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Post by agedhippie on Jun 26, 2023 7:04:52 GMT -5
For T1s I am always assuming they are using a CGM. If they are not, well, they are probably not too worried about great control nor hypos. And just to be clear on this. Good control is the control that you want, it's not what someone choses for you. That's fundamental - it's your life, not theirs. |
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Post by sayhey24 on Jun 26, 2023 9:09:58 GMT -5
Aged - these T1s have been so out of control for so long it would be some what dangerous to get them under 140 in a study like this. However, if you are following some of the social media a lot of them are now targeting 100 as their baseline and are seeing no hypo concerns.
As far as TIR, its a worthless metric the way its defined. 180 as an upper limit with afrezza is OBE. The 2 hour PPG is the correct metric and we will see what Irl Hirsch can do to push it as the new standard of care.
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Post by agedhippie on Jun 26, 2023 10:12:02 GMT -5
Aged - these T1s have been so out of control for so long it would be some what dangerous to get them under 140 in a study like this. However, if you are following some of the social media a lot of them are now targeting 100 as their baseline and are seeing no hypo concerns. ... I have no idea where you get this stuff from, but it's flatly wrong. For a start the 770G pumps that they were using are hardwired to target 120, and the Tandem IQ pumps usually target 100. There has been a PPG target for years, it's to be below 180 two hours after the meal. That aligns nicely with TIR. If Irl Hirsch is going to argue with it should be lower then he is going to have to argue that the TIR limit should be lower. There has been no evidence to date that he is going to do that, but if you know of any I would be interested. |
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Post by hellodolly on Jun 26, 2023 10:23:18 GMT -5
Just add to the discussion, SENS just did a multi-center year long trial and achieved this with their device.
ADA Poster Presentation – Glycemic Improvements in CGM Naive Patients during SMBG and Implantable CGM Use:
***While there was a decrease in HbA1c after 6 months of SMBG use, there was a further significant reduction after 6 months of Eversense CGM to a mean value of 6.93%
***CGM use resulted in a significant increase in time in range (70-180 mg/dL) to a mean of 74.2%
***There were significant decreases in both time below range (<70 mg/dL) and in times above range (>180 mg/dL and >250 mg/dL)
***68% of patients achieved >70% TIR by the end of the CGM phase
This study, reporting on 100 adult patients with diabetes, showed that superior glucose outcomes were achieved with 6 months use of Eversense CGM compared to the initial 6-month period where management was achieved with SMBG only.
TIR and A1c were measured and reported which, makes the point that they both must be critical endpoints regardless if it's a device manufacturer or insulin provider.
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Post by beardawg on Jun 27, 2023 15:43:20 GMT -5
Thank you agedhippie. Can you elaborate the phrase in bold please? (Not stting a trap, but didn't understand.) Non-diabetics fixate on needles and build a whole mythology around injecting, this is at complete odds with reality - largely Tupe 1s don't care, it doesn't hurt, and we use insulin when we want and if someone objects that's their problem. (This is my experience with other Type 1s.) The selling point of inhaled insulin, no needles, is fundamentally flawed and we need to move beyond that to outcomes. Maybe for those that are already taking insulin, but those starting it probably won't want to use needles. I know I would want to avoid it, and I wouldn't be as tied to a particular brand/delivery method as someone who's been taking it for years. Those that don't think it's anything to take shots feel that way because they have to. It's a coping mechanism. |
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Post by lennymnkd on Jun 27, 2023 15:51:15 GMT -5
Come on there has to be an inconvenience somewhere in everyday life …it not all just getting use to the sensation!
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