Question for Type 1 Diabetics

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  • DoggyDaddy

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    First, let me say that I'm not diabetic, but I have a question. I keep seeing commercials for these monitoring devices that work through a phone app, like Dexcom, etc.. The claim seems to be that by using them, instead of finger sticks to check glucose levels, that A1C levels drop automatically? How does that work exactly? They literally seem to make that claim. "Since I stopped sticking my finger and using Dexcom (or whatever), my A1C has dropped X points!" :scratch: And to be honest, I don't even know what A1C is, but apparently it's best if it's below 7?
     

    MrSmitty

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    My son was diagnosed at age 2, he's 19 now, the Dexcom has a device that attaches to the skin, with a canula inserted below the skin, that "reads" the Glucose, and sends the info to the PDM, or your Smart phone. The attached part need to be changed every 2-7 days, keeping the area clean and dry. Not sure what A1C stands for except when I was in the Air Force, it stood for Airman 1st Class, as to what it stands for concerning Diabetes, not sure, but my sons recently was 8. The finger still needs sticking at least once a week, for calibration purposes. My son also has a OmniPod insulin delivery device, it has changed his life, due to not having to inject insulin a few times a day, the pod lasts about 2 days, I'm hoping they will come up with a larger capacity reservoir so that it would last longer, they're not cheap..
     

    MCgrease08

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    What Mr. Smitty said.

    I dated a gal for a few months that has a son with type 1. He was diagnosed at something like 20 months old which is super early. Basically the Dexcom tracks blood sugar levels via an app on the phone. Ideally it alerts you if levels rise or drop so you can address that through food, or let you know if you need more insulin. An insulin pod can also be worn on the body and you can use the phone to tell it to release some rather than using the syringe.

    My ex's kid wears the Dexcom on one arm and the insulin pod on the other. It makes managing his levels much easier, but is pretty costly.
     

    Lmo1131

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    Not sure what A1C stands for
    I' prediabetic, so I'm learning too.

    A1C is a blood test for type 2 diabetes and prediabetes. It measures your average blood glucose, or blood sugar, level over the past 3 months. Doctors may use the A1C alone or in combination with other diabetes tests to make a diagnosis. They also use the A1C to see how well you are managing your diabetes.
     

    jkaetz

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    First, let me say that I'm not diabetic, but I have a question. I keep seeing commercials for these monitoring devices that work through a phone app, like Dexcom, etc.. The claim seems to be that by using them, instead of finger sticks to check glucose levels, that A1C levels drop automatically? How does that work exactly? They literally seem to make that claim. "Since I stopped sticking my finger and using Dexcom (or whatever), my A1C has dropped X points!" :scratch: And to be honest, I don't even know what A1C is, but apparently it's best if it's below 7?
    Not diabetic, but the spouse is. Diagnosed at 18 months. A1C as noted is a long term blood sugar average. A non-diabetic will be in the 4 - 5.6 range which should be a blood glucose in the 70 mgdl range. The true CGMs will actively monitor blood glucose levels on an interval and alert if it goes higher or lower than you want. It's not realistic to have a diabetic with a stead 70 mgdl glucose level so they aim for 70 - 120. Staying in that range takes a lot of effort and diligence when eating to dose the proper amount of insulin to counter act the food. This leads them to end up with a higher BG level and A1C. The CGMs will alert when their BG goes out of range prompting them to take insulin and bring it back down. This is how they would help lower an A1C.

    Now here's the part they don't tell you. The monitors are not as accurate as the marketing people would have you believe. They currently only check every five minutes and you can swing from a good range ~100 mgdl to 50 (Anything below 70 is too low and will start to make you act and feel drunk as your blood can no longer get enough oxygen to your brain) mgdl in 10 minutes depending on what's happening. They also try to alert on steep up or down slopes but a BG level could reasonably go from 150 -> 70 quickly and then stop dropping around 70. You will still get an alert because the machine doesn't know if it will stop at 70 or continue to 50 or less. In a best case you get a false alert in the middle of a meeting or while trying to sleep. Worst case you take action and end up bouncing your BG back high again because you overcorrected the other way.

