Discover and read the best of Twitter Threads about #CGM

Karl Nadolsky

@DrKarlNadolsky

12-week, open-label, randomized controlled trial. 126 participants with type 2 #diabetes (just 27% on basal insulin) were randomized 1:1 to either the intervention group (structured education + #CGM) or the control group (standard care with blood glucose monitoring).

The Self-Evaluation Of Unhealthy foods by Looking at postprandial glucose (SEOUL) algorithm was developed and applied to aid structured education in guiding patients to follow healthy eating behavior depending on the postprandial glycemic response.

Those assigned to CGM achieved average of 0.5% HbA1c reduction just by modifying their dietary behavior.
Diabetes Care 2022;45(10):2224–2230
doi.org/10.2337/dc22-0…

Read 3 tweets

Tim Street

@Tims_Pants

If you're in #Lomdon and have #T1D, you may be interested in this thread. It outlines the @NHSLdn_CN for Diabetes pan-London plan for #cgm access.

There are three linked documents and some commentary.

#GBDoc

/1

The first document is the written pathway, that outlines the suggested implementation of NG17 across London:

england.nhs.uk/london/wp-cont…

#CGM
#GBDoc
/2

The second document is a list of systems, split into three lists.

List 1 is the "specialist rtCGM" that needs your clinic involvement.

List 2 is FP10 (on prescription) rtCGM.

List 3 is FP10 isCGM (scanned).

england.nhs.uk/london/wp-cont…

#CGM
#GBDoc
/3

Read 10 tweets

Nat’s Pancreas 404 🐝 #COVIDisAirborne

@1derfultype

Digitalization in Diabetes Education and Care:
'We know that autoimmunity starts way before #T1D diagnosis - if screened. We learnt that #cpeptide might not be relevant thanks to models'
-Dr A. Galderisi

#ISPAD #ISPAD2022 #dedoc°voices
#patientvoice #payitforward @dedocORG 1/n

Digitalization in Diabetes Education and Care:
'We can find heterogeneity in #T1D even before diagnosis. Important to individualise treatment.'-Dr A. Galderisi

Yes, every #PwD has their own #diabetes.

#ISPAD #ISPAD2022 #dedoc°voices
#nothingaboutuswithoutus @dedocORG 2/n

Digitalization in #diabetes Education and Care:
'#TIR and #BG daily variability matter though we still look at the big picture. #AI can help us understand further.'
-Dr A. Galderisi

#ISPAD #ISPAD2022 #dedoc°voices
#patientvoice #payitforward @dedocORG 3/n

Read 6 tweets

Nat’s Pancreas 404 🐝 #COVIDisAirborne

@1derfultype

Are we becoming robots? #AID systems for everyone with #T1D:

'#CGM is the Archimedean point of #diabetes technology. This is when the idea of closing the loop really emerged.'
-Moshe Phillip

#EASD2022 #dedoc°voices #nothingaboutuswithoutus @EASDnews @dedocORG 1/n

Are we becoming robots? #AID systems for everyone with #T1D:

'#CGM opened our eyes to the fact that the data we used to get was very different from the reality #PwD live.'
-Moshe Phillip

So true. Connecting the red dots' never been our reality.

#EASD2022 #dedoc° @dedocORG 2/n

Are we becoming robots? #AID systems for everyone with #T1D:

'I'd like to convince you they are efficient. Automated Insulin Delivery is safe and efficient.'
-Moshe Phillip

#EASD2022 #dedoc°voices #nothingaboutuswithoutus @EASDnews @dedocORG 2/n

Read 6 tweets

Carrie Diulus, M.D., FAAOS

@cadiulus

via @NYTimes
nytimes.com/2022/08/09/hea…

I have not watched this documentary yet. As someone who lives w/ #Type1Diabetes I have a few immediate thoughts based on this article.

If I had a dollar for every “expert” in the field who told me it would be 5 years until there is a cure…

Some of you are reading this right now.

You were wrong & are still wrong. And as the article brings up it is psychologically exhausting & harmful. Stop.

T1 & T2 diabetes are very different diseases.

They can coexist.

Pathophysiology of both is complex.

I have lost close friends & family to complications of both types. Including my sister. I am now raising her kids.

T1 is far less common & many wish it had a different name.

