Before I explain my perspective on the CGM in the Cloud movement, the technology I’m utilizing to make this part of my diabetes management, and the resources I used to complete my implementation of said technology, I figured now would be a good time to put in a bit of a primer on Dexcom, the benefits I’ve found in wearing a continuous glucose monitor, and if you’re up for it, why this cloud business might be worth your time, energy, and money. If you want to skip to the CGM in the Cloud bit and ignore the tl;dr bits, this link will skip you a few paragraphs down. I’ll try to keep the run on sentences to a minimum.
I started wearing Dexcom’s Continuous Glucose Monitor (CGM) in March, 2010. At the time I didn’t fully recognize what wearing a medical device would do to my psyche, or what having access to all this data would do to my sanity, or my diabetes management. But I can safely say, four years later, that after meeting Dayle and starting this blog (in order of importance), wearing a CGM is the best thing I did to improve my diabetes management. Rather than blood glucose data every few hours when I poked my finger with a lancet, the CGM “connected the dots” between blood glucose checks, opening my eyes and my mind to the reality of my diabetes. Instead of two results at 120 mg/dL 7 hours apart, now I can see the wild swings above 250 and below 55 to put my daily diabetes management in better, and proper context.
Whenever people ask about Dexcom, I immediately assert that this device should be a standard of diabetes care and I couldn’t imagine my life without it. Yes, I may occasionally take an extended (read: 24-36 hour) break from wearing the transmitter on my arm, but the benefits of wearing this thing far outweigh any less-than-fun moments that include, but are not limited to: overnight buzzing, overnight beeps, that time it got lost in our couch and couldn’t find it because of course my blood glucose levels were fine and there was no reason for it to raise an alarm. If you’ve been on the outside looking in on the CGM revolution, I highly encourage you to talk to your medical professional of choice about this technology. See if it’s something that might work for you, if it’s something worth investing in. It’s done wonders for me. And in my completely non-medical opinion, it will do wonders for you, too.
It’s worth noting that everything I’m going to share can be traced back to my time spent browsing nightscout.info. It’s ground zero for all this stuff. Now, about the cloud…
Simply put, the CGM in the Cloud movement is a community-organized, open-source solution to monitoring blood glucose remotely. Some really smart people figured out how to take the data from the Dexcom’s receiver, put it into “the cloud” (or if you want to get technical, a cloud-based database), and then pull that data back out and view it on any device with a web browser, or even a Pebble watch. Others have taken this concept to another level and developed a Do-It-Yourself-Pancreas-System (#DIYPS), complete with predictions and treatment recommendations (that, obviously aren’t approved by the FDA, but they’re pretty smart/safe about it). If after all of this you want to learn more about #DIYPS, start with this podcast.
I’ve previously shared my thoughts on CGM in the Cloud, how I was impressed by the technology but couldn’t find a reasonable application for my life (and life with diabetes) to justify the investment. Now, I have one.
Tomorrow I (finally) start pumping insulin. Between the time waiting for my endocrinologist appointment, waiting for my insulin pump and supplies to arrive, and time spent navigating the poorly-communicated education process, and these two weeks pumping saline: I think I’ve proved myself ready (and worthy). But, Dayle leaves for a work conference for 10 days on Wednesday – which means I’ll embarking on a brand new insulin delivery system and and adjusting to a new normal for my diabetes care without my most trusted and reliable diabetes resource: my fiancée. For a few days I considered waiting to start on insulin until she got back. As prepared as I am for this, there’s still an amount of unexpected that I don’t think I can ever fully prepare for. I then realized that this situation is the perfect justification for taking my CGM to the Cloud.
With Dayle gone for 10 days, the best way to maintain our collective peace of mind is for her to know how I’m doing, diabetically speaking, and reduce the fear of being away during this transition. Having my CGM data accessible to her, on demand, is the best way to keep her informed, me safe, and both of us content with the situation. Which brings me here.
The CGM bit, you already recognize, but here’s a list of the other items I purchased, each linked to Amazon for your convenience.
- The Pebble Watch I’m using was offered at a discount from Dayle’s sister’s boyfriend. But they are pretty common among technology purchase avenues.
- Because this pebble didn’t come with a wrist band, I spent some time browsing the extensive selection online and settled on this guy….and this one, too.
- The specific connection between the Dexcom receiver and an uploader is mostly up to personal preference, but you will need a Micro USB OTG connector, like this one, and a USB to Micro USB cable. I purchased this one because I’m not planning on using the Shapeways case that is quite popular among CGM to the Cloud-ers, so minimizing space isn’t a concern for me.
- Finally, the uploader. Starting with all available options, this PDF details which phones will work with the Nightscout system. From there it was a matter of talking with people whose opinions I’d trusted, determining what was available at a reasonable price, and what was popular among the Facebook group in case I needed help troubleshooting. I decided on the ever-popular Moto G. Specifically, I purchased two (2) of the Boost Mobile Pay-as-you-go variants. One of the phones is only configured for wifi, to be used at home – mostly for overnights. The other is registered with Ting for proper mobile data usage. What’s Ting, you ask?
- Ting is the provider du-jour among the Nightscout community. Using Sprint’s network, they offer the cheapest pay-as-you-go rates for data. From what I’ve seen, I’ll spend between $9-12 a month on through their service. What’s great is the people at Ting have recognized their popularity within the Nightscout community, are surprisingly quite active and responsive within the CGM in the Cloud Facebook group, and even have a custom page set up on their website just for us, detailing how you set up a newly acquired phone (uploader) with their network. Further, that page also links out to a step-by-step tutorial on registering a Moto G on Ting, as there are a few extra steps required with that phone.
The most important link I can give you through all of this is, however, nightscout.info. Everything you need on your way to liberating your Dexcom data is carefully detailed for anyone, regardless of tech savy-ness, to follow. If you have questions along the way, there are forums within the Nightscout site, and the CGM in the Cloud Facebook group is over 7,500 members as of this post.
Nightscout represents the best of what the diabetes community can offer. With this and things like the Spare a Rose campaign, it’s a blessing to be part of such a vibrant and enthusiastic community. If you have any questions, feel free to leave a comment or get in touch with me directly. I’m quite excited by all of this, as you can tell.