The Eversense CGM: an 8 Month Review

After trying all of the big-name CGMs, I couldn’t find one I trusted enough to link to an insulin pump. Until I found the Eversense, a CGM implant that I’ve found to be more accurate and reliable than any other I've tried. It hasn’t been all sunshine and rainbows, but it’s been a life-changing improvement nonetheless. If you’ve had reliability issues with your CGMs or are just tired of having to change them out every 2 weeks, this article is for you!

What is it?

To begin, the Eversense is a continuous glucose monitor(CGM) like the Dexcom or FreeStyle Libre. However, rather than being disposable every 7-15 days like most CGMs, it is semi-permanent, lasting an entire year. Instead of being a device with a small wire inserted under the skin, it is a small surgical implant placed under the skin just above one of your triceps with a transmitter worn over the top on an adhesive patch.

Wait…operation?

But don't worry, it's not as intense as it sounds; the operation takes about 5 minutes and doesn't hurt at all. The sensor itself is about the size of two Tic-Tacs stacked on top of each other, so the procedure is more like a hormonal birth control implant than becoming a total cyborg (that'd be cool too, tho IMO). The recovery process takes 2 weeks; just keep it covered and dry while uploading calibrations. Think tattoo recovery.

Getting Started

The start-up process is waiting 24 hours after the sensor has been implanted, then uploading 4 calibrations in one day, then one calibration per day for 2 weeks. The sensor will give blood sugar readings, but they will become more accurate over the course of the start-up process. After that, you are good to go, only needing to calibrate it once per week. I would recommend having a standardized system for calibrations, though, like doing 4 finger poke tests to avoid uploading an outlier reading, and making sure your blood sugar is stable while you test and calibrate.

Why did I make the switch to Eversense?

I have been using CGMs since I was 16, starting with the Dexcom G6, then the G7, and the Libre 3+, before finally sticking with the Eversense. I knew that these traditional CGMs worked for a lot of people, but unfortunately not for me. Here’s why:

• Inaccurate readings (sometimes off by 100 mg/dL!). Because I felt like I couldn’t trust the readings, it prevented me from getting on a hybrid closed-loop pump system. I was worried that the inaccurate readings would cause the pump to give me the wrong amount of insulin.

• Skin/Site irritation. My sites would often get inflamed by the end of the 10-day life of a CGM, like my body was fighting against it.
• Dealing with customer service for replacements at least monthly. This made it feel like the CGM was adding to my diabetes mental load instead of easing the burden.

This worked well enough while living with the support of my family. But moving out to grad school and becoming more independent…it was not enough. My life had become little more than attempting (and sometimes failing) to manage my diabetes and doing my schoolwork. Something had to change, so I decided to try Eversense and, if I could trust it, pair it with the Twiist pump.

How's it Going?

It's been about 8 months, and absolutely life-changing. Even when I was on injections, the ability to genuinely trust my CGM gave me so much peace of mind.

Highlights

The problems with inaccurate readings were gone. I finally felt safe enough to get on the Twiist pump, currently the only compatible pump with Eversense, and my diabetes has never been better.

• • The site irritation was gone. Since the insertion is only once per year, rather than every 10 to 15 days it has time to heal up nicely. Without the transmitter on top, you’d have no idea there was a CGM in there.
  • Only one site change per year. A year-long sensor is plain convenient, and one less thing to deal with insurance over
  • Vibrating alarms. No more annoying audio alarms- the transmitter vibrates on your arm in its own language you will learn over time to alert you about your blood sugars. For example, 3 short buzzes mean it’s predicting a high.

• • • You still have the option for audio alarms on your phone. For me, the on-body vibration alarms are much less stress-inducing, and makes relaxing much easier without the jumpscares.

Challenges

• My first implant had a fault. 99% of the time it was perfect, but after about 6 months I started getting these weird, clearly false readings, like my blood sugar was 0. Then my pump would act as if I was severely low and cut off my insulin, causing me to go high. This happened 3 times, each lasting about half an hour.
• The solution? I called customer service, and they got me a replacement sensor and operation for my opposite arm for free, and the new one has been working perfectly. Even with this failure, I never considered going back to a conventional CGM, since it was otherwise such a significant improvement.
• My other complaints are extremely minor:
• It has a physical power button on the transmitter that can be turned off by accident.
• The transmitter makes it the largest CGM to wear, but the insertion location offsets that most of the time.
• And for some reason it has a micro USB charger rather than USB-C, which is just an odd choice.

Putting it Together

Overall, I am beyond thankful I decided to give the Eversense a try; if you have issues with your more conventional CGMs, I cannot recommend it enough. The semester I got the Eversense, I was seeing psychotherapy clients under supervision(through video recordings and one-way mirrors; it was intense), and even my supervisors noticed a difference in my ability to be present for my clients. As much as I don’t want this to be an advertisement, I owe a lot of my newfound peace of mind and independence as an adult to the Eversense.