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Post by peppy on Apr 25, 2019 20:45:58 GMT -5
I think we should post this. "How you doing?" Lol. Truth is most peoples CGM graphs look nothing like that. Actually this is why I don't like the current crop of manufacturers devices and apps.Looking at that graph I could guess a likely scenario. They wanted to go to sleep around 10:30pm but were dropping so they ate something (that brief upturn) and went to sleep. However they had far more insulin onboard that they thought so it quickly swallowed the spike and they kept dropping. The alarm goes off and they panic ("what happened? I ate and I am still dropping, arghhh") and completely over treated - cue the rising curve at about 3:00am that pushes them up to that peak. Now they are bout 400 (22 on the CGM) and have to beat it back down contending with insulin resistance from the high as well. They over do it... and so on. All of this could be avoided by using a CGM with decent software. If they were using an app like Spike or xDrip+ it would show the insulin remaining and graph the predicted glucose level so they would know there was a problem and could deal with it before you went to sleep. Sensor problems on report all the time Dexcom facebook.
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Post by agedhippie on Apr 25, 2019 21:39:12 GMT -5
Sensor problems on report all the time Dexcom facebook. Definitely. CGMs are far from a silver bullet. I am running a Libre and G5 at the same time at the moment and the Libre tracks my levels pretty well, but the current sensor is usually 30 points below where it should be and there is no way to fix that (other than mentally adding 30 to all readings). The Libre seems to weight readings to a central range and I see compression above 200 and below 90. That's off a sample set of one though, lets see how the next one goes... In my experience two things cause what she is seeing; inflammation causing a fluid build up around the sensor needle, or compression. Given the time it's been happening for my bet is on the former.
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Post by mango on Apr 25, 2019 21:44:15 GMT -5
I think we should post this. "How you doing?" Lol. Truth is most peoples CGM graphs look nothing like that. Actually this is why I don't like the current crop of manufacturers devices and apps. Looking at that graph I could guess a likely scenario. They wanted to go to sleep around 10:30pm but were dropping so they ate something (that brief upturn) and went to sleep. However they had far more insulin onboard that they thought so it quickly swallowed the spike and they kept dropping. The alarm goes off and they panic ("what happened? I ate and I am still dropping, arghhh") and completely over treated - cue the rising curve at about 3:00am that pushes them up to that peak. Now they are bout 400 (22 on the CGM) and have to beat it back down contending with insulin resistance from the high as well. They over do it... and so on. All of this could be avoided by using a CGM with decent software. If they were using an app like Spike or xDrip+ it would show the insulin remaining and graph the predicted glucose level so they would know there was a problem and could deal with it before you went to sleep.
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Post by mango on Apr 25, 2019 22:46:15 GMT -5
Lol. Truth is most peoples CGM graphs look nothing like that. Actually this is why I don't like the current crop of manufacturers devices and apps. Looking at that graph I could guess a likely scenario. They wanted to go to sleep around 10:30pm but were dropping so they ate something (that brief upturn) and went to sleep. However they had far more insulin onboard that they thought so it quickly swallowed the spike and they kept dropping. The alarm goes off and they panic ("what happened? I ate and I am still dropping, arghhh") and completely over treated - cue the rising curve at about 3:00am that pushes them up to that peak. Now they are bout 400 (22 on the CGM) and have to beat it back down contending with insulin resistance from the high as well. They over do it... and so on. All of this could be avoided by using a CGM with decent software. If they were using an app like Spike or xDrip+ it would show the insulin remaining and graph the predicted glucose level so they would know there was a problem and could deal with it before you went to sleep. Dude, you can't be serious. The underlying problem is not the CGM software, but you already knew this. Why do you keep deflecting and diverting from the truth when there's no one here stupid enough to believe you?
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Post by uvula on Apr 25, 2019 23:20:48 GMT -5
Mango, read the old one's post right before your attack. It sounds very credible to me. I can't figure out what you're screaming about.
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Post by mango on Apr 26, 2019 0:40:32 GMT -5
Mango, read the old one's post right before your attack. It sounds very credible to me. I can't figure out what you're screaming about. What do you see? An insulin that is ineffective or do you blame the CGM software for the blood sugars? What do you see when you look at the Afrezza users blood sugars recorded by their CGMs? Do you see an insulin that works or does everyone just have decent CGM software?
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Post by letitride on Apr 26, 2019 1:03:00 GMT -5
Mango, read the old one's post right before your attack. It sounds very credible to me. I can't figure out what you're screaming about. What do you see? An insulin that is ineffective or do you blame the CGM software for the blood sugars? What do you see when you look at the Afrezza users blood sugars recorded by their CGMs? Do you see an insulin that works or does everyone just have decent CGM software? I salute you Thanks Mango!
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Post by uvula on Apr 26, 2019 8:29:42 GMT -5
Mango, read the old one's post right before your attack. It sounds very credible to me. I can't figure out what you're screaming about. What do you see? An insulin that is ineffective or do you blame the CGM software for the blood sugars? What do you see when you look at the Afrezza users blood sugars recorded by their CGMs? Do you see an insulin that works or does everyone just have decent CGM software? Thank you for clarifying. I'm not sure if I completely agree with your argument but now I understand what you were thinking.
