Nope. I’m still the captain…
“You still have to check?” My coworker says, glancing at my open meter case. He’s referring to the fact that next to the case is my continuous glucose monitor. I work for a pharmaceutical company that makes diabetes drugs, so its no surprise that folks at the sales meeting I’m working are familiar with the ‘betes gear. But never quite friendly enough.
I look up at my colleague. “Yes. CGM doesn’t eliminate the need for finger stick testing. You still have to back up your readings so you can make an accurate management decision, and you also have to calibrate the CGM by entering finger stick results. It doesn’t replace testing.”
“Oh” he nods, and turns his attention back to the high-science presentation we’re being schooled on. I can’t help but notice the irony of the fact that the cohort in the study we’re discussing happens to be people with Type 1 diabetes using “insulin delivered via subcutaneous delivery. Dude, just say “pump.” Digression. Ahem.
People without diabetes make many assumptions about what it’s like to live with the disease, and often the somewhat-informed-guesses are worse than the flat-out misinformation. By that, I mean the folks that think insulin pumps are a replacement pancreas, no thinking required. Or that a CGM means never having to draw blood again. Even the most recent issue of Oprah Magazine touted “100 Things That Are Actually Getting Better” on the cover, and included “Diabetes Management” as one of the items. The blurb cited that sensors under the skin “improved on the pincushion approach.” True, but they haven’t replaced it.
The bottom line is that although pumps, basal insulins, CGMs, and all the other awesome gadgets have definitely improved diabetes care, nothing has replaced the fact that every management decision requires brainpower and decision making. I decide how much insulin my pump gives me. I decide to what to do with the arrows and numbers on my CGM. So far, there isn’t anything out there that takes the mental aspect out of diabetes management. It’s important for folks without diabetes, especially the “Type 3s” in our lives, to know that diabetes is always a 24/7 job, no matter what hardware we’re rocking.
Technology makes the ship easier to steer, but it can’t plot the course.
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Comments
Claire!! Laughing my sox off over here with your quote about “healthy people removing their pancreas.” HA!! I love that. But its so true isn’t it? People say the craziest stuff – of COURSE it’s annoying to wear a pump 24/7, but I do what I gotta do to STAY ALIVE!! Good insights Claire, thanks so much for your thoughtful comments!
Hi, you’re absolutely right about the brainpower requirement
personally, I don’t have any problem with this particular feature of having diabetes – I would not prefer some high-tech machine doing ALL the diabetes-thinking for me. A closed-loop technology would be awesome, indeed, but there should still be an option for self-decision based management of the device that would be attached to my body. I can’t imagine the programs in the device suddenly going crazy and almost killing me without a chance for me to stop it 
)
The questions like “and isn’t it annoying having the pump attached 24/7″ or “you still have to check your BGs?” are quite funny actually. Imagine healthy people removing their pancreas when they don’t feel like carrying it