With type 1 diabetes and an insulin pump for over twenty years, I’ve always felt like a bionic superhero. I used to picture myself as somewhat of a robotic Wonder Woman, fighting diabetes and powered by electronics. Don’t judge me, I was just a kid…although, I’ll admit, some of my fantasies were reborn recently when I was implanted with the Eversense continuous glucose monitor. This time, however, I was given the power of blood glucose insight; highly predictive and accurate, which for many type 1’s, may as well be a superpower.
Eversense is the first implantable continuous glucose monitor…yes, it’s very SciFi.
Not only is it accurate, but it is discrete and convenient, two words I’d rarely use to describe anything diabetes. The sensor is powered by a sleek rechargeable transmitter worn on top of the skin and this transmitter can be removed and reattached via silicone tape, a reusable two-sided tape. This has changed my world.
My history with real-time glucose management started a few years ago when I trialed my first CGM while attending Physician Assistant school in the U.S. Virgin Islands. Suddenly, my blood sugars were telling me a story. No longer a mystery, I was finally able to achieve the glucose control that I always wanted. This did not come without a price, however. Although I had always worn an insulin pump, adding another external device to my body was intimidating, especially because I basically lived in a bathing suit at the time. I can see how the ability to remove and reattach a CGM, which can now be done for the first time with Eversense, could increase adherence, especially in younger populations.
I also struggled with catching my CGM on my pants or swimsuit, and especially on my sports bra. All you ladies out there know what I mean. I’ll never forget the first time I got my Eversense caught on my shirt and it fell off. I had a short freak-out until I realized that all I needed to do was stick it back on. It was so easy!
One of my biggest challenges initially was finding the right transmitter placement, necessary to keep a consistent and reliable connection between the devices. Luckily, the Eversense app comes with a “placement guide” which shows the strength of the transmitter-sensor connection while searching for placement. After a few weeks, accurately placing the transmitter became easy and I now usually get it on the first try.
The insertion of my Eversense was fairly painless and done in a short 15 minute in-office procedure. After I chose where on my upper-arm I wanted the sensor implanted, my doctor injected a local anesthetic. Ironically, this was the most painful part of the procedure, but only lasted a couple of seconds. He made a small 5mm or ¼ inch incision and inserted the sensor with a custom Eversense inserter. He then applied steri-strips and voila. It was over. To see the video of my insertion, check out https://www.diabetespa.net/blog/eversense. The sensors do need to be replaced every 90 days. In Europe current models last 180 days and studies are being done now to get them approved in the U.S.
Once implanted, there is a 24-hour warm up phase after which four calibrations are required two hours apart. Once this initialization phase is completed, a calibration is required every 12 hours, but will be accepted 10-14 hours apart. I’ve set my calibration times at 8am and 6pm. In theory, two calibrations a day is doable, but I often find myself kicked back into the initialization phase for missing my second calibration…oops. The trick is in finding a good balance between the more rigid calibration schedule and the freedom of transmitter removal. I’ll get it eventually!
An Apple or Android mobile device is your receiver, and the Eversense mobile app displays data in easy-to-read charts and graphs.
My fiancé has enjoyed watching my trends with the Eversense app “my circle” feature. I can see this being a great tool for parents with young type 1 kids, but unfortunately for us, the app does not allow me to set different alerts for my fiancé than I have for myself. Cue the diabetes police. He is alerted of all my rises, falls, transmitter disconnections, threshold, target, and calibration alerts. On top of the alarm burnout he has now developed, I have developed text message fatigue from all his “eat something” and “did you take insulin?!” texts. We eventually both concluded that the only person who needs to know everything about my blood sugars is me, and resolved our issue by turning his alerts off during the day and on at night for safety. I believe they are working to customize the “my circle’ alerts, but for now…this technique works for us.
My favorite feature of Eversense is the on-body vibe alerts. I consider myself a very active person and I’ve always been a water girl. The light, low-profile transmitter sits over the sensor on the upper arm and can be submerged in 1 meter of water for up to 30 minutes.
A simple vibration can now tell me when I have hit a high or low threshold without me having to leave the ocean. I’m sure Eversense will be a game changer during water activities on my next trip home to Hawaii. The third week that I was implanted with Eversense I went on a snowboarding trip to Steamboat and loved being alerted of my trends without even having to remove my gloves!
Lastly, and possibly most important, let’s talk about accuracy. Although it was a bit iffy during the first 2 weeks of healing, the accuracy is now fantastic, and it is possibly the most accurate CGM I’ve ever worn! Not only this, but it picks up my highs and lows much quicker than other CGMs, leading to quicker corrections and more time in range…yes, I’ve experimented.
As a clinician and a type 1 myself I strongly encourage a CGM for all people with diabetes. Although the insertion process may not be for everyone, this CGM is great for those who want the benefit of a CGM, but also want the freedom of removal. Although Eversense does not currently pair with an insulin pump, hybrid and closed loop pairing are on the horizon along with longer sensor wear and less calibrations. I, personally, can’t wait.