Read 14 tweets

Lissa Bauer

@lissabauer

Starting day 2 #AACE2022 with @ArchanaSadhu talking to us about #diabetes technologies in 2022 #endotwitter

Look how far we have come in #diabetes technology and there is still a lot more to go #AACE2022. #CGM technology has been a game changer and the accuracy continues to improve with each generation

So what's new in the pipeline for #diabetes technology? Let me tell you starting with #dexcom G7. It will be smaller with a better MARD, better warm up and ALL-IN-ONE applicator and transmitter! Just pending FDA review #AACE2022 #endotwitter #medtwitter

Read 11 tweets

Chris Wilson

@gwsuperfan

14-day comparisons! Photo 1 (2/27-3/12) is the baseline. #2 (3/13-3/26) is full #closedloop with Humalog and #DynamicISF. #3 (4/20-5/03) is full closed loop w/a 50/50 Humalog/Lyumjev mix. Best results with faster insulin. TIR gains are minimal (starting from a high baseline). 1/?

What jumps out at me are the reductions in variability. Also, the Lyumjev/Humalog results probably would have been even higher TIR and less variable had the restaurant not messed up last night, delivering basically a whole chicken rather than the 2 chicken burritos I ordered. 2/?

Common conditions in full #closedloop- basically no manual boluses. Even if a meal sent me close to 300 (16.7). Manual boluses were only applied when the loop was not running (comms failures, #CGM warmup, etc) maybe 2/week. No carb counting at all. Ate when hungry. 3/?

Read 9 tweets

Dr. Rahul Baxi

@baxirahul

“Doctor, what should be my targets for Hba1c, Fasting and Post meal (PP) glucose?”

Many of our friends with Diabetes have this question. I will try to explain in the thread below.

#Diabetes #GlycemicTargets #HbA1c (1/n)

HbA1c should be done at least 2 times a year if goals are met and glucose control is stable,

Done more often if goals not met or there is change in the medicines.

A1c goal for many non pregnant adults is < 7% without any significant hypoglycaemia.

#Diabetes #HbA1c (2/n)

Tighter HbA1c goals ( less than 7%) may be considered in some.

Less stringent goals (less than 8%) may be appropriate in pts with limited life expectancy or side effect of drugs.

Individualisation of glycemic targets is a must. It’s not a one size fits all criteria.

(3/n)

Read 11 tweets

dr roth ⓀⒸ

@mrc314

Three days. Three #CGM plots. Difference 100g sweet potato early, late, and absent

THREAD

Daily Average Macros: 1967 kCal
Grams: 25% Fat, 57% Pro, 18% Carbs
kCals: 43% Fat, 44% Pro, 14% Carbs

100g sweet potato: 20g carbs, 4.2g sugars/net

#1 Sweet potato first thing (9am for me) along with 4-6oz burger, then main meal around 1pm.

High peak, brief hypo, quickly returns to baseline.

#2 No sweet potato. 4-6oz burger around 9am, then main meal around 1pm.

Much flatter response. 20g fewer carbs than the other two days.

Read 6 tweets

dr roth ⓀⒸ

@mrc314

Looks like another low-fat heart-healthy diabetic special tray!

https://twitter.com/lowcarbcanberra/status/1378267362500042752

Potatoes and sugar syrup fruit. So sad. Sorry for your loss Sean.

https://twitter.com/SeanCodling/status/1388780789995872261

Sample menu is vegan and all carbs:

https://twitter.com/RF_Jenkins/status/1395764853558685700

Read 19 tweets

dr roth ⓀⒸ

@mrc314

#GatedEating Week 14
Cumulative change: -15.5 lbs
Weekly change: -3.5 lbs

Back on track. Extended fasts seem to do the trick. It takes at least 48 hours to see any drop in typical BG levels, and a rise in ketones. With all this fasting, #CGM Daily Patterns graphs are quite flat.

#CGM Daily Patterns

7-day
14-day
30-day

During considerable fasting, zero carb some days, 4-8g other days, and deliberate weight loss.

This week's weigh day "of record" will be Thursday, rather than Friday. It's not because I'm going to (carb) binge on Thanksgiving. I'm long past that habit now. Rather, I usually feast on Fridays. This week I'm shifting forward one day is all to align with family day of thanks.

Read 46 tweets

Nat’s Pancreas 404 #Masks4All

@1derfultype

@Insulet is working on #Omnipod5, their #closedloop system connected to the #DexcomG6 #CGM. The PDM will be similar to #DASH.

#dedoc° #dedocvoices #EASD2020 #EASD
@EASDnews #NothingAboutUsWithoutUs

@Insulet travaille sur #Omnipod5, leur système de #bouclefermée connecté au #DexcomG6. Le PDM sera similaire à #DASH.

#dedoc° #dedocvoices #EASD2020 #EASD
@EASDnews #NothingAboutUsWithoutUs

#Omnipod5 is actually Omnipod #Horizon 🚀

Read 3 tweets

dr roth ⓀⒸ

@mrc314

#T2RevFoodCGM #keto #CGM #ketoAF

A thread on two diets with differences in WHAT and WHEN to eat.

