Got questions about navigating life with diabetes? Ask D'Mine! Our weekly advice column, that is — hosted by veteran type 1, diabetes author and educator Wil Dubois.

This week, Wil takes another swing at the previously-discussed topics of e-cigarettes and how long a certain type of diabetes device is meant to last. As it is with all things diabetes, there's always room to learn more!

{Got your own questions? Email us at AskDMine@diabetesmine.com}

 

Emily, type 1 from the UK, writes: I know you wrote about electronic cigarettes last summer. Any updates or changes in your thoughts about them?

Wil@Ask D'Mine answers: Well, I still haven't started using them myself, if that's what you're asking. I'm sticking with the occasional tobacco pipe on my back porch, and an evening cigar on my front porch.

News nuggets from around the diabetes community

NEWSFLASH: FDA Clears Dexcom Share Direct
Dexcom gets regulatory approval of its 'on-the-go' mobile apps for CGM data-sharing.
Snail Uses Insulin to Poison Fish
New study shows these slow-moving creatures use toxic form of insulin to capture prey.
A New Square Patch Insulin Pump
Israeli company developing new reusable square insulin pump that has Bluetooth for smartphone communication.

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I think I might have mentioned that I'm a better tour guide than role model.

Clinically, I've seen a lot more of my patients who smoke switch to e-cigs and be very happy. So that's a good thing. I've also seen a big upswing in doctors recommending e-cigs as an alternative to traditional cigarettes. So that's a good thing, too, although new research suggests that we may be kidding ourselves. Statistics on the number of people smoking the real deal have remained somewhat flat, rather than dropping significantly as you would expect with the upswing in e-cig use. Are non-smokers taking up e-cigs? Are tobacco smokers double dipping? It's not clear yet.

But as to the various worries about e-cigs killing people with toxins and heavy metals E-Cig Kitor whatever, that doesn't seem to be happening. And although there was a storm of controversy over the findings of some Greek research showing that e-cigs might damage the lungs, most medical professionals concede that if not 100% safe, e-cigs are certainly less damaging than traditional cigs with their 4,000-odd nasty chemicals and compounds.

What's not such a good thing, however, is what I've observed out in the world: A lot of young people are now using e-cigs. In fact, a new study here in the States found that nearly 7% percent of kids in grades 6 through 12 have tried them. Where are these kids' parents, you ask? Well, they're probably out on their front porch smoking cigars after a hard day at work. (It's harder being a parent than non-parents think it is).

My first thought was that I guess I'd rather see kids this young smoking e-cigs than the traditional cancer sticks, but guess what? Rather than an alternative, the e-cig may be a gateway. The same study shows that more than three-quarters of young e-smokers also smoke good ol' fashioned cigarettes. And another thing to consider, even though this study was just published this Spring: the data is from 2011-12. How many ads for e-cigs did you see in 2011?

How does that compare to how many you see today?

According to experts, there's a current "explosion of youth exposure to e-cig ads." That cannot be a good thing.

 

Scott, type 1 from Ohio, writes: While answering a question about cases about cases for the Dexcom CGM receiver, you mentioned another serious problem: "... a Dex receiver is only intended to last for one year, anyway."  My G4 receiver expired after 14 months. I understand recurring charges for sensors and transmitters, but "planned obsolescence" for a modern electronic consumer device with a $600 price tag is unacceptable. My supplier indicated that my experience was typical. In the absence of misuse (mine is also in a front pants pocket and was recharged according to Dexcom specifications), why are receivers dying so soon? A Dexcom tech supervisor was entirely unhelpful and parroted the one-year warranty policy. Online forums have not addressed this issue. Do you have any information or suggestions?

Wil@Ask D'Mine answers: To be honest, Scott, this is the first I've heard of receivers not holding up, but that may be due to the nature of how they are paid for, and who's using them. Because the warranty is only one year, most health plans replace the whole kit and kaboodle each year, so most CGMers don't use the receiver much beyond 12 months; and as there are very few uninsured people who can afford CGMs, we don't have good data on how long they could theoretically last in the hands of a large body of people who aren't having them replaced regularly.

Now, I wasn't clear on how yours failed, but because you mentioned charging, I suspect that may be part of the issue. I confess that when it comes to charging, I don't know what the "Dexcom specifications" even are. When I first had re-chargeable D-devices, they made me so nervous I never let them go below three-quarters of full before I had them plugged into a wall somewhere. Over time, I've mellowed out. Now, when they get down to one bar I plug 'em in overnight. At least as far as my Dex receiver goes, I've not noticed any change in how well it holds a charge, and I don't recall talking to anyone else who has had any trouble in that department.

Keep in mind, the Dexcom G4 transmitters are only designed to last 6 months compared to twice that time the earlier generation was supposed to. But we are talking receivers here... so let's stick to that.

I am feeling the need to defend Dexcom on this whole issue of a one-year warranty, because while it's easy for us to be angry about the cost of our survival gear, I think that sometimes we need to step back and see it from the other side. But first: let me state categorically that I have no vested interest here. I'm not on their payroll. In fact, my payroll goes straight into their pockets, and has for years.

Now, to your statement of the one-year lifespan perhaps being "planned obsolescence" on the pDexcom G4art of Dexom: I doubt that they actually engineered the receiver to fail after one year. Hell, I doubt they could do that successfully, even if they wanted to. Engineering anything to that degree of precision is easier said than done. But setting that aside, why a one-year warranty in the first place? Who knows? I suspect the origins go back to the previous generation of CGM, when their Dex 7+ transmitter battery lasted a year. That was the best they could get out of a sealed battery, and it was actually a damn impressive feat. As the transmitter lasted a year for that CGM generation, the task for the folks designing the receiver was only to make it last as long. Given the nature of rechargeable batteries a dozen years ago (when that unit was being developed), probably getting a year out of it was a tall order.

I think it's also important to compare apples to apples. The Dex receiver would like to be, but actually is not "a modern electronic consumer device." It's a medical device. And that means the Feds constantly have their noses in Dexcom's businesses, and that makes things more complex. If your iPod craps out before whatever warranty period Apple decides to place on it, it's really no skin off Apple's nose to replace the few units that bite the dust early. If a medical device fails early, however, there's all kinds of hell to pay. And speaking of paying, lurking in the shadows are legions of lawyers sacrificing goats, lighting black candles, and praying that some medical device or another fails early and kills someone so that a class action suit can be launched.

Oh what the heck, let's go ahead and compare apples to oranges, after all. A brand new Apple iPhone 5, arguably the pinnacle of modern electronic consumer devices, only has a one-year warranty, too. And if you want to buy an iPhone unlocked and contract-free, expect to pay $549 — nearly as much as the Dexcom receiver.

So I don't see that Dexcom is acting any differently than any one else. Could they do better? Maybe. But at the same time we D-folks are always gunning for improvements and upgrades. I see no reason for Dex to build battle-hardened gear that will be obsolete as soon as we get it. And while a few of us have NRA-like bumper stickers that read, "You can have my CGM when you pry it from my cold, dead, hands," the truth is that most people still don't stick with CGM for the long haul. So why over-build it, running the price up?

I'm sure I'll get a lot of flack in comments for saying this, but I'm actually pretty happy about $600 receivers that last a year. That's because my checkbook has a good memory. Back in 2005, my first CGM receiver cost me $2,790 — half the cost of an insulin pump in those days.

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

 
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This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.