I’ve been a T1D for 55 years and still going strong. For much of that time, the most wonderful technology was simply having access to insulin - in those early days, Regular before meals and NPH.
More recently the pace of tech improvements has quickened. Insulins are better, but for me the breakthrough was CGM or “continuous” monitoring (actually every 5 minutes, not continuous, but you can’t fault them for their marketing). I love what my Dexcom G6 allows me to do.
The other tech breakthrough is the insulin pump, which my Endo has offered to me, but I have chosen to wait. I get good control using Tresiba every 24 hours – talk ablut FLAT BG levels when fasting!) and Fiasp before meals or as needed. My background is info technology and I love the idea of closed loop systems, but I have chosen not to go with pumps until later.
So I discover from my CGM that I have been having Dawn Effect an hour or two before morning wakeup. Apparently the body has evolved to put out some hormones that have the effect of raising BG levels just before dawn. I suspect I’ve experienced this for most of these 55 years but just didn’t know it until CGM. I asked my Endo if there is a solution short of moving up to a CGM/Pump closed loop solution.
She said people are having success using a combo of insulin and a drug developed to treat T2D. She prescribed Metformin just before bedtime. Since it lowers BG levels somewhat, we dropped my Tresiba by 20%.
Looks like it is a successful solution – if I go to bed in the target BG range, my BG level stays essentially flat all night – no more Dawn Effect.
I do expect to go closed loop with pump someday, but for me, this is a perfect solution for now.