CGM's

[longliner]

news.yahoo.com/those-trendy-continuous-glucose-monitors-110000617.html

[longliner]

news.yahoo.com/why-alaskan-ace-kristen-faulkner-102841759.html

[sportsrancho]

Thanks long… interesting

[lennymnkd]

Wow ! The athletic market might be here … always felt it would be a good add on.
sens seems like a practical choice. Even for X-ray and MRI and shower usage .
 Fair disclosure; I own the stock 😜               

[cretin11]

Good article. It throws some cold water on the notion of CGMs becoming mainstream, but i'd rather hear the truth from a real user rather than overblown hype from a CGM company.

[uvula]

The user claims (and I believe it) that there is a delay between blood stream glucose levels and interstitial blood glucose levels. Is there even more of a delay with apple watch skin surface glucose levels? If so maybe the apple watch will never be good enough for real medical use.

[lennymnkd]

Interstitial glucose values are determined by the rate of glucose diffusion from plasma to the IF and the rate of glucose uptake by subcutaneous tissue cells.
Readings can’t be adjusted for a true value .. I’m sure somebody at apple will figure it out.

[agedhippie]

Mar 14, 2023 13:25:36 GMT -5 uvula said:

The user claims (and I believe it) that there is a delay between blood stream glucose levels and interstitial blood glucose levels. Is there even more of a delay with apple watch skin surface glucose levels? If so maybe the apple watch will never be good enough for real medical use.

I find the lag is between 15 to 20 minutes. It's why if your levels are changing fast you use a finger stick, which only lags by 5 minutes, rather than a CGM. Exercise is one of those things that induces big swings. CGMs attempt to reduce the apparent lag with predictive algorithms, but generally this video from Abbott explains the issue:

www.youtube.com/watch?v=I3tQ80NXvGk

[Clement]

"The accuracy of continuous interstitial fluid (ISF) glucose sensing is an essential component of current and emerging open- and closed-loop systems for type 1 diabetes. An important determinant of sensor accuracy is the physiological time lag of glucose transport from the vascular to the interstitial space. We performed the first direct measurement of this phenomenon to our knowledge in eight healthy subjects under an overnight fasted condition. Microdialysis catheters were inserted into the abdominal subcutaneous space. After intravenous bolus administrations of glucose tracers, timed samples of plasma and ISF were collected sequentially and analyzed for tracer enrichments. After accounting for catheter dead space and assay noise, the mean time lag of tracer appearance in the interstitial space was 5.3–6.2 min. We conclude that in the overnight fasted state in healthy adults, the physiological delay of glucose transport from the vascular to the interstitial space is 5–6 min. Physiological delay between blood glucose and ISF glucose, therefore, should not be an obstacle to sensor accuracy in overnight or fasting-state closed-loop systems of insulin delivery or open-loop therapy assessment for type 1 diabetes."
diabetesjournals.org/diabetes/article/62/12/4083/33941/Time-Lag-of-Glucose-From-Intravascular-to

I would guess the delay would be greater during the day in non-fasting conditions.

[peppy]

Mar 19, 2023 9:22:44 GMT -5 agedhippie said:

Mar 14, 2023 13:25:36 GMT -5 uvula said:

The user claims (and I believe it) that there is a delay between blood stream glucose levels and interstitial blood glucose levels. Is there even more of a delay with apple watch skin surface glucose levels? If so maybe the apple watch will never be good enough for real medical use.

I find the lag is between 15 to 20 minutes. It's why if your levels are changing fast you use a finger stick, which only lags by 5 minutes, rather than a CGM. Exercise is one of those things that induces big swings. CGMs attempt to reduce the apparent lag with predictive algorithms, but generally this video from Abbott explains the issue:

www.youtube.com/watch?v=I3tQ80NXvGk

Makes sense to me, the CGM is measuring the glucose level of interstitial tissue. 

"The interstitial space that lies between blood vessels and cells provides the fluid and structural environment surrounding those cells. Under most conditions in most tissues, fluid from the vascular space continually filters from the microvessels into the interstitial space and is not reabsorbed "

[sayhey24]

Mar 14, 2023 13:25:36 GMT -5 uvula said:

The user claims (and I believe it) that there is a delay between blood stream glucose levels and interstitial blood glucose levels. Is there even more of a delay with apple watch skin surface glucose levels? If so maybe the apple watch will never be good enough for real medical use.

I don't think the intent of the Apple watch is to replace CGMs.  Its currently slated to be a fitness device which will be useful for trends and to make people away of blood sugar levels.   If things seem out of wack then they should go to the doctor.  Then they can get a script for CGM or go to the drug store and get a meter.

Even CGMs are more trending devices than using a glucose meter.

[agedhippie]

Mar 21, 2023 7:12:15 GMT -5 peppy said:

Mar 19, 2023 9:22:44 GMT -5 agedhippie said:

I find the lag is between 15 to 20 minutes. It's why if your levels are changing fast you use a finger stick, which only lags by 5 minutes, rather than a CGM. Exercise is one of those things that induces big swings. CGMs attempt to reduce the apparent lag with predictive algorithms, but generally this video from Abbott explains the issue:

www.youtube.com/watch?v=I3tQ80NXvGk

Makes sense to me, the CGM is measuring the glucose level of interstitial tissue. 

"The interstitial space that lies between blood vessels and cells provides the fluid and structural environment surrounding those cells. Under most conditions in most tissues, fluid from the vascular space continually filters from the microvessels into the interstitial space and is not reabsorbed "

What they don't mention are fun things like compression lows. If you lie on a sensor it pushes the interstitial fluid away which reduces the glucose in the area and as a result the sensor thinks you are low. Having that happen in the middle of the night is no fun because the alarm is loud!

[lennymnkd]

Aged ; “death and taxes “

[longliner]

finance.yahoo.com/news/nick-jonas-and-dexcom-talk-partnership-the-future-of-diabetes-management-tech-191659734.html