In the last 28 years of living with type I diabetes, I’ve lived through a progression of treatment technologies. When I was diagnosed at the age of 11 in 1986, my parents were handed a couple bottles of insulin, a box of syringes, a vial of glucose testing strips, and a prescribed diet of an exact number of bread, protein, fat, and fruit exchanges to be eaten at each meal and snack. For the rest of my life.

Back then, I’d lance my finger and place a huge drop of blood on a long strip pulled from a tall white vial. Wait 60 seconds. Wipe the blood off. Wait another 60 seconds. Then I’d compare the color at the end of the strip with the range of blues on the bottle to get a general idea of what my blood sugar was, two minutes ago. The colors ranged from that of a robin’s egg (too low) to the blue of a summer’s sky (just right) to dark cobalt (far too high).

Electronic blood glucose meters became available a few years after my diagnosis, and I received my first one in 1990. They offered far more precise blood glucose readings in much less time than the old visual strips. While the size of these fingerstick meters has shrunk considerably (my first meter was the size of a large portable hard drive and the one I use now is shaped like a snack-size candy bar) their function hasn’t changed much in the past 25 years.

My current fingerstick meter sucks a miniscule drop of blood from the tip of a finger and spits my blood glucose number back at me in 5 seconds. I very rarely give myself a shot with a syringe these days. I have a constant stream of insulin infused in my hip via my insulin pump, which looks a lot like an old fashioned pager. I can pop in my current blood sugar number and the amount of carbohydrates I’m eating and the pump will calculate the precise dose of insulin to give, to keep my numbers in the right range.

That’s the theory anyway. In reality there are tens if not hundreds of factors that make my blood sugar rise and fall on a moment by moment basis. The weather. Lack of sleep. Exercise. Lack of exercise. A cold coming on. Stress. My period. For all these reasons, I’m grateful for the latest diabetes technology: the continuous glucose monitoring system.

Via a teensy wire inserted in my side with a plastic transmitter stuck on top, I get a blood sugar reading every five minutes on a handheld receiver that looks like an mp3 player. I can view a graph for the previous three, six, or 24 hours that shows how my number is trending: steady, up, down. Arrows too, if it’s rising or falling at an unnerving clip. It even emits a piercing alarm if my number rises above my set threshold, or below it.

I still use my handheld glucose meter, as CGM readings can lag slightly behind blood values and the device needs to be calibrated twice a day with a fingerstick reading. But I’ve come to depend on the little device that lives in my pocket in my attempts to keep my blood sugar in the right range and avoid both high and low blood sugar—the results of which can be the destruction of blood vessels, nerves and tissues, and death, respectively.