Friday 31 March 2017

Enlite Vs Dexcom

Shortly after getting my insulin pump 2 years ago I started using Medtronic's continuous glucose monitor (CGM) Enlite. It didn't take long for me to absolutely love such wonderful technology. For those of you unheard of a CGM, it is a small wearable device inserted in the interstitial fluids giving me a blood sugar reading every 5 minutes. In addition, with the use of arrows, I was able to plan ahead by knowing which direction my blood sugars are heading. In short, I could see the behind the scenes of my blood sugar that my glucometer simply did not offer. About a week ago after using Enlite sensors for 2 years, I decided to make a switch to another brand of CGM's called Dexcom. Having both accessible to me I decided to test them both out by inserting an Enlite sensor on my left arm and the Dexcom sensor on my right arm and compare the pros and cons of each device.


Enlite Sensor
Dexcom Sensor












Accuracy 



When I first started on the enlite sensors two years ago...they weren't accurate a high percentage of the time. However, over the past year, I have been super impressed with how much it has improved. The Dexcom has always been known for its accuracy, so I decided to compare their accuracy and very interestingly they were both extremely accurate and very close.


But, just like all technology they both have their fair share of pros and cons which I believe should be considered when choosing your perfect CGM.

Here is a summary list below of the pros and cons of both sensors:


Enlite Pros:

  • Low Glucose Suspend: 
    • This is a feature that is perfect for people who struggle to fear their lows. This feature suspends your insulin pump once the enlite sensor reads the set blood sugar.
  • Single Device: 
    • The good thing about the enlite sensor is that it is connected to your insulin pump. That means that you do not need to carry another device around with you to view your blood sugars and since the pump is attached to you, you will never forget at home (I hope not anyways lol)
  • Accuracy: 
    • The enlite is fairly accurate after the warmup period
  • Pre-Warning: 
    • If blood sugars are getting close to the high or low set limit, the enlite gives you a high or low predicted. This means you can react ahead of time before reaching your set limit.
  • Warmup phase: 
    • If you decide to reuse the same seƱsor for longer than 6 days and restart sensor as new the warmup phase is only 15-20 mins long rather than the normal 2 hours

Enlite Cons:


  • Sensor Adhesive: 
    • The sensors adhesive is super irritative and becomes itchy and causes rashes 3 days from insertion.
  • Calibration: 
    • With enlite in order to ensure accurate readings you must calibrate your sensor 3-4 times a day when your bg is steady. Another point is if you do not calibrate after 12 hours you stop receiving any BG readings.
  • Ripping: 
    • Depending on where you insert the sensor makes it more or less venerable of getting ripped out. The transmitters design gives it the vulnerability of it getting ripped out.
  • Insertion: 
    • Insertion Device
    • The insertion for it can be painful. However, the worst thing about the process is the insertion device. It is big, scary and makes me cringe every time I had to use it. 
  • Transmitter: 
    • The enlite transmitter can remember BGLs for up to 15 mins when it is has lost connection with the pump and later fill in those 15 mins once it gains connection again.

Dexcom Pros:

  • Sensor Adhesive: 
    • The Dexcom adhesive causes no rashes or itchiness around the area
  • Sensor Age: 
    • The Dexcom can last much longer than the 7 days and still be accurate. Most people seem to get a solid 2 weeks out of them before inserting a new one
  • Bluetooth: 
    • Having the Dexcom link up to your phone makes it an easy and accessible way to stalk you BGLs. In addition, although this feature is currently not available in Canada, having Dexcom link to your apple watch allows you to know you BGLs by a quick glance at your watch.
  • Followers: 
    • This can have its benefits and setbacks but having others be able to have access to your BGLs can be beneficial especially at night time if you don't feel your lows. This is extremely beneficial to children as their parents can have access to their BGLs at all time even while they are at school or a sleepover.
  • BGLs on Phone: 
    • So this isn't really a big thing but I found having the change colours on the screen between yellow for highs, white for in range and red for lows really puts in perspective how blood sugars looked like for the day.
  • Calibration:
    • For Dexcom to be accurate I seem to only need 2 calibrations rather than the 3-4 like enlite. That means fewer finger pricks for me!
                      Dexcom Cons:

                      • Transmitter: 
                        • Compared to the enlite sensor where you just had to charge the transmitter and you're good to go...with Dexcom the transmitter dies out every three months and you have to purchase a new one. 
                        • The transmitter does not keep store of BGLs so when you lose connection you end up with gaps in your graph
                      • Connection with Phone: 
                        • With the G5 you need to purchase the receiver or else your only access to your blood sugars are through your phone and say your phone runs out of battery that means you no longer have access to you BGLs. 
                        • I'm not sure if it's a Dexcom problem or the Dexcom app on the iPhone but having the Dexcom for a bit over a week, the app has crashed maybe 5-6 times. It says you need to delete the app and re-download however if you restart your phone it seems to start work fine again.
                        • In order for anyone following your blood sugars to receive data...you need to have an android or iPhone with you and it must be connected to wifi or data. This point might be a bit of a let down for young kids.
                      • Accuracy:
                        • The first 24 hours of the Dexcom can be a bit inaccurate

                            Saturday 25 March 2017

                            Growing With T1D

                            I guess there is one thing we can all agree on...diabetes is not easy! it takes effort, planning and a whole lot of time to manage it. However, with ever age group diabetes presents you with a set of unique challenges and obstacles. 

