Proof that sensors and sensor pumps work fantastically

[bigpurpleduck]

I want my CGM full-time.

I know there's next to no chance of it happening, given how terrible funding for pumps is in Scotland, but I'm going to chat to DSN about it.

Seeing the trends overnight in particular is brilliant. And by setting the pump to alarm if it predicts I will hypo within 15 minutes, I sleep far better and don't need to set alarms to get up & check unless I'm doing a basal test.

My only criticism is that it's not terribly comfortable to wear. Small price to pay!

 

[Adrienne]

I wouldn't say it's useless to use perodically...

Don't forget as parents you are seeing it form a 3rd party point of view...I don't think that makes a difference, if anything it gives us more objective as we are on the outside looking in so to speak

As we all know some of our diabetic management is purely base on a 'stab in the dark judgement based on past experience' which for me is fine as I'm privy to a lot more information, when I take my dogs out for their daily exercise, I know roughly what sort of intensity the exercise is going to be, and after the event, whether it was more or less intence than usual! A child can say yes or no to whether they've had a game of footie at playtime, but can't tell you whether it was more or less intense than usual! How does a parent equate for that in their calculations! Out of interest why are you privy to a lot more information? We all know our kids and what they mean and what they say. By using a CGMS we can make decisions on that as well as what we are told or what we have seen, we do not need to be feeling it. You can see from the download that I can do all this without being the person with diabetes and that cannot be disputed.

Same as illness, if I'm coming down with a stomach bug I get a warning for probably a good few hours before hand, wishy washy stomach feel, feeling off colour, kids have a nasty habit of being fine one minute and throwing up the next without prewarning, as they don't associate that wishy washing feeling with a stomach bug/illness.. Generally, at least with my daughter and others on the cwd the blood sugars start doing odd things a day or two before an illness can kick in including a stomach bug so we generally know what is going to happen. Levels can continuously be high and no amount of insulin lowers it and normally an illness will kick in like a temperature or whatever. If sickness bug then lots of hypos or fighting to keep levels off hypo generally means coming down with the dreaded sickness and diarrhoea (can't spell that). Plus they can tell us themselves if they are feeling ill, Jessica does and always has done.

So for a parent/child a CGM is almost a must, a very useful management tool enabling the parent to keep on top of things with short term and long term management..

Adults are different, we have a lot of imformation to hand that parents don't have and we don't change as quickly as children do, so the information we gain from even periodic use has many benefits for us and our management..Sorry disagree, you can glean so much more from CGMS inbetween your tests and trends. You personally may not need it but I know some adults do on here without a doubt. There is easy to control diabetes and at the other end of the scale, very hard to control diabetes and this all occurs in adults as well as children.

Chrismbee

I know what you mean that medical technology doesn't fall in price as quickly as general technology... There are several reasons

More expensive to get through licencing regulations involved..
And they can be made to withdraw the product a lot easier and quicker if found faulty in any shape or manner

Smaller customer base..

And yes you are right there is a percentage added to medical products, wheather they are medication or medical aid based which is totally unfair...

Take items such as none spill beakers in a residential care setting, almost identical to a Tommy Tippee beaker for a child but without the cute little pictures! But costing 3 to 4 times as much!

Answers above in blue. 🙂

 

[SilentAssassin1642]

Hiya

NICE hasn't been updated since 2004 but there is a new position statement here :


http://www.technologyadoptioncentre...1276787962_ABCD_position_statement_on_CGM.pdf

It was produced in 2010 and has helped a few people get CGMS

The still says this :

Continuous glucose monitoring systems have a role in the assessment of glucose B profiles in adults with consistent glucose control problems on insulin therapy, notably:
● repeated hyper- or hypoglycaemia at the same time of day
● hypoglycaemia unawareness, unresponsive to conventional insulin dose adjustment.

This needs updating big time as there was not sensor pumps in 2004 and only antiquated CMGS. It has advanced hugely.

The position statement helps more.

CGM's aren't yet NICE approved we were told that on the input training day, but input are working on it, because they're ace like that

 

[Adrienne]

CGM's aren't yet NICE approved we were told that on the input training day, but input are working on it, because they're ace like that

Unfortunately they are out of date and need updating all the NICE says is what I quoted. The position statement could help a bit. It has certainly helped one person I know get fully funded sensors.

 

[Ellie Jones]

I checked NICE website there isn't any mention of GCM mention anywhere, I even looke for CGM 15, no mention of it at all either in appraisal's being worked on..

INPUT are very much up to date where NICE are concerned at they play a part in the appriasal process, and will take part in the pump therapy review that started last month.. And it was down to INPUT that we've got Guidelines for insulin pumps...

Adriene I will answer you and Bev's comment concerning me in a separate post..

 

[Adrienne]

I checked NICE website there isn't any mention of GCM mention anywhere, I even looke for CGM 15, no mention of it at all either in appraisal's being worked on..

INPUT are very much up to date where NICE are concerned at they play a part in the appriasal process, and will take part in the pump therapy review that started last month.. And it was down to INPUT that we've got Guidelines for insulin pumps...

Adriene I will answer you and Bev's comment concerning me in a separate post..

I got this from the NICE guidance, I haven't made it up, the latest one but very out of date, 2004 and this is what it says :

Continuous glucose monitoring systems have a role in the assessment of glucose B profiles in adults with consistent glucose control problems on insulin therapy, notably:
● repeated hyper- or hypoglycaemia at the same time of day
● hypoglycaemia unawareness, unresponsive to conventional insulin dose adjustment.

