Silverman: Using a wearable sensor to battle diabetes is mostly … – Houston Chronicle

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A user holds a smartphone over the FreeStyle Libre 2 sensor to check glucose levels. The technology is the same used with Apple Pay or Google Pay. 
The FreeStyle Libre 2 sensor, a device known as a Continuous Glucose Monitor or CGM, is attached to the back of a user’s arm. A tiny filament inserted in the skin measures glucose levels, which are collected via smartphone or a reader device. 
A smartphone app captures data from glucose measurements in the FreeStyle Libre 2 sensor. 
In early October, I learned I had developed diabetes. The news came in a blunt letter containing the results of a recent physical (yes, a snail-mail letter; my doctor is seriously old-school). 
“Dwight,” he wrote, “your blood sugars are getting out of control.”
Yeah, it was a wake-up call, one I knew was coming. My diet has long been typical of America (and Houston). I’m a sucker for Tex-Mex, burgers, Westernized Asian dishes and classic comfort foods. Nearly all of my social media profiles include the phrase “pizza lover,” and that’s not hyperbole.
I’ve struggled with my weight for most of my adult life, and longtime readers of my columns may remember a series I wrote about using technology to shed some pounds. I was using a calorie-counting iPhone app called Lose It! and reporting my progress through a Twitter account. That started in January 2011, and I lost close to 50 pounds by February 2012. 
But once I’ve lost a lot of weight, I typically start thinking, “Hey, I’m cured! Now I can eat what I want!” That’s an attitude that leads to my dietary downfall and now my diabetes diagnosis.
I have Type 2 diabetes, also known as diabetes mellitus. Weight, diet, heredity and other factors can bring it on, preventing the body from adequately dealing with glucose levels in the blood. Type 1 diabetes, sometimes called childhood diabetes, shows up often in children and requires lifelong management. 
I’ve decided to improve my diet and increase my exercise, this time for good, because the stakes are higher. I’m lucky that I don’t have any of the severe complications that befall diabetics, such as heart and circulation problems, vision deterioration, nerve damage, kidney issues and more. I do not have to take insulin injections, but I do take metformin, a kind of “training wheels” medication that helps with glucose control.
I have what I call “diabetes by the numbers,” but if I don’t make a course correction, I could end up debilitated. At 66, that’s not how I want to spend my golden years.
I’m not alone in my diagnosis. The Texas Department of State Health Services in 2020 estimated that 13.7 percent of adults in Harris County are diabetic, compared with about 10 percent for the national average. And the Centers for Disease Control and Prevention estimates that 96 million adult Americans — about a third — have pre-diabetes; many aren’t even aware of it.
Diabetes, in which the body can’t adequately manage glucose in the blood, also is a key factor in hospitalizations and deaths from COVID-19. The Houston Health Department in November 2021 said 51.9 percent of people who died from the coronavirus in the city had diabetes — it was the No. 1 comorbidity in COVID deaths. I’ve been fortunate enough to not have contracted the virus during the pandemic, and I hope to keep it that way.
My doctor, when discussing his alarming letter, told me what I needed to do: cut back on carbohydrates and sugars, eat more vegetables and less fat and begin monitoring my blood glucose. If my body couldn’t control those levels, I’d have to help it by improving what I ate and keeping an eye on the numbers. 
For a long time, diabetics checked their glucose levels by drawing blood using a finger-stick and putting a drop on a test strip that is read by a glucose meter. But technology has helped eliminate that painful process, and being a techie, I leapt at the chance to use it.
Since mid-October, I’ve been wearing a sensor that monitors my glucose levels. The data is collected and displayed on a smartphone app. The FreeStyle Libre 2 I wear is a continuous glucose monitor made by Abbott and available with a doctor’s prescription. It’s about the size of two stacked quarters and worn on the back of an arm. 
Several companies make the monitors in various configurations, but most work like this:
A thin filament, inserted just under the surface of the skin is coated with a chemical that reacts to glucose in the blood surrounding nearby cells. A reaction generates electrical current indicating glucose levels, which are measured by the sensor. 
In the case of the Libre 2, the sensor comes in a two-part package; you combine them by loading the device into the applicator. The applicator is held against the skin, and with a firm press the sensor is popped in place, secured by a waterproof adhesive. A needle is used to puncture the skin and inserts the filament, and when you remove the applicator the needle is withdrawn. It’s mostly painless.
The sensor — essentially a digital chemical analysis lab — is a miracle of miniaturization. It includes a processor to analyze glucose levels; a near-field communication transmitter, similar to that used for digital payment systems such as Apple Pay or Google Pay; a Bluetooth transmitter to send alerts to your smartphone; enough storage to hold eight hours of readings; and a tiny battery to keep it all working. 
Once you have the sensor in place, it takes an hour for it to warm up. Once it does, you can begin getting readings. Install the FreeStyle Libre 2 app on your iPhone or Android smartphone, launch the app and tap an onscreen “Check glucose” button. You hold the top of your phone over the sensor, and data is transferred to the app.
You’ll see the current glucose reading, as well as a graph showing levels collected every 60 seconds and stored in the sensor since you last checked. Over time, the app curates data into charts showing your average glucose levels, including and hourly, daily and monthly trends. 
This data also is available on a user portal on Abbott’s website, which allows you to see a more detailed analysis and print out charts to give to your health care provider. Some providers can receive these reports directly from your phone, over the internet. 
The sensor stays in communication with your phone via Bluetooth, and if your glucose levels spike too high or drop too low, you receive an alert. The app also will complain if it loses contact with the sensor. 
A newer version of the product, FreeStyle Libre 3, does away with the need to scan the sensor manually. Instead, the sensor sends data in real time to your smartphone. It’s also much smaller, about the size of two stacked pennies.
If you don’t have a smartphone, or one that’s compatible with the sensor, Abbott also makes a reader device. Most commercial health insurance will cover all or part of the devices’ cost, as does Medicare. Each sensor is good for 14 days, and with insurance co-pays costs about $75 a month. 
With a change in diet and using the CGM sensor, I’ve lost more than 20 pounds. I’m able to keep my glucose levels in a normal range 99 percent of the time — and now I’ve got the data to prove it.
dsilverman@outlook.com
twitter.com/dsilverman
 
 
Dwight Silverman worked for the Houston Chronicle in a variety of roles for more than 30 years, serving as a technology reporter and columnist; manager of HoustonChronicle.com; social media manager; online news editor; and assistant State Desk Editor. 
He has returned as a freelancer to continue his long-running technology column. You can email him at dsilverman@outlook.com and follow him on Twitter twitter.com/dsilverman.
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