                            Here are a few things to keep in mind when growing with type 1 diabetes: 

                            Driving
                            Driving gives you your freedom and gives you a sense of growing up. However, for people with diabetes, it is very important to learn about safe driving while managing your diabetes. Firstly know the rules and regulations for driving in your province or country. In Canada, it is a must to drive with a blood sugar level above 5mmol/l (94mg/dl). Ensure that your car is always stocked up with low supplies in case you have to pull over to treat a low. Depending on the temperature keeping a backup meter in the car can be handy. I'm sure we've all left our meters accidentally at home every now and then. Lastly, make sure to wear or have on you some form of medical identification and emergency contact number.

                            Moving Out/Dorm Life/University
                            Who's not excited to leave high school and move onto university? Whether or not you are moving out or staying at home, here are a few things to keep in mind before starting university. Make sure to set up exam accommodations to suit your needs and diabetes. Whether that is extra time, unlimited breaks or stopping the clock when needing to deal with bgls. Despite some classes being large in university it is still important to inform your professors about your diabetes in case you need assistance at some point during the lecture. Lastly, know what's around you and where to access the medications you need in case you forget spares or run out. Let me give you an example...about a week ago I was about to devour in a delicious bowl of quinoa salad when my pump gave me no delivery. I was stuck at university for another 5 hours and without insulin, I was sure to end up with ketones. Knowing where the pharmacy is located at my university I managed to go buy some syringes and extract the insulin from my pump and give an insulin injection to keep me going for the next 5 hours. Of course, its a great idea to keep spares on you but we all forget to refill our stock of spares so having a backup plan is a good idea.
                            If you are living in dorms, let your roommates know you're a diabetic and how they can help if need be. Make sure to stock up on low supplies and food to have on hand for when the cafe closes. Lastly set up a meal plan and ask if they have nutrition information such as the carb count for the foods they offer.

                            Transitioning
                            Depending on where you live this might or might not apply to you. At age 18 your pediatric diabetes team prepares you to transition to adult care. This can be a different experience for everyone however, a few things that you should keep in mind. Unlike at children's hospital, you are required to have your blood work done prior to your diabetes appointment. This can be done either at a blood work lab or at the hospital. Your endocrinologist is separated from your dietician and nurse. This means you will need to book two appointments...one every 3 months to meet your dietician and nurse and another appointment every 6-8 months to meet your endocrinologist. Another point to keep in mind is that it is very important to have a supportive and good communication between you and you diabetes team! That means you have the right to switch between endos/nurses/dieticians till you find the right ones for you. Lastly, because you're an adult and have to transition to adult care now doesn't mean you have to attend your appointments alone. Remember that you can always take a friend or family member with you to your appointments. 

                            Alcohol
                            Once again this might apply to some and just like driving, if you decide to have alcohol it is important that you are knowledgeable of the effects it might have on your blood sugar. It is very important to be aware that with alcohol in your system your liver is busy processing the alcohol that glucagon will not take effect if required due to a severe low. Make sure to have low treatment and medical identification when out at parties or with friends. Alcohol can cause unexpected changes in your blood sugar so ensure to check before heading to bed and possibly setting alarms to check through the night. After all...better safe than sorry!

                            Support
                            Just because you're older doesn't mean you've suddenly managed to get your diabetes under control. We all go through rough times with our diabetes at different stages of our lives AND THAT'S OKAY! It happens to us all...in fact, my first real burnout was early November. What is important when going through a rough time is knowing where to turn for help and assistance. Reaching out to other diabetics through social media is a very nice tool that can help out as they are the people who truly understand you since they have most likely been through it. Other resources are your diabetes team...remember they are always there to help out anytime you need them. At most diabetes clinics there is a social worker or a psychologist that you can book an appointment to see. Lastly, if you are in university visit student services and ask to connect with a social worker or psychologist...those services are there for you, so take advantage of them.  

                            Travelling
                            The last topic I wanted to mention is traveling. As you become more independent you will start to venture out on your own. When traveling it is very important to be organized. As you prepare for your trip search up pharmacies and supermarkets near your hotel in case you need to fill up on food or medical supplies. If you require a travel pump (spare pump) make sure to order that 2 weeks prior to you travel date. Carry all supplies with you in your carry-on bag in case you lose your luggage. Oh and don't forget to double up on supplies...more is better than less. Don't forget to change your medical devices ... pumps, sensors, and meters to your destination's time zone once you've landed. Lastly, carry or wear any form of medical identification.

                            Join our conversation on social media using the hashtag #growingwithT1D to share or learn about the journey of growing with T1D