting a new three month shipment. I also brought an extra transmitter with me as I knew mine only had one 10 day session left, and wanted the security of knowing I had a backup. For context in case you are unfamiliar, a three month prescription of Dexcom includes nine sensors and one transmitter. Before meeting my deductible, nine sensors can cost about $700 and one transmitter costs about the same, bringing the total quarterly bill to $1400. I often joke that packing for a trip, no matter how short, for someone with type one requires a complete doomsday attitude. What are the wild things that could go wrong? Could I lose one of my insulin pens? Could I get stuck somewhere for longer than planned? Could I have more than one CGM fail on me?
I woke up Saturday morning knowing that the bridesmaids and bride would start getting ready at 10:30am so I changed my sensor at 8am to allow the two hour warm up time to run its course before leaving our hotel room. I put the sensor on, and it bled immediately. I knew this either meant it would be accurate, or the opposite. And not to mention, it also hurt a lot. I let it do the two hour warm up, and it seemed to be working come 10am so I left it on. I had coffee and half of a Perfect Bar as I do most mornings, and went on my way to get ready with the bridal party.
My blood sugar seemed steady, and at about 11am I ate half of a bagel. About 20 minutes later, my Dexcom showed a steady decline. This is when I knew something was off, because as much as I'd love to think it was possible to have a low number after eating half of a bagel, I knew it was unlikely and I didn't feel any low symptoms. I ran back to our hotel room which was luckily close by, and confirmed with a finger prick that my blood sugar was not in fact 70 and dropping, it was 238. 238 wasn't a number I was unhappy with between having a carb heavy morning and the excitement of the day which I often find impacts my blood sugar, but if I had trusted my CGM and treated what I thought was a low without double checking - that is when I could have risked going to a dangerously high number.
It was about noon at this point, so I removed the seemingly faulty sensor not wanting to risk a false low alert sounding in the middle of what was sure to be a beautiful ceremony, and switched my sensor knowing that the two hour warm up period would be done before we walked over to the wedding venue. I got my hair done, chatted with the bridesmaids, the bride's mom and groom's mom, and corrected my blood sugar with a modest dose of insulin to ensure it would be steady for the rest of the afternoon through the ceremony.
A little after 2pm, I did a finger prick again to check that my new sensor was working and confirmed it was very accurate. I had a sigh of relief, decided to keep my blood tester in my tiny purse for the wedding just in case and went over with everyone to the venue. At this point, we took photos in our getting ready attire, and then were asked to change into our bridesmaid dresses. We all changed, and at that point realized our dresses had some wrinkles. Many of us got undressed again, and took our turns using the steamer. At this point, we were running up against the clock, and it was time to have our "first look" with the bride in her dress! Another girl stood in front of me to provide cover while I put my dress back on in a hurry. I pulled my dress up...and felt my Dexcom sensor peel right off of my leg. For a few seconds I stared down in disbelief unsure of what to even do at this point, feeling extremely defeated and anxious. I peeled off the remainder of my perfectly functioning Dexcom and took my transmitter to stash in my purse.
I was honestly at a loss. I finally got my sensor to function and it just ripped right off. And not to mention, I only had one sensor left and was about to head into photos, a wedding ceremony that I was VERY excited to attend, and then about six hours of celebration where I didn't want to be without my Dexcom. I also couldn't believe that part of my doomsday scenario had come true and that I had already blown through two sensors. I also was honestly mortified because I tried my best throughout the day and weekend to ensure all attention was on the bride in any way possible. I wanted my Diabetes to take a back seat so that I could fully focus on the celebration at hand. This was just a glaring reminder that sometimes that wasn't possible, and a reminder of just how unpredictable my type one, and the devices that help to manage it, can often be.
I ran to the bathroom, called Jake, and asked him to bring my last, bulky sensor with him in his tuxedo pocket so that I could replace my sensor during the cocktail hour. I didn't want anyone to know what had happened, but naturally a couple of people heard me on the phone and very kindly checked in to see "Was my blood sugar okay?" "Do you need any food?" "My brother is diabetic, so let me know if you need anything". All very kind, but I honestly was not in the mood to explain what was going on, and that nothing was "wrong" with my blood sugar. It was just a wildly frustrating technology/device malfunction and that I had just had it. I brushed it all off, told everyone I was all set, and let's just focus on the important thing right now - the bride!
I ate a small wrap to at least ensure my blood sugar wouldn't go low during the ceremony, knowing that my last reading was well in range so I wasn't worried about it being too high, and then did my best to move on my with my afternoon knowing that I would have one last shot to replace my sensor at about 7pm. I was anxious about what would happen if the last sensor had any issue, not only was I planning to drive part of the way home the next day, but I also knew I would be drinking and didn't want to have an overnight away from home without a functioning CGM.
We took photos with the bride and groom (who looked perfect and just SO happy), the ceremony was incredible, and then we all made it to the cocktail hour. I found Jake who had my last sensor, and with some anxiety about another malfunction, inserted the sensor right in the middle of the cocktail hour. It felt good being inserted and so I hoped for the best, accurate readings and a secure placement!
Because my transmitter had been disconnected from bluetooth for a while, I worried at first because it didn't seem to be connecting properly. Thankfully everything connected, and my sensor completed its two hour warm up and was functioning by the time dinner was served. We had such a fun rest of the night, my blood sugar stayed fairly steady and finally I was able to let it take a bit of a back seat.
The next morning I did wake up at about 7am to a low blood sugar alert, ate some cookies that we had from the night before, and went back to sleep until it was time for brunch!
Why am I sharing this? Other than the fact that it was an annoyance on a day where I wanted to focus solely on celebrating something and someone else, it reminded me of why hearing a phrase along the lines of "It's 2021, we have self driving cars, and diabetics are still pricking their fingers?!" is so infuriating. Aside from the issue of access to CGMs and the cost associated with them, it is not fair to assume that if you're able to get over those large hurdles that it will be smooth sailing from there. Diabetes (of all types) is a complicated chronic illness that often has a mind of its own, and the technology built to help often can too.
A reminder to be patient with your own frustration, and know that though things may be advertised as quick and simple solutions, the real story isn't often so simple.