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HI Dan, I've read this article several times and have shared it with the education staff at my son's pediatric endocrinologist office. My son has been using the G6 since we switched back from the G7 in March after 3 months of impacted TIR. My concern now is what will happen if Dexcom should decide to 'retire' the G6 without making changes to the G7? I'm sure you've given this some thought and I would love to hear what your backup plan is.

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Lynette -- You're commenting on the thread associated with my 50 years of T1D, but it sounds more like you're commenting on the article where I compare the G6 and G7.

Either way... I'd be curious what your Endo says in response to my article, and whether they are seeing the same things from other G6/7 patients. I've spoken to endos all over the place who claim to be seeing similar results (same with my own endo), and each of them have forwarded my article to their Dexcom rep, asking them to reconsider the plan to retire the G6.

So far, no formal word, but I have heard the COO of Dexcom on a podcast who was asked about the G6's future, and he hinted that he's aware many people want to see it continued. That gave me some relief, but the real question for me is whether they would modify the G7's algorithm to look more like the G6's. (Or, potentially have the G8 be more like it?)

In the meantime, there's not much I can do to hold onto a supply of G6s. The real problem isn't the sensors, but the transmitter life because the batteries can die long before the sensor enzymes (that make the sensor detect glucose). I've used sensors that expired years earlier and they worked just fine, so saving a bunch or sensors isn't very useful if the transmitters won't live longer than a year or so.

Sadly, there is no other backup plan that I can think of.

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Oops, you are right, I commented on the wrong article. I'd been reading through all of them again. Last visit our Endo didn't appear to be aware of any specific issues with G7. He's using one himself now! I'll ask again but I have a feeling they aren't as on top of the devices as you would think they would be. It's somewhat reassuring to hear the COO is hearing the concerns. I was trying to find a way to reach out to Dexcom other than talking to a customer service rep with a help manual to follow. Maybe I'll reach out to our local rep as well. I'm really concerned about alternatives if they were to EOL the G6 soon. Thanks again for your amazing articles. I'm having my son read your latest one before he writes his college essay. The point about this being his identity should tie in nicely.

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That your endo isn't aware of specific issues with the G7 doesn't surprise me. Being a physician is a very time-consuming and laborious job -- there are so many patients, it's hard to keep their own heads above water.

My endo once told me that all docs learn what they do from staff meetings with their other colleagues tell them about things they read, hear, or talk about, whether it's from medical journals, their patients, or other colleagues. Given how much there is that *can* be known, and the limited amount of time in these staff meetings, suffice to say they're only going to skim the surface.

The G7's volatility probably doesn't come up on their radar much, or perhaps they perceive it as a low-priority item, which probably explains why your own endo (who, I assume is a T1D) doesn't see a "problem" with the G7's erratic/volatile glucose readings. Remember, 90% of T1Ds view their BG levels every 3-5 hours or so, where they look for big spikes or dips. The other 10% of us (me, your son?) look at short time-windows and make granular decisions when a few readings suggest a sudden move. That's why the G7 is worse than the G6. For the 90% of everyone else that looks sporadically for macro-level movements, most CGMs are largely interchangeable; their differences in accuracy at that level is inconsequential.

Nevertheless, the volatile readings can be unnerving, which is why I think Dexcom realizes that the G6's performance was "better" in ways they didn't expect, even if it's just psychological for some. Reconciling that problem with the G7 is a business challenge, not a technical or medical one. All of which leads me to have more faith they won't EOL the G6 anytime soon.

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Hello Dan. Well-written article. I don't remember how I discovered your substack but I sincerely appreciate your extensive research and ability to understandably present it to others with T1D. Your article on insulin pumps was fascinating, especially the benefits of pumps stratified by age groups. At 69 years of age, I am content with insulin pens for my diabetes management (last A1C was 5.7%) and that article confirmed that my approach was sufficient. But, I will still pay attention to diabetes technology and advances; perhaps I'll try a pump in the future. My best to you and I look forward to more of your articles.

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Hi Richard--thanks for the comment... and for sharing your own story. Having an A1c of 5.7% is great, as you well know, so it begs the question, why change anything (such as trying a pump). As the old adage goes, "If it ain't broke, don't fix it." I think it's especially true when you're 69.

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Hey Dan, I just stumbled on your Substack article, and it was so informative and relatable and funny - in a quirky T1D kind of way. Thank you for writing from the heart and researching and sharing the good, bad, and ugly about living a long time with T1D. For me, I was 19 and in college when I ”got” diabetes. That was 1976, so I’m heading into my 50th year pretty soon. Our stories are so similar and yet so different, aren’t they? My husband and I have four grown kids, and everyone has always been so supportive, helpful, etc., but they don’t really “get” it because they never actually “got” it. Ha. Anyway, Dan, thank you for your writing and I look forward to reading more from you. I really appreciate it.

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Thanks, Mary--appreciate the feedback. I'm curious how you found out about my Substack? Via email from someone? A google search? A discussion group?

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Hey Dan, I don’t really know myself. I got an email this morning, directly from you on Substack about your article. It wasn’t a forward from anyone or anyplace, I hadn’t been searching, I read through discussion groups but I’ve never posted anything.

Your piece sounded so interesting, I clicked on it. I follow only one person on Substack, but she has nothing to do with diabetes. She’s a really good Christian writer, blogger, etc. But I also subscribe to a broad range of online things related to T1D, so maybe somehow my email address came your way via one of those?? It’s a true mystery…

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I see -- well, it seems you got the email because you signed up for my substack in November of 2023, and you've read many of my articles! :-) So, mystery solved!

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Wow. I have no memory of any of that. My brain has seen better days. Way too many hypos!

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Found it!

<<Conditional life expectancy for each age interval (i.e., the average number of years of life remaining in participants who attained the age at the beginning of the interval)>>

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Great article! One observation regarding that chart. I think you need to add the 10 yrs old you were at the time of diagnosis. I say this as if you look at the chart for the first column say diagnosed at age 50 and follow that over, with your interpretation of the chart, they would die at age 31....

I think they could have made this clearer by adding the word additional; as in estimated additional life expectancy. I am sure this is likely defined somewhere, but with a quick look I did not find it.

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I read the study again, and there are lots of caveats and other statistical gymnastics the authors used to try to nail things down. I can appreciate the complexity. But what now stands out to me is this statement from them: "The life expectancy at birth for the participants diagnosed with type 1 diabetes between 1950 and 1964 is 53.4 years." So, technically, I should have died in 2015.

Interestingly, their stats show that, if I'd been born just three years later, my life expectancy would be 68.8 years an increase of >15 years!

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Fantastic article! You're a terrific journalist and I love that you cite so many references.

Thank you so much Dan. I started taking insulin and 1974...

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