Deciding if the new technology is right for your diabetes life.
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July 2008 — While we are both trying to minimize our focus on diabetes in our daily lives, we cannot deny that we would like more visibility into what this disease does to us on a daily and a monthly basis. Greg often experiences borderline hypoglycemia in the afternoon. I have a wicked dawn phenomenon where any amount of carbohydrate intake at breakfast sends my blood sugar readings sky-high. The whys and hows overwhelm us.
Before Greg had his hypoglycemic seizure in the middle of a grocery store four years ago, he wore the proud badge of an A1C under 7.0% for several years. With that badge came numerous hypoglycemic episodes, but none as serious as the seizure that hit him on his way home from work. Since the seizure, his concern over a similar episode has increased his threshold for treating lows ... and highs. That translates to higher A1C levels, though it looks like he's on the downward trend.
Greg has little interest in the insulin pump, as he's concerned with pump failure and all the training that is involved. You might call him an old-school person with type 1 diabetes who doesn't mind shots. We don't know of anyone who has tried a CGMS out with multiple daily injections, but he might just want to try if it means bringing tighter control without all the hypoglycemia. (And there you have a computer geek who is picky about the technology he uses!)
I know that I am an even less likely candidate for CGMS as someone with type 2 diabetes and "only" on medication, but the dawn phenomenon wreaks havoc on my mornings. While morning exercise is usually a decent combatant, I don't always have the time. I'd like to know what dinner and bedtime snack combination provides me with the best fasting blood sugar readings and if I can swing a low-carbohydrate breakfast without retribution from the dawn phenomenon.
CGMS has the potential to be a powerful tool in our diabetes management. Of course, I'd rather see my husband get the opportunity to bring his A1C to a safe range than to see me figure out what works in my diet. And of course, the technology is new and either of us would still have to monitor ourselves the traditional way. If we could find the sliver of a benefit in CGMS, in keeping our lives healthy and happy for years to come, shouldn't everyone? Imagine the rate of diabetes complications decreasing as a result of CGMS – with the benefits to individuals with diabetes outweighing the cost of the technology.
From those diabetics with the first signs of complications to those needing a little help figuring out when and why hypoglycemia might happen, this technology needs to be covered by insurance companies. And soon.
Read more of Rachel's columns.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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Like many of us who live near major cities, I've been to a few ADA Diabetes Expos — my first in November, 2003, just over a year after diagnosis. The Expo took up a large part of New York City's Javits Center; most of the major meter, insulin, pump, and pill manufacturers were there; there were enough food vendors (with free samples!)...