I was given a heads-up that a player in a tournament that I’m directing this weekend has a cell phone-based glucose monitor. My only familiarity with this is from the TV commercials where people are actively checking their readings. Does anyone have experience with these as to what type of accommodations might be reasonable? (Clearly telling her she can’t have the cell with her isn’t going to work).
I don’t have any experience with this, but unless the device is one that continually monitors her glucose, then she doesn’t need to have it on all the time. In that case I would tell her that she can have the phone with her, but it must be on the table and in plain view at all times. If/when she feels the need to check her glucose she has to do it while a TD is present and observing her.
When dealing with CGMs (continuous glucose monitors), the sensor is attached to the patient and is read using either a standalone reader or a cell phone-based reader app. I think more patients are tending to use the app rather than a standalone reader, if only because it is one less thing to have to carry around.
Some types of CGM sensors can update the readers (app or standalone) autonomously (presumably via bluetooth, because it has a range of 20-30 feet) and the reader/app can then raise an alert (signalling and/or vibrating) if the wearer’s glucose is too high or too low, but I believe all of them can be read on demand by activating the reader or app and using NFC (near field communication) to take the reading.
Putting a cell phone into airplane mode is supposed to turn off cell service, wifi service and bluetooth, though there are some reports that the bluetooth doesn’t always get turned off. Whether it also turns off NFC is unclear.
You could try asking the player if they can get a reading manually when their cell phone is in airplane mode. (This could vary depending on the CGM in use and the type of cell phone.)
Whether having a cell phone on but in airplane mode is OK is a somewhat separate issue. Airplane mode would permit a chess app to run, though it shouldn’t be able to communicate with anything else.
An iPhone will get a manual reading from a Freestyle Libre sensor even if the phone is in airplane mode.
Also, putting the iPhone in airplane mode doesn’t turn off bluetooth, just cell and wifi. You can disable bluetooth separately, though NFC still works (ie, the iPhone still gets a reading from the CGM) even with all 3 off.
Other CGM devices and cell phone types may operate differently.
Airplane mode did seem to work fine. And fortunately, she had no alerts.
I have had a student wear a device that was tied to their parent’s phone. I allowed the mother to come into the closed floor (staying behind her son of course) and administer insulin from 10 feet away. Had the player been an adult, I would have allowed them to keep their phone on but make sure it’s visible. As technology continues to evolve, there are going be more questions regarding things like this.
When the Apple watch introduces glucose monitoring, I wonder how many people will want to keep their watch on to monitor their blood sugar levels.
I’m sure that’s not what you mean. I know of no way possible to administer insulin from ten feet away. Perhaps “monitor blood glucose”?
Alex Relyea
P.S. I use a dedicated device, leave it on the table at all times, and inform the chief TD at the beginning of the tournament.
I assume you mean by dedicated device: “not a cell phone”.
I think all the major CGMs can use a standalone reader in addition to or instead of the cell phone app, though I think users are trending to using just the cell phone app. As I said before, it’s one less device to have to carry around.
One complication with that is that if you start a new sensor with the standalone reader, it may not work with the cell phone, or vice versa.
The player’s mother told me his pump was controlled via Bluetooth.
Wow! What a terrible design!
Alex Relyea
As I understand it, the bluetooth device is used to set and update the schedule for the insulin pump, as it is more convenient since the pump is on a fairly short cord down around the patient’s waist.
If the phone was unavailable for a while, I think the pump would continue with the latest schedule, but especially with kids revisions during the day are common based on activity and blood sugar readings.
And with kids, there might be good reasons why allowing adjusting the schedule on the pump itself might be a very bad idea.