Stepping Out with Diabetes and a Fitbit

Laddie_Head SquareThis is one of those posts where I need to state that I am not a medical professional and nothing I write should be considered medical advice. My aim is to share some ideas about how a Fitbit activity tracker fits into my life with diabetes.


In the last couple of weeks there has been chatter around the DOC about Fitbit and other activity trackers. Some of the talk has been about Fitbit challenges which are well-described in Kerri’s post at Six Until Me. I also wrote a post about one specific challenge.

Although I have enjoyed recent challenges, I owned a Fitbit for almost 2-1/2 years without linking it to social media. Even without friends and challenges, I found a Fitbit to be very motivating in an un-nagging sort of way. Although no one was monitoring whether I reached my daily goals, seeing the numbers tended to encourage me to take the dog for another walk or start using the upstairs bathroom to get extra steps (doin’ the Karen Graffeo).

I am a big fan of activity trackers when it comes to diabetes. Most of the things we PWDPump and Fitbit-001 are told to manage fall into the following areas:  diet, medication, exercise, BG monitoring, and psychosocial support. It is impossible to be perfect in any of these areas, but in my opinion the better I can do “on average,” the better I feel and the better my diabetes numbers are. For me there is no doubt that my Fitbit helps with the exercise component of my diabetes care.

Some of the reasons are:

Consistency:  Diabetes like consistency. By trying to reach my Fitbit step goal every day, my activity level is steadier than it would be without the device. Over time I believe that consistent exercise has resulted in lower and more predictable insulin requirements and I have fewer severe lows when I work out. At age 63 I can arrange my schedule to walk a few miles every day after breakfast and that exercise is reflected in my basal rates. If I skip the walk, I often set an increased temporary basal rate for a couple of hours.

Many of you are not be at a stage in life where you can exercise at the same time every day because jobs, children, weather, etc. demand your attention. At the same time you can work to be more active every day as you try to reach your step goal. Park your car at the far edge of the parking lot, take a longer route to the water cooler, walk around the house when you are on the phone, take a lunchtime walk. The advantage of an activity tracker is that you have data to monitor changes in your daily activity.

Motivation:  By starting with reasonable goals, I was able to achieve success right away. I have always enjoyed the weekly email I receive titled “Fitbit Weekly Stats.” This report gives me information on how many steps I walked the week before as well as total distance, averages, weight change if I choose to enter it into the website, and so on. Not every week is an improvement over the previous one, but in general my average daily steps have increased during the time that I have owned a Fitbit.

I am a believer that starting slow is fine and knowing your limitations is important. Some people have no problem achieving 10,000 steps per day. Others will work hard to reach 2,000 steps and their success is as admirable as those running marathons. Over time as you become more active, you can increase your goal if that makes sense for you. Or maybe your goal will stay the same and you can take pride is meeting that step count most days.

Easy to use:  Fitbits are simple to use. The Zip uses a disc battery which lasts for about 3-6 months. I have the One which is rechargeable with a USB cord. You can check out other models at the Fitbit website.

What is most fabulous is that the data from each tracker downloads automatically to the Fitbit website. When I open the app on my smartphone, it syncs automatically. I also have a USB wireless dongle connected to my desktop PC and the Fitbit syncs whenever I am within 15-20 feet of the computer. I don’t have to do a thing. (This is of course what I wish would happen with all of my diabetes devices….)

Fun:  I enjoy seeing my Fitbit stats whether or not I compare them with others. Challenges can motivate me to take more steps than usual, but at the same time I rarely win the challenges or even expect to. One thing I like about the challenge called Goal Day is that it is based on how each competitor does compared to his/her daily step goal. If my goal is 10,000 steps and yours is 2,000 and we each walk an extra 500 steps, you will crush me because you are at 125% of goal and I am only at 105%.

I have found everything about Fitbit reports and challenges to be positive. When I hit personal milestones, Fitbit rewards me with silly badges like the Penguin March for having cumulatively walked 70 miles or the Happy Hill for climbing 10 flights of stairs in a day. My experience with challenges has been that everyone is positive and supportive. I am awed at my personal stats on the Fitbit dashboard. FYI I have taken over 9,300,000 steps (4,200 miles) since I purchased my first Fitbit. My “best” day was April 5, 2013 when I walked 32,095 steps (a very long Arizona hike).

Diasend:  Diasend is an online system for uploading most diabetes devices except Medtronic products. It is a free service and all you need to do is set up a personal account. I use an Animas Vibe pump, a Dexcom G4, and several Freestyle meters. All can be uploaded to Diasend and there is Compilation report that displays all of this data in one report.

A new development is that I can link my Fitbit account to Diasend. (Other compatible activity trackers are the Moves App, Runkeeper, Jawbone Up, and Nike+.) Because my BG levels and insulin doses are highly dependent on activity level, it’s nice to see them in one report. Below you will see part of a two week report. (I have blocked out some of the data for personal reasons.) But you can see the potential for starting to track the effect of exercise on your diabetes numbers.

Diasend Compilation with Fitbit_1

If you currently use Diasend and don’t know how to link your activity tracker, click on the Account Admin tab and then select the tab that says “Browse & connect activity tracker.”

