In case you haven’t heard, Dexcom recently came out with the Dexcom Share System. The Dexcom Share system essentially allows a person using a Dexcom CGM to connect their receiver to their iPhone via bluetooth and a special Share app and send their Dexcom readings into the cloud, where they can be accessed by up to five “followers” the Dexcom user has invited to view their data, also via a special Follow app. It’s a pretty basic system compared to Nightscout, but it is also very easy and simple to set up and go. The downsides for many people at this point is that it requires at least 2 idevices – 1 for the sharer, and 1 for each follower (each follower would need their own idevice). There is not currently a supported watch that can display the numbers although it is rumored that the apple watch will have an app available when it is released in April. Assuming you want to or can afford to purchase an apple watch. At $350+ price tag this mom will not be getting an apple watch, and neither will her 11 yr old. The apps also are not currently Android compatible, and many people with Android phones are stuck waiting for this compatibility or trying to find other options (Some have started nightscout, while others decided to purchase idevices to use, others still have chosen to just wait for Dexcom to come out with android apps).
So, once again, the nightscout team has come to the rescue. Within a few hours of receiving their Dexcom with Share receiver fellow Nightscouters Scott Hanselman and Ben West were able to cobble together a system that allows current idevice users with Dexcom Share to upload their Share receiver data into their nightscout database and websites, which allows for continued use of the existing pebble smartwatches that many nightscouters have been using since early on in this project. This system is independent of the nightscout “rig” and for many people who simply want an inexpensive system (assuming they were already idevice users) with watch compatibility NOW, this is an awesome solution. It does have some quirks, but for what it is, it’s pretty amazing. I set our “bridge” up today and when Angelina goes back to school she will have to carry half the stuff that she’s been carrying since we started Nightscout last July. We have been an iphone family since 2010 so upgrade to the Dexcom Share was a no-brainer (especially considering we just got a ne receiver in February so we qualified for the upgrade free of charge) and added no additional cost to our management options. By using the new Share2nightscout bridge Angelina no longer has to carry around the nightscout rig. She can go back to snapping her Dexcom receiver onto her pump belt and having her iphone in her bag like she did before we started remote monitoring. This also means no more carrying the diabetes bag during PE, unless she chooses to, while still utilizing the Dexcom during that time, as well as the remote monitoring.
I posted on Instagram a few weeks ago a picture that told a pretty powerful story: the best system is all of the systems. They each have their benefits, but also their weaknesses. I have NEVER, not once, received any kind of audible alarm from Nightscout on my iphone. I’ve tried using several different browsers and I have even opened the most reliable browser, hit the alert sound test button to make sure it works then sat and watched the red box show up on the NIghtscout screen showing an alert state, but still NO audible alerts, even after 10-15 mins of the phone clearly showing an alert state. This has definitely been one of the downsides to Nightscout for me. Since getting my Pebble watch at Christmas I get vibration alerts on my wrist, which are VERY reliable. But, they are almost TOO reliable. Any time you switch to any of the other apps or watchfaces on the Pebble it resets the “snooze” feature, this seems to include clearing notifications, etc. so that means that my watch vibrates a LOT. Anyone who’s ever used a Dexcom and set their alert settings very tightly probably knows about alarm fatigue. Essentially, you become desensitized to the alarms because it seems like they are always alarming. So, you’re more likely to ignore them assuming that it’s the same thing it was 10 minutes ago. The bright side of this is it’s a watch, so it takes little to no effort to glance at it to see if it really is something I need to pay attention to, or if it’s simply vibrating because I just cleared the notification that someone liked my facebook status.