Low-fat, three meals plus snacks (my HistoricDiet™)

vs

Low-carb, 4 hour TRF (time restricted feeding)

There is a lot of chatter on social media debating whether a low-carb/keto diet can improve health, and perhaps prevent certain disease. Much of this chatter turns out to be covert vegan disdain for consuming animal products, which confounds any discussion of the real question:

Does consuming less carbohydrate improve health and prevent or reduce the severity of long term chronic disease? We can't really know for sure given the prohibitions against conducting RCTs to find out. IRBs won't approve such trials. Subjects would never actually comply.

Read 17 tweets

Nat’s Pancreas 404 #Masks4All

@1derfultype

I’m level 37 ✨✨✨
Celebrating that I’ve been keeping myself alive - and well - for the last 37 years living with type 1. This month marks my #Diaversay. As I don’t know the exact day of my #diagnosis - it was at the beginning of the summer break - I have decided it's July 7 🎉

I had been having the usual symptoms for some time before I arrived at my grand parents for the holidays: weight loss, unquenchable thirst, constant peeing. My grandma realised something was wrong and took me to the GP.

#type1diabetes #invisibleillness #diagnosis

I thought I’d share a throwback picture to remind me how far I’ve come with living with #T1D for 30+ yrs: rigid treatments in the 1980s, denial in my teen yrs, hiding to inject my life saving #insulin, 1st pump in 2009, 1st #CGM when I was pregnant in 2010, & looping last yr 🟢

Read 4 tweets

dr roth ⓀⒸ

@mrc314

#CGM update THREAD

I've been #LCHF since 2014, and KetoAF for nearly two years. I am still prone to growing a spare tire and hypertension, two conditions indicative of metabolic syndrome. The other MS markers are good: My blood glucose (90) and TRIGs (60) are lower, and HDL is

higher (62). I've wanted to use a CGM for a while, to track BG on a OMAD KetoAF diet, and to see how adding in some carbs affects BG levels. I assumed BG would rise after eating, the question is how far and for how long? Then, during a carbohydrate assault, how far and for

how long does BG rise? I'm also interested in the theory that abstaining chronically from all but 20g carbohydrate per day, I've become psychologically insulin resistant and somewhat unable to handle carbs (as @CarnivoreMD suggests). The second question: Does introducing a

Read 16 tweets

F Best

@BlutzuckerCoach

Menschen mit Diabetes haben oft einen schweren Verlauf, wenn sie an #COVID-19 erkranken. Grund genug für die Diabetes-Schwerpunktpraxis, den persönlichen Kontakt auf ein Minimum zu reduzieren. Video-Sprechstunden dienen als Ersatz.(1/11)

Man kann den Kontakt halten, kann gemeinsam die BZ- oder #CGM-Werte betrachten.
ABER: Viele Patienten scheuen sich, ihre Daten in die Cloud zu stellen. Gibt es eine Alternative?(2/11)

Zumindest bei CGM-Geräten kann man die Daten NICHT lokal auslesen und speichern und z.B. per Mail an die Praxis zu schicken. Wenn der Medtronic-Server ausfällt — das ist nicht selten —, können meine Patienten keine Daten mit mir teilen.(3/11)

Read 12 tweets

Dr|YASMINE⁦👩‍⚕️⁩⁦

@yasmineKT2

Thread for @ashish30sharma versatility ✨💥
#AshishSharma

Gif 1 ..The early days is the fun days 😜🕺💃
#LSD movie
@ashish30sharma was such a cute in it 💕
#AshishSharma

Gif 2: The Badass 💥 Bhayaji 🔥🔫
Though it was @ashish30sharma First Role in ITV but turned to be one of his best and one of my favorites ❤️..He rocked it 💥👏
#GKD #Ashishsharma

Read 56 tweets

Simon Tobin

@DocRunner1

I’ve been “lent” a #cgm (continuous glucose monitor) so I’m fascinated to see what I can learn over the next 2 wks about how my life affects my sugar
I’m NOT diabetic or pre-diabetic and plan to monitor the impact of different foods and activities
@grahamsphillips @Diabetescouk

1st observation is that application of #cgm is painless and adherence to skin is secure
Surprised my ave glucose is 6.3mmol/l
3 x glucose by finger prick finds #cgm over-reads by 0.9-1.5mmol/l (have allowed for 10min delay in #cgm but assumes sticks accurate) 🤔
@DrScottMurray

Effect of exercise: 50min hard interval session running in the pinewoods shoots my glucose up to 9.8 from 5.9 just before I set off. In <1 hour it’s back to 5.9
Conclusion: Exercise puts my sugar up. Surprised at this but @lowcarbGP noticed the same

Read 49 tweets