When I first set eyes on the new Eversense implantable continuous glucose monitor from Senseonics few years back, I mustiness admit I was non all that impressed. The thought of having a little stick actually implanted into your shoulder and then having to wear a black box taped over it day in and day out to get readings seemed like a non-starter. Just I can now honestly say those compromises should not concord anyone back from this challenging new system.

I got the Eversense implanted in my branch in San Francisco on December 3, and after a rocky first some years, I've had a quite good experience with this novel new arrangement just FDA approved this June. I've learned quite bit, and am excited to share my impressions and user tips with our community.

Eversense Organization Basics

For those who may be unfamiliar, or need a reminder, the Eversense system from Free State-based Senseonics is the world's first long-term implantable CGM. It consists of a tiny sensing element the size of a small twig that is implanted underneath the peel in the upper arm for 90-day wear (approved for 180 day-wear in Europe); a flat oval black transmitter worn over the insertion site and held in place with an adhesive; and a smartphone app that contains the data monitoring and control functions. We detailed all the specs of the organisation in our original coverage here.

As a new patient, you get a set of boxes that include the black transmitter and charging cable, and a put back of 100 adhesives – 90 white and 10 clear (presumably because the clear ones look nicer, simply preceptor't stick as well?)

You also engender a receive folder with big, bold instructions on how to treasure the initial incision, and how to set up and use the system. Being a typical go-getter impatient patient, I did non record these same carefully at first — which makes me a good test casing for some of the issues very much of impatient PWDs will experience call at the real world.

The Eversense Insertion Cognitive process

Let's start with the interpolation process. Having witnessed a couple of Nexplanon birth control insertions, likewise a tiny deposit implanted in the pep pill arm, I thought I knew exactly what to expect. However, mine felt a bit many "operative" than I remembered, with my doctor exploitation a postoperative cover sheet and attractive extreme caution to dungeon everything sterilized.

This system is so new that Eversense is sending out a small squad of experts to help train endocrinologists on the implantation procedure, taking new patients in groups of threes. As they discussed how my endo should guard the device and where to take a leak the track, I felt like a Cavia cobaya but in selfsame safe hands.

The introduction itself was same faithful and mostly painless — not more a minute of sting and uncomfortableness arsenic something moved around under my skin. The injure was taped with steri-strips (that light off by themselves in a few years) and cloaked with a waterproof dressing for the eldest few years. I was instructed non to exercise too toilsome, raise up my arms vigorously, or float for a hardly a days thenceforth. Luckily, I got the sick clean to go ahead and do my regular spin class, every bit long as my arms weren't flailing 🙂

I did non have any bruising. But yes, I do have a teentsy scar happening my left shoulder now, just a couple of centimeters above where I can feel the sensor under the skin. I'm non fazed aside that, given that I had a small inoculation pock there already.

After insertion, there is a one-time, 24-minute warmup period before you can direct the transmitter over the blob to start getting readings.

What's Different from Dexcom

Since the biggest question on everyone's mind seems to exist how this new system differs from the marketplace-leading Dexcom CGM, let's address that next. Wherefore would I even want to test Eversense?

First off, I'm all about founding and new D-tools, just in case you hadn't detected! The prospect of a possibly tiptop-accurate detector that does not motivation to be reinserted every 10 years became challenging for certain. Also very intriguing is the idea that this transmitter actually vibrates right your skin, alleviating the involve for thus umpteen (beeeeeeeep) audio alarms. In that respect are various companies workings happening wearable medical devices that expend "tactile stimulus" for alerts, which I now trust will live the way of the subsequent. And I sure do like that part!

Boilersuit, some main differences from wearing Dexcom are:

  • as noted, the Eversense transmitter VIBRATES perpendicular on your skin – allowing you to disenable all non-critical audible alarms if desired
  • you have to take the transmitter off and charge IT for 15 minutes every day, and then re-attach it with a fresh adhesive
  • you can take it off and subsequently re-attach IT any time you want without wasting away anything (else than one adhesive mend)
  • there's no want to carry inserters, and the bondable is always fresh — but of course you'll be covering the same spot for a whole 3 months
  • you are encouraged to calibrate often using fingerstick tests
  • the looking of the app is real big and bold, but also not entirely intuitive, and design-wise IT's a little bit jagged (many along that below)
  • that black thing happening your fortify

On that last point, I was happy to begin my trial run in winter, when I'm almost entirely wearing sweaters and long sleeves — so I preceptor't ingest to answer questions too often.

Also note that the vibrations do have unique patterns for for each one alert — 3x three short vibes for Low Glucose; 1 long vibration and 2 improvident vibes for a High; 3 quick vibes and 2 long vibes for Low Battery; and so on. At first I thought I would birth to memorize these patterns, but quickly learned that any vibration is cause to look at the app for a quick view of what's up.

Be a Careful Calibrator

When the squad walked me through the frame-up and how to use the organization, one of the first things we had to enter into the app was my daily standardization times. That is, this system REQUIRES two calibrations per day at specialised times that you set up in advance. Matchless thing I learned the hard way is how important it is to pick your times and stick to them — especially in the first week or and then when the sensor is "setting in"! If your calibrations are too far asunder, or "unsatisfactory" for any reason, you may get wacky readings like I did in the first fewer days.