One caveat. When you first link your Fitbit, it starts with current data and includes no historical data. If you normally look at 2 weeks of data for your diabetes devices, the Activity data will not be correct until the link with Fitbit has been active for two weeks. But from then on your data will show up automatically. No download cables required.

Summary:  I am very happy with my Fitbit. If you are in the market for an activity tracker, you should probably check out all the brands. Some cell phones, including the iPhone 5S and 6-series, have activity trackers built into them. For the budget conscious, a basic pedometer is adequate to monitor your activity level and allow you to keep track of stats that interest and motivate you. Use whatever works for you.

If you can’t stand the idea of more numbers in your life, just ignore everything I wrote today. Put on your sneakers and take a walk. Take time to smell the roses and enjoy your day while secretly thinking that people like me are crazy.…

Why I Don’t Download

Laddie_Head SquareThere are many discussions around the DOC about data interoperability and ownership of data. There are also survey results that indicate how rarely most people with diabetes download their devices.

Last week I had an endocrinologist appointment. I know that I am guilty-as-charged about not downloading my devices very often. But I always do it prior to endo appointments. I consider data extraction a tedious process and it seems to take forever. To figure out if the download time is a legitimate excuse or whether I am just a slacker, I decided to chart my experience.

10:38  I gather up the necessary cords and my two Freestyle meters. My pump and CGM are of course close by in my pockets.

10:40  I prepare my Animas Ping pump for the download. I change the Display Timeout from 15 seconds to 1 minute. If I don’t do this, the pump will sometimes turn off before the Diasend Uploader can start reading its data. Then I suspend the pump and unhook it from the infusion set. I open the Diasend Uploader and attach the wireless upload device to my computer.  I start the download which is always a slow process. After the pump is downloaded, the Diasend uploader asks for my login info and I type it in.

10:47  I have finished the download of my pump and I download Freestyle Lite Meter #1 to Diasend. Quick and and easy.

10:48  I download Freestyle Lite Meter #2 to Diasend. Once again, quick and easy.

10:49  I plug in my Dexcom G4 receiver. The download to Diasend is simple and finished within a minute.

10:50  I follow the Uploader prompt to go to the Diasend website and sign in.

10:51  While the Dexcom receiver is attached to the computer, I open Dexcom Studio and download the CGM data to the Dexcom program.

10:53  All of my devices are downloaded and I cram the cords back into my “Diabetes Download” handy-dandy storage box.

I have invested 15 minutes in my diabetes download project. If I didn’t have an endo appointment and just wanted to view the reports on the computer, the bulk of the work would be done. Both Diasend and Dexcom Studio do a good job of displaying reports clearly and quickly.

But I want to save some of the reports to my “Medical Reports” folder and print them out for my doctor to review.

10:54  In Dexcom Studio I open the Summary Report in Microsoft Word using the last 14 days of data and save it to my computer. Then I print it for my endo. I have felt that I have really been struggling lately with my diabetes, but the reports look quite good. When you’re stuck in the trees, life can look bad although the forest view is quite respectable.

10:57  I go to the Diasend website to print reports. The Compilation Report is the most useful summary because it merges data from my pump, meters, and CGM. I also like one of the CGM reports. I save both to PDF.

I am going to digress here and talk about how some endocrinologists hate Diasend reports. They look fabulous on the computer and many doctors view them that way. But when they are printed, the charts are so small that they are almost unreadable. HEY DIASEND! NOW THAT YOU FINALLY DOWNLOAD ALL OF MY DEVICES, PLEASE PRINT THE REPORTS SO THAT MY DOCTOR CAN READ THEM!  

We own a full version of Adobe Acrobat (a different program than the free Adobe Reader) and I am able to crop the Diasend reports and enlarge them. They are still small but better than the standard reports. My endo will be able to read them. I print the reports and save them to my computer.

11:08  My pump and CGM are back in my pocket. Freestyle Meter #1 is in my purse and Freestyle Meter #2 is on the floor by the stairs to be returned to the master bathroom on my next trip upstairs. (I never put anything on the stairs because my first frozen shoulder developed after a fall from stepping on shoes left on the stairs.)

So here’s a summary:

15 Minutes: That’s what it takes to download my diabetes devices to Diasend and Dexcom Studio. If I didn’t want to print anything, various reports are immediately available.

30 Minutes: That was the total time to download my devices, print several reports for my doctor, and save those same reports to my computer. Obviously I spent more time than other people might.

15 minutes. 30 minutes. That is why I don’t download all of my diabetes devices very often.Download Time

Okay, now it is time to stop making excuses. The data from my Dexcom G4 is by far the most useful information I have when it comes to evaluating blood sugars. I can download the receiver to Dexcom Studio in one minute. It takes another minute to download to Diasend. And maybe another minute to find the download cord and open the computer programs. So from start to finish it’s two or three minutes. I can even save a minute by downloading to only one program instead of two.

So what have I learned from my time study? I have learned that it would make sense to start downloading my Dex G4 on a more regular basis. It’s super quick unlike the time and effort that it takes to download four devices. I can download my G4 to Diasend (unfortunately not yet to Dexcom Studio) on my MacBook and that is even faster and more convenient than with my Windows desktop.

Will I change? I actually think I might. (Just for my Dexcom, not the other devices)

One last question: If I download my data, am I supposed to look at it?