Dexcom musings - a month in
With this sensor still going strong, soon entering it's 14th day, by now I've had my little device for about a month. I've learned a lot about it, about myself, and about our interaction. Here are some thoughts:
1) it almost sounds strange, but I want more granularity. Right now I get a reading every 5 minutes; while that's eons better than anything I've ever had, between missed readings and the display limits (see below for further discussion on this), I am occasionally desperate for more granularity. Every 2 minutes or even a minute would be great. I'm not sure if this is possible with the current Dexcom technology - it may run through the transmitter too fast - but if they move to passive transmitters (a notion I've presented in a post a little while ago), this should be easily attainable.
I think the Navigator does every minute, and that will be a big - huge - competitive advantage.
2) to further elucidate on this issue, the Dexcom has allowed me to "prove my brittleness" to a degree I never anticipated. My 100 mg/dl drop in 15 minutes was scary, but it was great seeing it on the Dex.
Thing is, I didn't actually see it develop, because the drop was too fast for the Dex (which can only display a rate of change of 15 mg/dl per 5 minutes), and it has no directional indicators. I saw the start and end points, and confirmed with my meter. Thing is, these kinds of events are exactly when I want my Dex to function best. And it isn't. That sucks. With more granularity in the tests, I am almost certain I'd have seen a few "in betweens". But other indicators could be valuable, too.
3) for example, if the Dex could at least display a directional indicator when blood sugars are moving too rapidly for a reliable result, that would at least tell me what's going on to a great degree. In the situation above, I would have loved to have had some indication that the Dex is thinking I'm dropping real fast even if I don't have a number attached.
While I (think I) understand the reasoning behind not wanting to display rapidly changing readings (due to differences in measurements between meter and Dex, suspicion of malfunction etc potentially leading to mistreatment), I think I'm smart enough to act appropriately even with potentially suspicious data. Maybe some sort of advanced mode where I get the numbers and trend anyway, together with a "use at your own risk" indicator?
Give me data. I can work with it. Don't hide it from me. Don't use the least common denominator. Shoot, I'm an early adopter, I sure as heck do not need babying. It's not like I could have found out about this if I wasn't intelligent enough to seek it out in the first place, you know what I mean?
This also holds true for the way Dexcom is choosing to hide raw data values. I'm already 95% of the way to getting them anyway - I know what needs to be done and how to do it, I just don't have the skills to code for it - but dang it, why should I go through all that trouble? if you don't want to make it "generally available" then just put a little software tool in the software directory, don't announce it to anyone, but put it there. Trust me, I'll find it. Or just make it available by request.
4) I wish my Dex had the ability to show the last "reliable" measurement somehow, instead of the "???". So you can't display a number - fine. But give me a way to know what the last data point was. Otherwise, you are pretty much forcing me to look at the screen every 5 minutes. That's OK in the first couple of weeks when I do it anyway, but otherwise it's just annoying.
In fact, I wish the "???" would provide indication of why it is there. Is it processing? complaining about signal unreliability? indicating too rapid of a change in blood sugars? again, don't hide data from me, please.
5) speaking of "???", I'd like some indication - like a less obvious vibration - of a series of missed readings. For example, if the "???" appears 5 times in a row, let me know. NOW. I hate peeking at the Dex in the middle of a meeting and suddenly seeing a blank 1-hour graph. It makes me anxious. And what I can't do is start fiddling with it, because the buttons click way too loudly and it draws a lot of attention. Speaking of which, can't the buttons be designed to be less "hard" and noisy?
6) I'd like a "quick reset" mode for when I am simply trying to reset with an existing sensor. The 2-hour gap really isn't needed for this instance, as the sensor is well saturated. This feature will be particularly useful at the 7-day session threshold.
Yes, I understand the 7-day limit comes from the FDA's approval. But I doubt having a "quick reset" mode will violate it, especially considering that a reset is sometimes needed for other reasons, and Dexcom support admits that in those cases it would be helpful to have it happen sooner. In other words, it's a useful troubleshooting technique.
7) That 2-hour gap is a psychological killer. Yeah, I know I'm being ridiculous here, but I become irritable when it takes place on a new sensor placement. And it's more than 2 hours, you know; it's the 10 minutes it takes to replace them, the 2-hour calibration, then the 15-20 minutes until I get the first number. That's, like, 2 1/2 hours. And it feels like 2 1/2 weeks.
8) The transmitter/sensor array in itself has interesting psychological implications. I find that I keep touching it ever so often. I am always aware of its presence. I do a lot less roughhousing with my kids now, because I'm afraid it will get ripped out. I just can't seem to "forget" about it. I wish I could.
9) when all is said and done, I am absolutely addicted to this technology and device. With all its shortcomings, it has become a central, leading elements in my diabetes management. And it has done some amazing things for me; I am controlling my blood sugars way better now (as evidenced by my long terms graphs, especially peaks and valleys), and as a result I feel better. I am not afraid of spending long hours in "good" territory now (my "fear of 100"), and weather changes can be handled a lot more effectively. I haven't seen a single 300 since I've started using this - I used to see them 2-3 times a week before.
The list goes on. If you are thinking of getting a CGMS, stop thinking. Get one.
Happy new year.
1) it almost sounds strange, but I want more granularity. Right now I get a reading every 5 minutes; while that's eons better than anything I've ever had, between missed readings and the display limits (see below for further discussion on this), I am occasionally desperate for more granularity. Every 2 minutes or even a minute would be great. I'm not sure if this is possible with the current Dexcom technology - it may run through the transmitter too fast - but if they move to passive transmitters (a notion I've presented in a post a little while ago), this should be easily attainable.