I picked 7am and 5pm, As good multiplication for me happening a daily cornerston, but realized only later that I amaze alerted at 7am happening weekends too, which is not my preferred thing (merely I'm sticking with it, since IT whole kit well for Maine 5 days a week and you cannot currently set different calibration times for weekends).

What I learned about the Eversense calibrations is:

  • Be consistent about calibrating inside an minute of the time of your on the job!
  • As nigh current CGM users sleep with, you must be aware not to calibrate at times when your BG is changing chop-chop — increasing or decreasing — as this will confuse the organisation
  • Eversense needs 15 transactions to sync after each calibration, thus do not remove the transmitter for charging during this time! Again, that will but bedevil the organisation
  • Unequal with Dexcom, which is even FDA approved for use without any calibrations the least bit, this system benefits from existence calibrated often, as long as your BG is comparatively stable while calibrating
  • Musical note that after from each one scheduled standardization, the system of rules will not take up another for a menses of two hours, so don't try to "stuff the standardization box," as it were

Living with the Eversense App

I think the designers were optimizing for people with compromised vision (?), but the current glucose reading displayed at the top of this app is HUGE. Forget about being discreet; expect your loved ones and anyone within a 6-ft radius to make comments thereon number, just humorous off the screen:

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On top of that, the look of the ongoing line graph is very jagged, like scary mountain peaks. My 18-year-old daughter gasped when she showtime byword information technology, asking, "Isn't that kind-hearted of disturbing to look at for someone trying to manage their diabetes?"

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I had to admit, I missed the smoother, more subtle lines of the Dexcom app. Besides, when you change your phone from vertical to horizontal orientation, this app does not automatically change view with it. Rather, you have to tip a trifle build icon in the corner. And the views of 7, 14, 30 and 90 years of glucose data are not very intuitive. I find it in truth challenging to even construe with where one twenty-four hour period separates from the next, to add up out of the information.

Just there are some things I suchlike very much close to the Eversense app:

The app does non often disconnect or lose signal, and if it does, it's easy to localisation. Sporting go to the Card, and dog "Connect." The hardly a multiplication when that didn't work, I simply exited the app altogether and so Re-wide-eyed it, and it reconnected immediately.

There's a continuously displayed dun-coloured bar at the top that shows you evidently in Red, Yellow or Green where you stand in price of firing range.

The clearheaded, soft-to-use Menu includes an Alaru History, where you john see records of every Pinched Alert, Low Wide-awake, Vector Scattered or Graduate Now alert received, with exact day and time. This is super useful for sledding back o'er your day or week to retrace your BG steps.

The Event Log is equally clear and easy to navigate, and appears to contain at least a month's worth of detailed info if you continue to scroll back.

The Reports surgical incision shows you a Weekly Modal auxiliary verb Summary; a Glucose Pie Chart for 1, 7, 14, 30 or 90 years' worth of information; and Glucose Stats Report with the same 1-90 day options, displaying your average, highest and lowest readings, and standard digression broken in quartet sections by hour (midnight to 6am, 6am-midday, noon-6pm, and 6pm-midnight). To email any of these reports to a receiver of your select, you righteous get through happening the Share ikon in the upper right of the screen.

If you click into the Share My Information area, you can also base email invitations to your doctors or loved ones to exist able to view your continuous stream of data, including alerts and events logged. Remember when we dreamed of having such capabilities? Dexcom successful those CGM dreams come rightful, and it's great to see parvenue systems making data unselfish and remote monitoring a proper none-brainer.

The Settings area is course where you control all the basics, from a sub-card including: Glucose, Daily Calibration, System, Sound Settings, and Temporary Profiles. Note that under "Glucose" in this area is where you fructify your BG mark lay out, and also your Screechy and Low alert levels, which will presumably Be a wider distribute than your ideal targets. You can also set a Prophetic Alert for 10, 20, or 30 minutes in advance of an oncoming Low operating theatre High (fast alteration charge per unit).

Under Sound Settings, you can choose the ring tones for audible alerts, and also come home to "disable all non-critical alerts and notifications." This option makes it so you only induce sound alerts if you dismiss the transmitter vibration for a Luxuriously or Low "snooze" period that you choose yourself, from 5 to 30 minutes.

In the Temp Visibility orbit, you sack set the audio alerts to sound for only a mere number of time, from 30 transactions to 36 hours. This could be a potential repair if you prefer to have completely sound alerts activated overnight only — setting them to go off only for your 8 hours of sleep metre for example — but be aware that you can't set this to automatically repeat each night. As an alternative, you'd have to go in manually each evening before bed to activate your 8-hour Temporary worker Profile.

I've opted to "disable all non-caviling alerts" 24 hours a daytime yet, and am stunned at what a difference this makes in quality of life — no more alarm fatigue!! I hadn't realized how incredibly burnt out I was on altogether that beeeeeeping noise day and Night. It has sincerely been a gift to free myself of one major source of alarm dissonance.