Dexcom Follow app clearly has the advantage here, at least in my experience and opinion. The alarms have fully customizable settings. You can choose settings like “Alert me to readings over 180 mg/dL after 60 minutes and snooze for 120 minutes” So, I’m not getting a high notification every time Angelina eats something, but I will get one if she went above her target range and stayed there more than an hour, meaning that it might be time to send a gentle reminder to check and do correction. Or at least a prompt for me to take a look at the graph (from home, or the grocery store- all while she’s at school) and see if I can figure out why things aren’t where they should be. The delayed alarms are pretty awesome in my eyes, especially since I am dealing with a tween who is slowly learning to take on more responsibility for her care. It allows me to still know when things are going on, but without the temptation to text or call as soon as something happens – often even before she gets a chance to think about doing something about it. It’s a safety net that allows her to take care of herself, but I’m there to catch her if she doesn’t. I’m not rushing to give instructions right away, but also not sitting back and letting things go totally off the rails, or at least not for very long.
With that said, down side to share2nightscout bridge is you lose some of the advanced features of nightscout. Raw data is a big thing that was recently added that I find incredibly helpful. Raw data is basically the data sent from the transmitter before the algorithm is applied in the receiver. The benefit of this is that when the receiver shows ???, hourglass, or is in the warm up period and not showing numbers you can still see the raw data and have a ballpark of idea of what glucose levels are. Rather than give this up completely, I opted to set up a separate azure site and Mongo database for the bridge data. This way other times I can still hook up the full nightscout system to still get readings, without ending up with duplicate data on our nightscout site, etc.
I also installed a new pebble watchface today that shows two receiver’s data on the same watchface. The watchface was created for those who are monitoring more than one person with diabetes, but I set it up to show me data from both the nightscout rig (when we use it) and the Share receiver through the bridge.
On to the Chicken Soup portion of my post. As I posted over the weekend, Angelina and I attended JDRF Type One Nation Summit event on Saturday. There were several hundred people at the event so it was inevitable that one of us would pick up some kind of bug and bring it home. Of course it had to be Angelina who got sick. She started complaining of a sore throat yesterday afternoon and by bedtime had a low grade fever. Overnight her blood sugar levels shot up pretty drastically and she got correction around 3am and again at 6am, along with an increased temp basal rate. She also stayed home from school today, which kind of stinks because she will also be missing tomorrow and tomorrow was supposed to be field trip day (and I was going as a chaperon as well). I emailed her teacher this morning to let her know we most likely would not make it tomorrow just in case she needed to make other arrangements for chaperons.
It was a pretty low key day. Angelina ended up sleeping in until almost noon and when she did get up she moved from the bed to the sofa and has sort of just moped on the sofa all day. She definitely has some kind of upper respiratory thing going on and was complaining of her ears feeling clogged and her hearing being impaired like her ears need to pop. She still had a little bit of a fever and just generally was feeling tired and weak. So I decided to make some homemade chicken noodle soup.
I don’t normally post recipes on my blog, but it’s my blog and I do what I want, so I’m going to tell you how to make some chicken noodle soup.
Ingredients: 3 ribs of celery, cut into 1/8 inch slices
About 12 baby carrots, cut into slices or quarters
3 packets Knorr Chicken Stock
10 1/2 cups water
3 boneless, skinless chicken breasts, cubed (About 1 to 1 1/2 lbs)
2 tsp Italian seasoning
1 tsp black pepper
1/2 tsp onion powder
1/4 tsp celery salt
12 oz package extra wide egg noodles
In a stock pot or dutch oven combine veggies, chicken, stock and water. Bring to a boil for about 10 minutes, or until chicken is cooked through and veggies are softened. Add Italian seasoning, black pepper, onion powder and celery salt – listed amounts are estimates, adjust to taste. Reduce heat to low and allow to simmer until vegetables are tender, about 20 minutes. Meanwhile, in a separate pot bring water for noodles to a boil and cook egg noodles according to package directions. When noodles have finished cooking rinse in hot water and add to soup. Allow to simmer for a few additional minutes for noodles to soak up broth. Serve! My pot of soup contained about 8 large-ish servings that were approximately 35-40g carbs per serving. If you eat soup in more normal sized bowls or portions this would easily make 12-16 servings which would be between 20-25g carbs per serving. You can further reduce the carbs per serving by using less than the entire 12 oz package of noodles. As you can see it was quite a lot of noodles, but that is how everyone in our house likes it.