As Mike said NICE doesn't recognise it yet as a stand alone treatment but in some cases it fits the criteria above to have a CGMS to see what is going on. We had one twice when my daughter was little for a week each time and it picked up lots of hypos overnight.

I do know about INPUT. I know two of them quite well. I received an award for my services to others from DUK a few years back now, I came third and John came first and that is where I first met him. I am sitting on a panel soon with Lesley.

 

[heasandford]

Don't get me wrong, I'm not disputing the pumps benefits/advantages, and I'll often recommend them to others. In terms of flexibility of delivery there are major advantages. It wouldn't surprise me if I end up pumping at some point, but a CGM? I'd take a consultant's arm off right now. Knowing spot-check BG level information is all very well, but adding in direction of change AND rate of change... Suddenly that's three times the info to work with!

Can I just belatedly add, I can't agree more! No chemical plant would run without all this feedback and we're expected to! I complained about this when I was diagnosed nearly 11 years ago and have been fobbed of ever since - actually tried to ignore it until I came on here. Can we campaign for this Mike??

 

[Adrienne]

Hiya

You could always contact INPUT and ask them how best to get involved and help with a campaign or start one. They may have some good ideas. I know I would join in.

🙂

 

[heasandford]

Just looked on their site, maybe I should - but not this week! (I know, but I am away visiting my mum 300 miles away)
On a different note, there was a report from a pumper talking about exercise and saying she used a fat-burning zone to prevent her going hypo - what's that about? Haa anyone ever heard of this?

I use a training program based on my VO2-max test results to stay in a fat-burning zone for most of my workout. Using fat as my main fuel prevents exercise-induced hypos and is very effective for weight control. My glucose level either stays steady or goes down just slightly during my workout.

 

[Ergates]

I'm not sure that works for me. Although I don't burn through carbs as quick when I stay in the fat burning zone, my insulin sensitivity still keeps increasing.

 

[Adrienne]

I use a training program based on my VO2-max test results to stay in a fat-burning zone for most of my workout. Using fat as my main fuel prevents exercise-induced hypos and is very effective for weight control. My glucose level either stays steady or goes down just slightly during my workout.


No idea. It sounds like that she goes to the gym maybe and instead of getting to her cardio work out level, or aerobic level she stays in fat burning zone (no idea where that is mind you).

It sounds like the Atkins diet based on fat and no carbs. The Atkins is protein and fat so have cream in your coffee and fry foods with oil or butter etc. You burn the fat off. However its not a great way to do it as you need to eat carbs to burn them off as it is harder to burn off the protein which gets stored where it shouldn't. Or rather that is what my personal trainer told me in my language 🙂

Or I'm talking complete and utter ....... (fill in your own word here) 🙂

 

[Ergates]

The "fat-burning zone" just means low intensity exercise, basically exercising whilst you're capable of holding a normal conversation without getting out of breath. It's nothing to do with the Atkins diet, and instead relates to how your body burns available fuel. The higher the intensity, the more glucose your muscles need, and the lower the proportion of fat used.

 

[Adrienne]

The "fat-burning zone" just means low intensity exercise, basically exercising whilst you're capable of holding a normal conversation without getting out of breath. It's nothing to do with the Atkins diet, and instead relates to how your body burns available fuel. The higher the intensity, the more glucose your muscles need, and the lower the proportion of fat used.

Hahaha sorry I didn't mean the fat burning zone was part of the Atkins, just that the eating fat bit could be, that is what the Atkins was about, eating no carbs but you have to have fat.

Thanks for the info about the fat burning zone though, didn't know that. The cardio zone is a flipping nightmare and I can talk although I try my damned hardest, not a lot can make me shut up, as people can probably tell by my posts 😉

 

[heasandford]

The "fat-burning zone" just means low intensity exercise, basically exercising whilst you're capable of holding a normal conversation without getting out of breath. It's nothing to do with the Atkins diet, and instead relates to how your body burns available fuel. The higher the intensity, the more glucose your muscles need, and the lower the proportion of fat used.

I thought if you had diabetes you could get ketoacidosis when only burning fat (- I am so confused!)

 

[Adrienne]

I can't answer that one at all, maybe someone else can but back to the Atkins, it is not recommended for diabetics obviously and you do have to test your ketones. They are more starvation ketones I would think.

I frequently had ketones when I was on the Atkins and also on the Lighterlife diet. I had to test weekly and the more ketones the more weight I lost but I was only on 450 cals per day. Not great idea for anyone with diabetes at all.

 

[Northerner]

I thought if you had diabetes you could get ketoacidosis when only burning fat (- I am so confused!)

DKA is only a risk if you do not have sufficient insulin circulating when burning fat. Burning fat produces ketones, but insulin helps process these out of the body. Where there is insufficient insulin levels of both glucose and ketones will rise unless corrected with additional insulin. 🙂

 

[heasandford]

DKA is only a risk if you do not have sufficient insulin circulating when burning fat. Burning fat produces ketones, but insulin helps process these out of the body. Where there is insufficient insulin levels of both glucose and ketones will rise unless corrected with additional insulin. 🙂

I suppose I thought that if there was insulin about, glucose was always the first target so you couldn't burn fat until all that was already used up? Doesn't the liver process fat into glucose to replenish its stores? - think I need to remember all those metabolic pathways!

(sorry I've rejoined this, away for a day, but this has caught my attention now from an academic but possibly useful point of view!)

 

[Ergates]

AFAIK your body will burn all three fuel sources simultaneously - protein, fat, and carbs. The proportions used change considerably with intensity of exercise. Protein is always a small proportion, something like 5% and under IIRC.