Ever-changing Adhesives and Charging

OK, let's talk system maintenance. As noted, the Eversense vector needs to be live all single mean solar day for about 15 transactions, and so atomic number 75-attached to your arm with a fresh adhesive. Yes, this is something you kinda need to contrive your Day around, otherwise you can easily leave and the system testament spill of juice. At first, I tried and true to be very controlled and bring down care of this at the same time each morning patc showering, but my schedule is pretty variable. On the mornings when I rushed off to the gym, I'd forget about charging often until New that good afternoon or evening. Then if it was more convenient for me to charge first thing the next morning, it daunted me that I wasn't getting a full 24 hours on the new tenacious. But that is where you need to have a different mindset: you're non actually cachexy a sensor, and you have wad of adhesives to work with.

Of course you no longer have to carry any inserters or equipment when traveling, differently the charging cable and a dinky pack of adhesives. I found a perfect little drawstring traveling bag for these supplies.

But the fact that the branded wire is so essential worries me a flake — it's so promiscuous to forget OR misplace, especially when you are at the gym often or travel a lot. I really would recommend that Senseonics start oblation 2 in the package to make users' lives easier.

When you'atomic number 75 at the ready to put the vector rearward connected your arm, you open the Placement Guide on the app and then peel off the paper front of the adhesive and stick the vector to that. Past you peel the large portion of the arm-facing adhesive position and lightly press it on your limb so that the sender is set fitting over the inserted sensor. The Arrangement Guide indicates whether you've slay the mark or non, with a jell of bars indicating Low gear, Good, or Excellent signal.

Remember, you've got a set of 100 adhesives – 90 regular white and 10 clear ones. Nary extra medical checkup adhesive wipes are necessary at all, nor do you indigence any remover wipes to get gunk off afterwards! They go along pasty and come away clean — Yay! But I was able to empirically prove that the clear constructive ones cause more temper, and appear to peel off faster when you're sweating. So I'm preservation those for special occasions.

This adhesives setup has Pros and Cons. On the good side, you'ray only wearing each Eversense stick-on for 24 hours, so they're ever fresh, and for longtime CGM and ticker wearers like me, you sire to give your belly, back up and other spots a break, which is very nice! On the otherwise hand, that single blot on your arm is right away going be splattered by adhesive for 90 years running. I'm still wondering what shape my bark in that respect volition be in at the conclusion of my first detector's life.

btw, there are Decorative Skins for the Eversense vector oversubscribed by Pump Peelz. If you use them, be true to look for the tiny slash-out at the top of the roundabout that you're meant to remove so you can still see the transmitter mode light. I missed that at first.

Accuracy Impressions

A jumbo plus of the Eversense is supposed to be its new accuracy, equal fetching out in a 3-way comparison against Dexcom G5 and the Abbott FreeStyle Libre monitor. In my case, I lonesome wore IT overlapping with my Dexcom G6 for the premier four days, in which the Eversense was even "settling in" and showing some wonky readings. After my G6 sensor requisite replacement, I exactly couldn't front wearing three gadgets all of a sudden (given I'm an OmniPod substance abuser). So I throne't say incisively how it stacked up to Dexcom person-to-person over time.

Merely ever so since those premiere 5 days passed, I can say that the readings have been implausibly close to what I fix on my fingerstick measure, usually within 15 points!

After I've burnt for a High or a Small however, thither is definitely still a lag until the system starts to recognize the BG flying back into range. It wish continue to vibrate for what seems like a years after it needs to. This is where vibrations vs. loud beeping alarms are a real summation, yet again.

Pros and Cons of the Eversense CGM

Hera's my precis of the advantages and disadvantages of this system:

Advantages:

  • You tail get rid of the Eversense transmitter for a free branch any prison term you wishing, without wasting much of anything
  • The Alert History along the app is precise useful for trailing your gross experience/BG control
  • Love the same easy data sharing on the app!
  • No take to carry inserters or re-insert a sensor
  • The daily adhesive girdle stuck to the skin really well and comes off clean – with no need for special wet wipes or remover wipes. You can even pull off the transmitter for a brief time and re-stick with same adhesive if necessary

Disadvantages:

  • You must remove the transmitter all day to charge and change the glutinous. I often forgot about this until late in the day — plus there's a charging cable to lug around
  • You will be wearing pasty in the exact same spot for three months operative, which I worry could at length cause skin irritation (or at to the lowest degree a big pallid maculatio on my arm)
  • I found the system slack to learn on changes after I'd treated a High up or Low (non unlike other CGMs along the securities industry)

My final word for at once would be this: Do non opt to use Eversense simply because you are looking for something "easier" than other CGMs available. As noted, this arrangement requires a lot of calibrations and some daily effort, so you have to be committed.

But if you're willing to do the lic, information technology is really poise to be free of current insertions and audible alarms, and the Eversense app is very clear and easy to use.

My BG control has improved! Whether that's from just focusing on a new toy, or truly a credit to the Eversense system is hard to say. Despite the turn requisite, I am in reality enjoying using Eversense. And enjoyment = motivating. Thusly kudos to Senseonics right there.