What's after CGM?

I have yet to take the CGM leap, because I think that they designs and technology can be greatly improved. Oh, and there’s the insurance issue too.

For those of you that have them…have you seen great results in your A1C?

I found an image of a pump that I wore for a little while back in the early eighties. It begs the question, “What is the next leap in technology?”
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Well since the CGM is not working out so well for me, I hope the next thing happens quickly. I am hopeful the implantable monitors are made available soon and that they work better than what we have. today. Mine just will not catch the majority of the lows, and it is messing me over. Does anyone have a diabetic dog? I have heard of these and am interested, if they work out.

Rick

Rick,

Did a little digging around for service dogs for diabetics. Here are some resources I found:

http://www.dogs4diabetics.com/

http://www.inch.com/~dogs/service.html

http://www.allpurposecanines.com/alert.html

http://www.heavenscentpaws.com/site/index.htm

I’ve been on the pump and the CGM from Minimed for about a year now and I love it. I’m hypo ad hyper unaware until I get almost out of control so having the CGM to warn me once my BGs get above or below my settings has been a life saver. Also, being able to see the trends has allowed me to fine tune my basal rates. In one year, my A1c has gone from 10 to 6.7. Shooting for 6.2 on the next round!

I think that the next “leap” won’t be anything like what we have now. An implantable CGM is really just and extension of today’s technology. Evolutionary not Revolutionary. I have no ideas, but we are in the infant stages of what could be truly amazing.

Justin

I am curious to know the answer to your question. I was on the CGM bandwagon but I am not sure I want to get one. We’ll see what happens.

Cherise

I was so hoping that when the glucowatch came out that it would work, that seemed so promising and easy to use.

I saw an olymipic swimmer on a show and she had a watch like apparatus that told her what her heart rate was and the calories she burned.

Why can’t it work for our bgs??

My A1C went from 6.9 to 6.1 the first three months after I started using the Medtronic CGM with my pump.

I love it and highly recommend it.

Hi. I have been wearing a CGM, Dexcm 7, for about 3 months now. It’s annoying, loud and obnoxious but I love it. haha! I have stayed steady at a 6.8 for my past 3 A1C’s. Can’t beat that. I love not pricking my fingers. I love knowing what my bs is at any given moment. It takes some getting used to and I haven’t had a good nights sleep since wearing it, but it is a life saver.

I agree that it can be significantly improved, just as the pump could be. But…what’s a little discomfort to a Diabetic? Good luck! :slight_smile:

Continuous whole blood glucose testing, I’d wager. It might be accurate and quick enough to allow for a closed loop pump system, in theory. There are other hurdles with that though (infusion of glucagon primarily).

Wha ! Now I know I’m completely thick, what is "whole bl. glucose testing ", don’t they do that at the moment. I also don’t understand the infusion of glucagon, is that what you guys have at the moment with CGMS. I think I need to read up on this a bit more. I don’t know if I’d be ready to know my blds the whole time, wouldn’t we keep correcting them the whole time not giving ourselves a chance to let things settle. I am not even making sense to myself, but I think my hba woud need to be really good before I could use this.

Whole blood testing is what your meter does. The CGMS measures glucose in what is called interstitial fluid just under the skin. Whole blood testing is more accurate and the only accepted standard for figuring out a dose of insulin.

One problem a closed-loop pump or “artificial pancreas” would have is raising blood glucose. The islet cells do this by secreting glucagon in response to low bloog glucose levels, but a pump cannot infuse glucagon and insulin through the same infusion set. So you would need an additional infusion set for the glucagon. Glucagon also needs to be stored at much lower temperatures. Injecting it often causes headaches, nausea, and other feelings of malaise.

if you’re truly a good candidate for it, the insurance issues are few if any. I have hypo unawareness and get seizures in my sleep a lot so I had absolutely no problem getting approved for it. It has helped tremendously… I feel naked without it! I believe the next advances in this area will be something you can blow into that measures your BG - I saw this somewhere once… some guy was working on it. Then there’s the next form of insulin delivery - being able to inhale it! I just don’t understand why there is no cure yet. Was anyone else told, when they were first diagnosed, that there would be a cure within the next 5yrs? How frustrating was that?!

I already had good A1c values (5.6-5.7) before CGM (MM 522/RTMS), but I also experienced lots of lows (hypoglycemia unawareness also) due to my aggressive diabetes control behavior. So my primary goal with CGM was to flatten out glucose levels, and have more early warning detection of pending lows (especially) and highs. I’ve been able to accomplish that very effectively with CGM. Interestingly…my A1c is now a tad bit higher than before (6.1, still pretty good), but I don’t mind that at all if I can better avoid the downsides of tight T1 diabetes management!