Wednesday, 6 May 2015

Why do I want a CGM ?

CGM = Continuous Glucose Monitor

Imagine you are flying a plane in the dark with only an altimeter to provide you information about the height above ground of the aircraft. You don't have any instrument that can tell you the rate of climb/descent. During your entire flight, you can only look at your altimeter 5-6 times... and you don't have an auto-pilot system that will maintain altitude. Seems like a nightmare ? Probably very difficult to safely guide the plane to your destination. Each time you have a look at the altimeter, you will have to try and guess how to correct. You might get a desired height above ground reading, but maybe you are descending rapidly ? or climbing ? or flying level ?? This scenario compares well with how a T1D has to manage glucose levels with only a BG meter. Test strips are expensive and limited, if you use more than 5-6 a day you will quickly deplete your monthly supply.

So, here goes a list of CGM benefits:
  • Continuous readings, every X minutes. No more limited to 5-6 a day. You can check the altimeter constantly.
  • Rate of change information available. No more guessing if we are climbing or descending.
  • Warning of going too low or getting too high. This can avoid a lot of hypo's and prevent the aircraft from crashing. 
  • Much better glucose control, will improve A1C a lot. ETA much sooner, flying in a straight line is faster than going up and down all the time. Thus, reduction in long-term damage / side-effects.
  • You can show the people that don't have T1D what certain foods actually do to BG levels.
  • It's cool technology!
  • If I happen to be hospitalized for whatever reason, the CGM will help keeping track of my BG levels... Sorry, but I just don't trust the hospital staff to care for my BG levels. When I was hospitalized due to a broken jaw in 2012, the nurse just could not understand why I wanted to check my BG level every 1-2 hours..
  • Physical exercise! Well, it gets very difficult to track your BG and avoid hypo's during and after exercise with only a BG meter. CGM should help tremendously.
  • My family will feel a lot more relaxed when I'm alone or travelling with a CGM. The CGM will be my sugar buddy, alerting me when getting close to a hypo.
  • Big Data ! Collecting data every day will allow me to train some deep neural networks on the data, it might be able to predict my future BG levels and reduce the latency issue that CGM's have.
Although the FreeStyle Libre is not really a CGM because you need to scan the sensor, I still see it as very close to a CGM, you just don't get the warning/alarm signals that the Dexcom will give you.

So, why don't I have one yet ?
  • Difficult to get them in South-Africa.
  • The postal service is .... not working ..... difficult to actually get one in your hands even if you try to import one.
  • The device is expensive, the sensors are expensive as well.

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