    Ultimately CGMs are a good thing, but they still have lots of room for improvement. And don't confuse the freestyle patch thing with a CGM. It only gives your BG when you touch it and not continuously like Dexcom and Medtronic. Eliminates finger sticks yes and checking more often can help but you won't get alerts for better or worse.
    My son was diagnosed at age 2, he's 19 now, the Dexcom has a device that attaches to the skin, with a canula inserted below the skin, that "reads" the Glucose, and sends the info to the PDM, or your Smart phone. The attached part need to be changed every 2-7 days, keeping the area clean and dry. Not sure what A1C stands for except when I was in the Air Force, it stood for Airman 1st Class, as to what it stands for concerning Diabetes, not sure, but my sons recently was 8. The finger still needs sticking at least once a week, for calibration purposes. My son also has a OmniPod insulin delivery device, it has changed his life, due to not having to inject insulin a few times a day, the pod lasts about 2 days, I'm hoping they will come up with a larger capacity reservoir so that it would last longer, they're not cheap..

    Have him look into Afrezza, an inhaled insulin. My wife has transitioned from a corded medtronic pump -> OmniPod and now -> Afrezza. She got a lot of freedom with the OmniPod and even more with Afrezza as it totally eliminates the need for a pump. Afrezza also has a much quicker rise and fall which more closely mimics the way a normal person's insulin reacts. Now she needs Dexcom to make their sensors more accurate. She is a control freak and closely watches what she eats but her A1C is typically in the low 6s.
     

    Bigtanker

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    My wife has been a type 1 (pancreas quits working and no insulin is made. Type 2 is a resistance to insulin from the body) since she was 10. She has been on an insulin pump for about 15 years and CGM (continuous glucose monitor) for several years. It does help her catch big swings in her B.G. If she starts dropping low, it can shut off her insulin. It will notify her if it's.going high but she has to check with a finger stick and tell the system it's ok to deliver insulin.

    But is still takes a LOT of work to keep her B.G. under control.

    I do believe the next big leap the pharm. companies are planning is a closed loop system. Basically an artificial, external pancreas. The CGM will be in constant contact with the pump and adjust insulin as needed. They say they are close but with the liability they take on, if something goes bad, I think it will be quite a while before they actually release it.

    She will be upgrading in the next few months. She has been with Medtronic for the entirety of the insulin pump/CGM path as they were really the only game in town when she started. Their customer service has been atrocious over the years. The stunts they've pulled to get the newest and "best" equipment have been almost unforgivable to us. Her brother has been with the Dexcom brand for a year or so and he really likes it.
     

    DoggyDaddy

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    Thanks everyone. So essentially, the monitors are just a tool to help manage glucose levels, which then helps the person to keep their average levels (A1C) in a better range. I thought the claims of the monitor folks were that the monitors in and of themselves did something to bring down A1C numbers. That makes much more sense than what I thought. In other words, there's nothing "magical" about the monitors... they're just an improved tool to monitor what was already being monitored with finger sticks.
     

    HoughMade

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    My wife has been a type 1 (pancreas quits working and no insulin is made. Type 2 is a resistance to insulin from the body) since she was 10. She has been on an insulin pump for about 15 years and CGM (continuous glucose monitor) for several years. It does help her catch big swings in her B.G. If she starts dropping low, it can shut off her insulin. It will notify her if it's.going high but she has to check with a finger stick and tell the system it's ok to deliver insulin.

    But is still takes a LOT of work to keep her B.G. under control.

    I do believe the next big leap the pharm. companies are planning is a closed loop system. Basically an artificial, external pancreas. The CGM will be in constant contact with the pump and adjust insulin as needed. They say they are close but with the liability they take on, if something goes bad, I think it will be quite a while before they actually release it.

    She will be upgrading in the next few months. She has been with Medtronic for the entirety of the insulin pump/CGM path as they were really the only game in town when she started. Their customer service has been atrocious over the years. The stunts they've pulled to get the newest and "best" equipment have been almost unforgivable to us. Her brother has been with the Dexcom brand for a year or so and he really likes it.
    Hope everything works out for her!

    Some of the early pioneering work in instant monitoring, insulin pumps and the "artificial pancreas" was done at Miles Laboratories, an Elkhart, Indiana biotech company which has since been bought up (by Bayer) and no longer exists. My Dad spent his second career as an engineer there. It has taken a long time for the technology to get fast enough and small enough to make these things a reality, but I'm, proud to say my Dad had a small part in making it possible...and as a lawyer, I supply evidence:


     

    hoosierdoc

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    Eversense by Senseonics is the most accurate, and it's impmantable under the skin. Waiting on 180-day FDA approval now.

    Amazing tech. They will start 365-day trial once approval of 180-day is done


    Disclosure: i am an investor
     

    MrSmitty

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    A few years ago there was a university in Canada, that transplanted the Islets Of Langerhans (they produce insulin) and it allowed a type 1 diabetic to be independent of insulin shots, it was called the Edmonton Protocol...the down side is the recipient is on anti-rejection meds......2 steps forward, 3 steps back....
     
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