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Post by agedhippie on Apr 26, 2019 9:13:45 GMT -5
Mango, read the old one's post right before your attack. It sounds very credible to me. I can't figure out what you're screaming about. What do you see? An insulin that is ineffective or do you blame the CGM software for the blood sugars? What do you see when you look at the Afrezza users blood sugars recorded by their CGMs? Do you see an insulin that works or does everyone just have decent CGM software? Everyone having software that works is a good start since you can get hypos with Afrezza as well. Also far more people use insulins other than Afrezza and they need this technology. I know the argument says they should all move to Afrezza, but realistically that's not happening any time soon or it would already have happened and it's going to be a slow steady growth. Medtronic and Blue Cross and Blue Shield of Minnesota (BCBSM) have just done a rebate deal for the Medtronics CGM where Medtronics pays BCBSM a rebate for time spent outside range.
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Post by uvula on Apr 26, 2019 9:47:33 GMT -5
If this "pay for time not in range" is widespread this would be a huge reason for all cgm companies to promote afrezza without it costing mnkd anything. Of course medtronic would probably promote their automatic pancreas thing instead.
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Post by Deleted on Apr 26, 2019 9:56:45 GMT -5
What do you see? An insulin that is ineffective or do you blame the CGM software for the blood sugars? What do you see when you look at the Afrezza users blood sugars recorded by their CGMs? Do you see an insulin that works or does everyone just have decent CGM software? Everyone having software that works is a good start since you can get hypos with Afrezza as well. Also far more people use insulins other than Afrezza and they need this technology. I know the argument says they should all move to Afrezza, but realistically that's not happening any time soon or it would already have happened and it's going to be a slow steady growth. Medtronic and Blue Cross and Blue Shield of Minnesota (BCBSM) have just done a rebate deal for the Medtronics CGM where Medtronics pays BCBSM a rebate for time spent outside range. Fee for outcomes. What a novel idea. Wait till they start wiring up patients for head to head evaluation and Afrezza is part of it. BTW, what does a MDT pump cost these days, over $10K? They used to ship the patient two so a backup was always in hand.
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Post by peppy on Apr 26, 2019 11:02:29 GMT -5
What do you see? An insulin that is ineffective or do you blame the CGM software for the blood sugars? What do you see when you look at the Afrezza users blood sugars recorded by their CGMs? Do you see an insulin that works or does everyone just have decent CGM software? Everyone having software that works is a good start since you can get hypos with Afrezza as well. Also far more people use insulins other than Afrezza and they need this technology. I know the argument says they should all move to Afrezza, but realistically that's not happening any time soon or it would already have happened and it's going to be a slow steady growth. Medtronic and Blue Cross and Blue Shield of Minnesota (BCBSM) have just done a rebate deal for the Medtronics CGM where Medtronics pays BCBSM a rebate for time spent outside range.I do not believe it. Have a link to a news thingy?
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Post by nylefty on Apr 26, 2019 11:22:22 GMT -5
Everyone having software that works is a good start since you can get hypos with Afrezza as well. Also far more people use insulins other than Afrezza and they need this technology. I know the argument says they should all move to Afrezza, but realistically that's not happening any time soon or it would already have happened and it's going to be a slow steady growth. Medtronic and Blue Cross and Blue Shield of Minnesota (BCBSM) have just done a rebate deal for the Medtronics CGM where Medtronics pays BCBSM a rebate for time spent outside range.I do not believe it. Have a link to a news thingy? www.medtechdive.com/news/medtronic-blue-cross-strike-value-based-pact-for-glucose-monitors/552311/
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Post by peppy on Apr 26, 2019 11:37:09 GMT -5
Everyone having software that works is a good start since you can get hypos with Afrezza as well. Also far more people use insulins other than Afrezza and they need this technology. I know the argument says they should all move to Afrezza, but realistically that's not happening any time soon or it would already have happened and it's going to be a slow steady growth. Medtronic and Blue Cross and Blue Shield of Minnesota (BCBSM) have just done a rebate deal for the Medtronics CGM where Medtronics pays BCBSM a rebate for time spent outside range.I do not believe it. Have a link to a news thingy? Thank you NY LEFTY! Looks like a service added penalty that s being marketed as add-on good for patients. REBATE? Reading over it again, reminds me of Gold Bond stamps, my mother used to get at the grocery. Save up enough gold bond stamps and you got to go to the Gold Bond center and redeem them.
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Post by agedhippie on Apr 26, 2019 11:42:32 GMT -5
Everyone having software that works is a good start since you can get hypos with Afrezza as well. Also far more people use insulins other than Afrezza and they need this technology. I know the argument says they should all move to Afrezza, but realistically that's not happening any time soon or it would already have happened and it's going to be a slow steady growth. Medtronic and Blue Cross and Blue Shield of Minnesota (BCBSM) have just done a rebate deal for the Medtronics CGM where Medtronics pays BCBSM a rebate for time spent outside range. Fee for outcomes. What a novel idea. Wait till they start wiring up patients for head to head evaluation and Afrezza is part of it. BTW, what does a MDT pump cost these days, over $10K? They used to ship the patient two so a backup was always in hand. The real price is around $4,000 to the insurer based on the retail price outside the US. Typically it costs the user $1,000 one off. MDT also do rebate deals on the 670G pumps with Aetna and UHC. At the moment the 670G has a 72% TIR range which is why they can do these deals. More to the point, for MDT it locks their competitors out of the market because they cannot afford to fund these programs (DEXCOM's CEO spoke about this). Certainly for the last ten years at least they have just shipped a single pump, and ship a next day replacement if necessary (you use pens in the interval).
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