tempdiabetic (u/tempdiabetic)

tempdiabetic commented on Know Labs unveils glucose monitor that swaps fingersticks for RF sensors fiercebiotech.com/medtech... · Posted by u/coatta

idealmedtech · 4 years ago

I've done accuracy studies of the G6 for a submission to the FDA, and while it's true they do filter out spikes, they're never more than 5mg/dL off from the measured value (which itself is usually within 10% of the real value). Interstitial lags are closer to 5 minutes when you're not experiencing severe perfusion issues, which is more than close enough for making dosing decision, especially considering subcutaneous insulin has similar or longer lag times (depending on lots of things of course, and subject to an individual's own body).

tempdiabetic · 4 years ago

Any diabetic can confirm for themselves my claim about the Dexcom G6's unacceptable persistent error states.

Simply compare the CGM with your glucometer (testing 8x per day, for example), and watch the CGM go wrong (and stay wrong) on day 5 or 6 of using the sensor.

I wish what you said was true. I would love to have a CGM that works better than a glucometer, but they don't exist yet. In particular, the Dexcom G6 is inaccurate in a harmful way.

tempdiabetic commented on Know Labs unveils glucose monitor that swaps fingersticks for RF sensors fiercebiotech.com/medtech... · Posted by u/coatta

beardface · 4 years ago

> To reiterate, I take zero boluses when I’m on the keto diet.

I'm very surprised by this and would love to hear what you eat while doing keto. I'm T1 but still have to bolus when doing keto, even when doing zero carb and fasting for 18+ hours a day. I only need between 1 and 3 units but there's rarely an occasion when I don't need to bolus at all.

> Doctors are against it because they’re dealing with ketoacidosis on a regular basis.

The issue my endo has is that my BG is much lower than he would like. I've heard the phrase "too well controlled" so many times and it irritates me no end. His concern is that I'll lose awareness of low BG, and can't comprehend how I'm able to function as usual even when my BG is ~2.5 mmol/l (to clarify - I don't aim to run that low; my target range is 4-6).

tempdiabetic · 4 years ago

The brain uses ketones as fuel, so you will find that hypoglycemia is easily tolerated.

In ketosis, your brain will have plenty of fuel, even if your blood glucose drops too low.

tempdiabetic commented on Know Labs unveils glucose monitor that swaps fingersticks for RF sensors fiercebiotech.com/medtech... · Posted by u/coatta

RHSeeger · 4 years ago

I can't say enough good things about my G6. It literally changed my life as far as how I interact with my diabetes.

- I feel safer when I go to bed, because it's there to wake me up if my blood gets low (or too high).

- I feel safer in general because I don't need to worry that my blood is low but I haven't noticed it; and that I'm going to just fall down face first while walking across the room.

- Testing my blood is just a matter of looking, vs going over to (or downstairs to) where the tester is.

- (Because of the above) I have a better "feel" for how my blood sugar reacts to various foods and activities.

- When I'm having trouble with my sugars (morning highs, for example), I can see what my history has been via nice graphs on their web site.

Honestly, it's amazing. While I respect your choices, I can only assume you weren't taking full advantage of just how wonderful having the G6 is.

tempdiabetic · 4 years ago

If I may ask, what's your HbA1c, and please be honest?

tempdiabetic commented on Know Labs unveils glucose monitor that swaps fingersticks for RF sensors fiercebiotech.com/medtech... · Posted by u/coatta

willcipriano · 4 years ago

> 16x daily finger stick blood testing

Is that typical for people with your condition? Once an hour while you are awake? I never knew people had to do it that often.

tempdiabetic · 4 years ago

I do what works best. Typical is not my concern.

A glucometer test takes 20 seconds, total.

tempdiabetic commented on Know Labs unveils glucose monitor that swaps fingersticks for RF sensors fiercebiotech.com/medtech... · Posted by u/coatta

jcims · 4 years ago

Is there a good source for info on ketogenic diets for type 1 diabetics? My youngest has been on pump therapy for the past 5 years and is completely burnt out from all of the alerts and scares (some of it is self inflicted). She was on a medtronic closed loop system for 4 years and that was the source of most of her frustration. She's on g6+tslim now which has been much better, but she still falls off the wagon regularly.

I just think a keto diet would make it easier for her, but I'm seeing all sorts of conflicting info on it and her doctors don't support it. I've done it a few times in the past and getting started is the hardest part. I'd like for her to try but I'm getting no support on the idea. ?

tempdiabetic · 4 years ago

Dr. Phinney's lectures (Virta Health) are a good resource. Here's the first one, it's easy to find the rest:

https://youtu.be/1IEuhp8RFMU

Your fat sources should be nuts and olive oil and chia seed, with some cheese and egg.

Healthy food with lots of healthy fat.

The brain uses ketones as fuel, so you will find that hypoglycemia is easily handled. In ketosis, your brain will have plenty of fuel, even if your blood glucose drops too low.

tempdiabetic commented on Know Labs unveils glucose monitor that swaps fingersticks for RF sensors fiercebiotech.com/medtech... · Posted by u/coatta

tronicdude · 4 years ago

“We know that not all people with diabetes are looking for a wearable continuous glucose monitoring device to manage their diabetes."

Okay that's pretty bogus. Some people can't afford it, but everyone with diabetes would benefit from a CGM. There's much more to be gained from trends in CGM data than singular data points. (I was diagnosed with Type 1 at 16, been on a CGM for most of that time).

tempdiabetic · 4 years ago

The Dexcom G6 is the best CGM on the market, but its sensor filtering (Kalman or particle?) has smoothness and/or continuity priors that cause persistent inaccuracies.

I observe these persistent inaccurate states on the fifth or sixth day using a sensor. Calibration doesn't help. The reading goes wrong and stays wrong.

It probably happens to you, too, but anyone who doesn't test with a glucometer will likely not notice the failure. You will be harmed by these inaccuracies. Persistent inaccuracy is different than the Gaussian (normal) error of a glucometer, which is far more benign.

Also, CGMs are slow. The reading is based on interstitial fluid and lags direct blood glucose test by 15 minutes or more.

I have completely abandoned the Dexcom G6 and have gone back to 16x daily finger stick blood testing. I am also on a low-carb/high-fat diet, which makes it easy to maintain normal human blood glucose. My HbA1c has been 4.9 for a decade.

I was overjoyed to use the CGM at first, but it turned out to be a net loss. If you want to control your diabetes, use a glucometer and adhere to a strict low-carb/high-fat (ketogenic) diet.