CGMS and THE PUMP a NEED FOR NEW UNITS?

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Willie

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Type 1
Given technology enhancements are proceeding apace should we develop units which better inform the user of the system and indeed clinicians.

Rather than merely reporting the % on target or the % off target, should the systems not seek to quantify the extent to which you have been above target and perhaps to a lesser extent below.

From that perspective can we take a lesson from our use of electricity and our adoption of KWH’s and adopt MmolH’s to depict the extent to which our sugars are above target and the duration they were above target. Having briefly had access to CGMS I feel that this would help me and probably others.

Regards low sugars I feel that the current reports from the systems seem fine, because from my perspective a hypo is a hypo.

What do others think?

I think we diabetics should drive forward information and product enhancements to a far greater extent because that will ultimately make them much more user friendly and more productive.
 
Welcome to the forum Willie.

When I download my data from my Libre I am interested in the graph showing the results in percentiles, which then shows me how I am diong for 50 % of the time but also shows me any outliers hour by hour. I can easily pick out the spikes that I have had with meals out, but also see the general pattern. On this graph I can also pick up the frequency of my swiping (I know on a CGm you don’t have this issue). The other graph I use is the box and whisker plot showing similar info but grouped by different time intervals.

On a day to day basis the graph shows me any spikes and blips I have had and helps me know more about foods I eat or need to avoid.
 
Welcome to the forum @Willie, I can't agree with you as have no idea what you are on about :D
 
Hi Willie, and welcome to the forum. Like SB, I find the graphs on my Libre print out the most useful thing. A trace like the Himalayas is bad news, gently rolling Cotswolds is better! I admit that for the purposes of quantifying the peaks and troughs for possible recording in computerised GP notes, this is probably not enough.
One of the first books I read after diagnosis was 'Think like a Pancreas' and I seem to remember the author talking about spikes, and the 'area under the curve' being the most important data, because it showed how high and for how long. (This reminds me of calculus at school) maybe we need to quantify something like that.
 
Welcome Willie. I hope you will find us a friendly and caring lot.

If I understand you correctly, I think you are talking about "time in target range" as being a more meaningful indicator of control rather than simply the number of highs and lows. I seem to be seeing this as a trending topic these days, although I haven't given it much thought yet. I have even seen the suggestion that it might be more useful than our Hba1c checks. It is, of course, predicated on the patient having CGM all the time, and for most that is unobtainable until costs fall dramatically. As you say though, the pace of technology is so great that universal CGM may be just around the corner. The advent of Libre has certainly generated some competitive responses from Dexcom and Medtronic.
 
I currently use the Libre and agree that the graphs are very useful as I am a visual person.

That said I think that whether it’s CGMS or Flash monitoring they now harvest data rich information which can be displayed in new innovative manners to help all of us.

The use of units something like Mmol Hours might be one such an example.
 
Yes Mmol Hours would be the area below the curve.

Seems like a more sophisticated unit for a data rich age?
 
Couldn’t agree more it is the future and the frustrating thing is that the future is here and now yet not enough Diabetics are being offered that form of treatment. Quite apart from the medical savings it will offer in the long term the positive economic impact that it offers people via a more dynamic and unfettered life shouldn’t be underestimated either.
 
When they download my meter which also downloads the pump since they communicate with each other by Bluetooth - the graphs produced by the software show you and them exactly what you are on about without the necessity of inventing something else.

Don't all pumps do this?
 
trophywench said:
When they download my meter which also downloads the pump since they communicate with each other by Bluetooth - the graphs produced by the software show you and them exactly what you are on about without the necessity of inventing something else.

Don't all pumps do this?
Click to expand...
To tell you the truth I have no idea, I've never had my pump downloaded or my meter read by anyone 🙂
 
Welcome to the forum @Willie 🙂. I can`t really comment as I have
neither libre or pump :(.
 
The graphs are great I use them all the time and intuitively review the area between my actual performance and my target.

What I am saying though is that if the CGMS or Flash system also gave you a MMol Hours figure for a 7 day, 30 day and 90 day period say (averaged per day), it would be a really good indicator of how you were managing to minimise the impact of readings above target over both a short and longer period of time.
 
I don’t think I’ve ever understood KWh in those terms myself.

For BG measures, the most useful I find in general ‘overview’ terms are: median (not mean) BG alongside Standard Deviation (how closely grouped or widely scattered the collection of results are). Time in range with percentages above and below range are also very helpful to me - and I think coupled with SD that most CGM seem to offer may give you what you are looking for.

Like others I also find AGP a *very* useful way of condensing multiple days to a more workable story. I wish there was an easy way of emulating that from a lower density selection of fingerstick BG results really.
 
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