From diagnosis, to doctor, to Dexcom: Thomas Grace’s lifelong journey with diabetes
Some discover their vocations in school, others job-hop until they find a passion and still others are content to just punch the clock for a paycheck. But some seem truly destined for their profession, like Dr. Thomas Grace, 41, of the Blanchard Valley Diabetes Center in Findlay, Ohio, and Dexcom’s newly named Head of Clinical Advocacy and Outcomes.
“Something I say frequently about diabetes is that I live it, eat it, breathe it, sleep it, teach it and preach it,” Tom said. “My wife once asked me why someone who has diabetes like me would want to muddle in it 24 hours a day, seven days a week. I didn’t really understand why that would be something people didn’t want to do. Many people look at diabetes as a curse. I look at it as a blessing, because it’s taking me to the path where I’m at in my career right now. We now live in a time where diabetes is no longer scary, as we know so much more than we did 100 or 50 or even 10 years ago. We have the ability to see our glucose in real time and make adjustments on the fly. Diabetes is something we can live with, not be afraid of.”
The life-long diabetes journey begins
That path began nearly 40 years ago during a road trip from a wedding in Michigan back home to Florida. A drive that should normally take a day or so turned into a four-day ordeal for the three-year-old Tom and his parents, who stopped at several hospitals along the way to find help for him for what they thought might be a virus. When they arrived in Florida, the long trip’s final hospital visit revealed Tom had lost several pounds since Michigan due to Type 1 diabetes.
“That was devastating for my parents, because no one in our family had diabetes,” Tom said. “I must thank them, because I wouldn’t be where I am if they hadn’t done such an amazing and diligent job. It wasn’t until I had children that I finally became appreciative of all the things they must have done and all the sacrifices they must have made to get me and my brother, who also has diabetes, to live so healthily without complications to this day.”
Later, while hospitalized himself, his younger brother was also diagnosed with Type 1. And they have been on a journey together ever since. He estimates that between the two, they have poked their fingers more than 100,000 times. His parents were so diligent, they’d sometimes poke his finger and his brother’s as they slept in the middle of the night just to be sure they were OK. His parents also stayed on top of their diet and ensured they stayed active.
“There were no restrictions in the Grace household when it came to activity or things you could or could not do,” Tom said. “We were expected to live the lives of normal boys, literally play every sport. Diabetes was never an excuse. It held us back from nothing, and it shouldn’t hold back anyone else with diabetes.”
Though grateful he never had issues with severe high blood glucose levels, diabetes did occasionally put a scare into his parents.
“Treats and candies and things like that were never a problem for me,” he said. “I was never hospitalized with Diabetic Ketoacidosis. But on the flip side of that, I was the kid always running low. My mother could probably better tell you about many times she had to call EMS because my blood sugar was too low for her to get control of me.”
A mentor and a vocation emerge
But diabetes also brought into his life a caregiver, mentor and friend – Dr. Fred Whitehouse, an award-wining and influential doctor and diabetes expert who took care of Tom after he and his family moved to Detroit.
“More than a doctor, he was a friend to me,” Tom said. “He came to my football and baseball games in high school, my high school graduation, my college graduation, my wedding and my medical school graduation. Going to a visit with him was never something I was fearful of. Diabetes is a disease where there’s a lot of judgment passed around, and no judgment ever passed in his office. I’ve taken what I learned from him and employed it my own practice. My office is literally what I call a ‘judgment-free zone.’”
Tom got his undergraduate degree at the University of Michigan, earned his medical degree at the American University of the Caribbean and then did his medical rotations in Detroit. After residency, Tom worked in the Blanchard Valley Hospital and grew frustrated seeing young kids repeatedly bounce in and out of the intensive care unit with Type 1 diabetes and diabetic ketoacidosis.
“For better or worse, I opened up a little bit of clinic time to try and help the young kids stay out of the ICU, which worked, and that blossomed into a full-time practice,” he said.
His patients would certainly argue it’s for the better. After all, who better to treat patients with diabetes than a doctor who has successfully managed his own diabetes for most of his life?