I think the Navigator does every minute, and that will be a big - huge - competitive advantage.
2) to further elucidate on this issue, the Dexcom has allowed me to "prove my brittleness" to a degree I never anticipated. My 100 mg/dl drop in 15 minutes was scary, but it was great seeing it on the Dex.
Thing is, I didn't actually see it develop, because the drop was too fast for the Dex (which can only display a rate of change of 15 mg/dl per 5 minutes), and it has no directional indicators. I saw the start and end points, and confirmed with my meter. Thing is, these kinds of events are exactly when I want my Dex to function best. And it isn't. That sucks. With more granularity in the tests, I am almost certain I'd have seen a few "in betweens". But other indicators could be valuable, too.
3) for example, if the Dex could at least display a directional indicator when blood sugars are moving too rapidly for a reliable result, that would at least tell me what's going on to a great degree. In the situation above, I would have loved to have had some indication that the Dex is thinking I'm dropping real fast even if I don't have a number attached.
While I (think I) understand the reasoning behind not wanting to display rapidly changing readings (due to differences in measurements between meter and Dex, suspicion of malfunction etc potentially leading to mistreatment), I think I'm smart enough to act appropriately even with potentially suspicious data. Maybe some sort of advanced mode where I get the numbers and trend anyway, together with a "use at your own risk" indicator?
Give me data. I can work with it. Don't hide it from me. Don't use the least common denominator. Shoot, I'm an early adopter, I sure as heck do not need babying. It's not like I could have found out about this if I wasn't intelligent enough to seek it out in the first place, you know what I mean?
This also holds true for the way Dexcom is choosing to hide raw data values. I'm already 95% of the way to getting them anyway - I know what needs to be done and how to do it, I just don't have the skills to code for it - but dang it, why should I go through all that trouble? if you don't want to make it "generally available" then just put a little software tool in the software directory, don't announce it to anyone, but put it there. Trust me, I'll find it. Or just make it available by request.
4) I wish my Dex had the ability to show the last "reliable" measurement somehow, instead of the "???". So you can't display a number - fine. But give me a way to know what the last data point was. Otherwise, you are pretty much forcing me to look at the screen every 5 minutes. That's OK in the first couple of weeks when I do it anyway, but otherwise it's just annoying.
In fact, I wish the "???" would provide indication of why it is there. Is it processing? complaining about signal unreliability? indicating too rapid of a change in blood sugars? again, don't hide data from me, please.
5) speaking of "???", I'd like some indication - like a less obvious vibration - of a series of missed readings. For example, if the "???" appears 5 times in a row, let me know. NOW. I hate peeking at the Dex in the middle of a meeting and suddenly seeing a blank 1-hour graph. It makes me anxious. And what I can't do is start fiddling with it, because the buttons click way too loudly and it draws a lot of attention. Speaking of which, can't the buttons be designed to be less "hard" and noisy?
6) I'd like a "quick reset" mode for when I am simply trying to reset with an existing sensor. The 2-hour gap really isn't needed for this instance, as the sensor is well saturated. This feature will be particularly useful at the 7-day session threshold.
Yes, I understand the 7-day limit comes from the FDA's approval. But I doubt having a "quick reset" mode will violate it, especially considering that a reset is sometimes needed for other reasons, and Dexcom support admits that in those cases it would be helpful to have it happen sooner. In other words, it's a useful troubleshooting technique.
7) That 2-hour gap is a psychological killer. Yeah, I know I'm being ridiculous here, but I become irritable when it takes place on a new sensor placement. And it's more than 2 hours, you know; it's the 10 minutes it takes to replace them, the 2-hour calibration, then the 15-20 minutes until I get the first number. That's, like, 2 1/2 hours. And it feels like 2 1/2 weeks.
8) The transmitter/sensor array in itself has interesting psychological implications. I find that I keep touching it ever so often. I am always aware of its presence. I do a lot less roughhousing with my kids now, because I'm afraid it will get ripped out. I just can't seem to "forget" about it. I wish I could.
9) when all is said and done, I am absolutely addicted to this technology and device. With all its shortcomings, it has become a central, leading elements in my diabetes management. And it has done some amazing things for me; I am controlling my blood sugars way better now (as evidenced by my long terms graphs, especially peaks and valleys), and as a result I feel better. I am not afraid of spending long hours in "good" territory now (my "fear of 100"), and weather changes can be handled a lot more effectively. I haven't seen a single 300 since I've started using this - I used to see them 2-3 times a week before.
The list goes on. If you are thinking of getting a CGMS, stop thinking. Get one.
Happy new year.
posted by Blinkered at 8:49 AM
1 Comments:
This is an interesting set of comments/suggestions. You may want to send them to Dexcom directly - it's not clear to me that anyone there actually reads the blogs.
I just replaced my sensor last night after 17 days. In the last 24 hours it was too unreliable. When I replace them, I do this in the evening and restart the system the following morning. This is a lot longer than 2 hours, but it gives me much better results. I believe the Navigator has a 10 hour startup. So 2-3 hours startup doesn't seem too bad to me, especially if you only have to do that every 2 weeks or so.
Anyway, I wish you the best for the new year. Thanks for all the thoughts about the Dexcom. I'm sure this has been helpful to many people.
Post a Comment
<< Home