LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Wednesday, October 31, 2012

My new office

Today’s CGM Primer: “At the end of the week you sit down with all this information and you break into tears. Because there is too much data, and none of it makes sense, and having diabetes sucks and most likely you’ll resort to either medical marijuana or medical whiskey.”

--Beyond Fingersticks

My new office is on the second floor of a building that was built in 1892. Right outside my door is a stunning view of the atrium, an art deco triangle of open space rising up eight stories to a massive stained glass ceiling bigger than most people’s homes.

My office itself has no view at all. It’s narrow and deep, like a ship’s galley. But it’s comfy. I have three computers to choose from, fast internet, and a delightful rust-colored suede chair that’s a joy to sit in. I have a laser printer, a trash can, and a phone. All I’m missing is a coffee pot.

Still, not bad for a refugee.

A castaway.

A victim of Blue Screen of Death.

Yeah, my aging laptop finally bit the dust. Within an hour, the first pangs of Writer’s Withdrawal were setting in. I knew it would advance to full blown typing tremens in no time at all. I was about to re-draw the day’s plans to include shop-for-the-cheapest-fucking-laptop-you-can-find, although I never use a laptop at home and rarely travel when I have to write, so I’m not sure how much sense it would have made to get a new one. Plus, I hate computer shopping. It stresses me out.

Then it occurred to me that the grand old hotel I’m staying in might have a business center. And sure enough it did. And I always carry a flash drive in my Go-bag, so I had everything I needed to blog away in exile.

So, speaking of computers and the failure of technology, this seems like the perfect day to talk about CGM software. Because, historically, this has been an area of major failure from all the folks who’ve made CGMs since day one.

Needless to say, I got my hopes down about the new software that came out with the new CGM in town. Because, in case you hadn’t heard, the new way to look back on what your G4 has been up to is called Dexcom Studio, which you can download for free from the Dex home page. I’m told it will also download the Seven Plus receivers too, but I’m only going to focus on the G4 today.

Getting your data from your receiver to your computer is a snap. The button-end of the G4 has a USB port hiding under a sliding cap that reminds me of the gun port on a pirate ship. Slide open the gun port and plug a cable into your receiver, then plug the other end into your PC. The software starts downloading data. It’s that fast and that easy.

Wait. Did you say PC? What about Mac users? Well, you Mac users are still screwed, but you should be used to that by now.

And when the download is complete you get:

As one would expect from a software named Studio, the graph has lots of pretty colors. It’s nearly a work of art. But is it useful? In a word: Yes. I think it is. Actually, I knew it was the second I saw the best part. And the best part is the rather clunkily named “Pattern Insights Summary” found on the upper right-hand side of the “patterns” graph.

I would have called it artificial almost-intelligence. And until now, only docs and a handful of sneaky folks like me have had access to anything like this. Look, think about the volume of data a CGM is creating. It’s checking your blood glucose 288 times a day. That’s 2,016 times a week. That’s 8,760 times per month. Over 100,000 times per year….don’t you think computers have come far enough to give us a little more than just pretty pictures? For God’s sake, help us understand all this information! Help us search this haystack for the needle!

Actually, the Other Guys did it first, a while back. There’s a clinical decision support tool built into Med-T’s CareLink Pro, the doctor-version of their pump and CGM software. It’s cool, but it’s of limited use, and it was clearly written by lawyers. At best, it feeds us an ass-covering trail of bread crumbs and vague hints, rather than concrete observations based on the ton of data. Words like consider, assess, and counsel dominate the conversation.

And even this very limited tool isn’t available in the “consumer” version CareLink. Why? Doesn’t Medtronic care? No doubt the suits were worried that somebody would get hurt following the advice of the software. But you know what? I guarantee you that many people are getting hurt by not having any help with all this information. Why do you think we’re building dialysis centers faster than we’re building prisons?

But with Studio, Dexcom has boldly brought some computer power to the masses. Take a look:

Sorry I didn’t have a more exciting week for you to look at. But see what it says: “Most significant pattern of highs found between 11:10 PM and 3:55 AM.”

No consider, no assess, no counsel.
Dexcom has jumped right in and boldly pointed out where the trouble is. Now, I could probably have figured that out myself by staring at the picture long enough, but it’s handy to have someone bluntly tell me where to look.

Of course the new software has other features, and many different ways of looking at the 100,000 data points regurgitated by your receiver. And we’ll talk about it in more detail on another day, but for now know that your new blood sugar GPS comes equipped with a simple compass to help you find your way through the forest of data it generates. A blunt, forthright, straightforward, no bullshit way of telling you where to start when you sit down with your data.

So, as they say, “alls well that ends well.” Kudos to Dex for taking a bold step with the new software for the G4, and kudos to the Brown Palace in downtown Denver for giving me a way to keep up with my writing despite the death of my laptop. I actually like “my” new office, even though I’ll only use it for a day.

But damn, I still wish it had a coffee pot.


Blogger Jonah said...

I have a PC, and Studio still isn't working well for me. It'll get my data, but it says No highs detected No lows detected no matter what I do- and lemme tell you, I've been high and low!
Also they've removed some of the tools I used for looking at the spreadsheet on Daily Stats and so even though I've got Studio, I'm using DM3.

8:33 AM  
Blogger Penny said...

This is revolutionary for so many of D parents. Imagine, a place to look first for patterns. Our kids sometimes have so many rates with puberty, constant movement and daily schedules that aren't routine. If we have ONE thing in a CGM that will help us, it's looking for patterns. And I think that's revolutionary. I can't wait til my daughter's G4 comes!

7:53 PM  

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