“I have empathy for my patients in the clinic and understand their problems, and I can better help them on their journey with diabetes,” he said. “But as much as we want to talk about how cheery and awesome things are, there are days that aren’t good. You’re going to have bad days here and there, and I can’t ever be without those. It’s something I must be mindful of 24/7, 365. You don’t get days off from diabetes.”
Dexcom makes a difference
Having not had a day off since he was three years old, Tom has experienced 38 years of evolutions in diabetes treatments and technologies. His life, and ultimately his patients’, changed when a Dexcom representative visited his office about six years ago. He had tried other continuous glucose monitoring (CGM) systems with varying degrees of comfort and success and was skeptical about the technology.
“I told her, ‘Please take that out of my office, I’ve worn these before,’” he said. “She spent a few minutes explaining to me, ‘No, this product’s different. You won’t have to poke your finger anymore.†’”
†Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings.
†Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings.
He wore the Dexcom CGM for the next 10 days trying to prove her wrong. “I was poking my finger at least 10 times a day to prove it wrong,” Tom said.
“I was literally tearful at the end when I was taking it off for the first time, and I said, ‘Well, I can’t wait until tomorrow in clinic when I put this on every single patient,’” Tom said. “And I’ve been on that path since that time trying to get every single patient on continuous glucose monitoring, because I saw immediately how beneficial it was to be able to see your glucose readings in real time.”
But he quickly discovered some insurance providers didn’t cover CGM.
“So, I’ve been on this mission to try and get others to understand this isn’t a medical cost – it’s a savings,” he said. “It’s a long play in the improvement of patients’ health and lifestyles, specifically those with Type 2.”
Image shown does not include required overpatch. Please be sure to follow instructions for using the overpatch.
Luckily for his patients, Ohio Medicaid covers CGM for those who have Type 2, regardless of what medications they are on. Tom now wants everyone who has diabetes to have that same access – no matter which state they live in – because he has seen firsthand how Dexcom CGM changes lives, including his own.
“Having worn one myself for six years and seeing what happens when I have behavior X, Y and Z, I can help patients through things they’re doing right,” he said. “I can reinforce all the things they’re doing right and help them redirect when needed. The power of this tool is that it gives the patients the power to take control of their disease.”
Dexcom CGM also offers more context and real-time information that helps doctors better care for patients and inspires patients to better care for themselves.
“When I just have an A1C reading, it’s difficult to make treatment changes, especially on patients using insulin,” Tom said. “I get a lot of the patients in my area who are not well-controlled and have not been well-controlled for a long period of time, and this device is making an unbelievable impact with how they can now see what’s happening in the background. That makes them much more eager and able to take care of it themselves.”
When his patients can take medications and feel confident because they can see what happens after they take them, they’re more apt to stay adherent to their medication protocols, he explained.
Already a Dexcom user and prescriber, Tom recently joined the company to help in any way he can help further patient access to this life saving technology. Access has long been a focus for Dexcom. Dexcom CGM is already available in more than 50 countries, and with recent expansions to Medicare coverage*, Dexcom CGM systems are accessible to an estimated 6 million additional people with all types of diabetes in the past year alone.
“Before I die, I’ll be in a happy spot if everyone with diabetes has a continuous glucose monitor,” Tom said. “I thought that would take weeks or months when I first put on my Dexcom CGM – we’re at least six years since then. It’s a long road, but I’m willing to walk down it with my fellow people with diabetes to help them garner better access.”
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*Medicare covers Dexcom CGM for patients who meet the Medicare coverage criteria. For the full list of Medicare coverage criteria, visit the Centers for Medicare and Medicaid services website.
BRIEF SAFETY STATEMENT: Failure to use the Dexcom Continuous Glucose Monitoring System and its components according to the instructions for use provided with your device and available at https://www.dexcom.com/safety-information and to properly consider all indications, contraindications, warnings, precautions, and cautions in those instructions for use may result in you missing a severe hypoglycemia (low blood glucose) or hyperglycemia (high blood glucose) occurrence and/or making a treatment decision that may result in injury. If your glucose alerts and readings from the Dexcom CGM do not match symptoms, use a blood glucose meter to make diabetes treatment decisions. Seek medical advice and attention when appropriate, including for any medical emergency.
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