Diabetes technology teardown, 2019 edition

The tools and services I use to manage my blood sugar

Please do not interpret this post as medical advice. Everyone is different, and the tools I use might not work, or may even be dangerous, for you. Consult your healthcare provider before making any changes to the way you manage your diabetes.

Last year, I wrote a post detailing the different tech, gadgets, and apps I use to manage my diabetes. Given how fast the world of diabetes is changing, I thought I’d update this post every year to go through any changes I’ve made. I use all the products and services below almost every day and I’m not paid to write about them. Well, maybe except for Steady which I founded 🙂

I’ll cover a few updates in this 2019 post: The InPenDexcom G6 CGMHealthKit, and Steady.

InPen — a connected insulin pen and app

The InPen connected insulin pen

First up is the InPen from Companion Medical that I now use for my fast-acting insulin Humalog. I switched to InPen mainly because it’s connected to my phone and reports my doses to its own app and into HealthKit. It’s useful for several reasons like when I’m not sure if I actually took the dose or not, or, trying to remember how large the dose was or when I took it. Even fast-acting insulin is actually not that fast and needs about 1 hour to reach its peak effect. Sometimes it can be really helpful to remember how long it’s been since your last dose to help make a decision about taking extra insulin to prevent taking too much.

The InPen app is pretty straight forward but includes a few nifty features like a bolus calculator (which I don’t use due to not counting carbs), how much insulin I have on board and my total dose per day.

Finally, I’m also happy to be back to using cartridges instead of single-use pens as it reduces the plastic waste quite a bit.

Dexcom G6

The G6 from Dexcom

At the beginning of the year, I switched from using Libre + MiaoMiao + Spike to using Dexcom’s new G6 system as my CGM. There were a few reasons I made the switch. First of all, its fully integrated which means the sensor talks directly to my phone, no need for an extra device that does that part. Also, I had been having a bunch of issues with Spike where it drained my battery, became unresponsive, etc. The G6 is also calibration free so no need to poke your finger to ensure its accurate which is one less thing to worry about every week.

These improvements are great but the biggest difference took me a few weeks to realize. All of the numbers and information that Spike was giving me was actually causing a fair amount of stress for me. I constantly checked my phone and since it was much more sensitive, I found myself overcorrecting more which led to lows. With the G6 I have far fewer lows on a weekly basis.

With the G6 I have far fewer lows on a weekly basis.

Now, the G6 is not better on all dimensions. The alarm system can be super annoying, especially at night, and it can be frustrating to not being able to see delta numbers sometimes but all in all, it’s worth it for me. I know Spike also supports the G6 but for now, I’m going to stay with the official app.

HealthKit

This is not new per se but I’ve been using HealthKit much more recently. My favorite feature is that you can quickly see how much insulin you’re using per day and compare it with previous weeks. Why is that helpful? Well, it allows me to understand how my insulin sensitivity is affected. Or, like in the case below, discovering when the insulin in my pen has gone bad. Switching out the reservoir helped me come down from 18U per day to 11.

The difference in dosing between stale and fresh insulin

Storing all data in HealthKit is great because it functions as an interoperability layer between different apps and services. For example, the InPen automatically writes all doses to HealthKit which allows me to review data without any manual input. And, Steady then reads the data, importing it to their system, and lets my doctor see all my doses. Mind=blown!

Steady

Last, but not least, I’ve switched to a new endocrinologist, Steady Health. Not surprising as I also founded the company but it does feel really good to be able to say that I’m now, together with a great team of course, responsible for my own care.

First of all, I look forward to every visit.

So what is it like being a member? First of all, I look forward to every visit. No more general advice like “eat healthier” or “exercise more” but instead we look at real data from my life trying to understand what can be improved. And the team has access to not only my CGM but also food, exercise, and insulin doses which enables them to give me actionable advice that’s personal.

But the thing that is most valuable to me that I now have someone that understands the disease as well as my relationship to it, someone that holds me accountable. I was recently in a tracking session and had been struggling with some overnight lows when my doctor sent me this message:

Continuous coaching by the Steady team

I can’t tell you how much better that message made me feel and how much less anxiety and worry I experience knowing that someone is actually looking at my data with the intention of helping me improve.

I’ll cover Steady more in the coming weeks and months but if you live in California and want to check it out, you read more about us on https://steady.health.

Hope you enjoyed this 2019 diabetes technology update, if you have any questions don’t hesitate to reach out!

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