Mirror, mirror on the wall... who's the smartest of them all?
The key to managing diabetes is a willingness to frequently check blood sugar (including CGM), thinking about the situation (assuming you already have the knowledge), and taking action (sometimes not doing something is the right action). Just do two of three and you'll miss the mark. Sugar Surfing is our attempt to impart the knowledge and to encourage you to check, think and do... repeat.
True, we now have mostly reliable CGM. But the key to it all is the appropriate application of personalized knowledge gained through experience. In my opinion, most people, including medical professionals, still have a long way to go and it starts with the motivation to learn new ways of performing old tasks.
Any one tool is optional. Pump vs. MDI? Both work. Meter vs CGM? Pick one. More importantly, commit to using it.
This post below is another one from the archive. Originally published in 2006, more than a decade ago, you'll see many similarities to life in 2017. Perhaps surprisingly, most of the information in the presentation is still accurate and relevant today.
So how much has changed, really? Read on to be reminded of the now extinct VCR. If you know what a VCR is you can comment to show your age or just keep it our little secret.
Patient Reported Data - True, False or Somewhere Inbetween?
May 5, 2006
Years ago I ran across a great stash of information from a presentation entitled, "Smart Pumps And Tomorrow’s Intelligent Devices", given by the esteemed John Walsh from July, 2005. He is also co-author of "Pumping Insulin", an excellent resource for people who are considering an insulin pump or who want to learn more. In his presentation, Mr. Walsh cites a study (1. JB McGill et al: Diabetes 54 (Suppl 1) poster 2035-PO, 2005):
From the presentation:
In this study that compared logbook entries to meter downloads:
One of every seven entries was not recorded because it was high
One of every seven entries was made up
No difference was found between adolescents and adults in the entry of fictitious and missing data
Time and date settings in meters are often incorrectly set. This causes patterns of high or low readings to be associated with the wrong time of day. Insulin adjustments made on faulty timing can worsen control rather than improve it."
It's so obvious isn't it that all of this talk about medical data is still, in this day and age, mostly talk? I stumbled across part of this problem back in 2001 when we first started using a glucose meter. Magically, the time on the meter would change. Come to find out, that's a fairly common occurrence for all current generation glucose meters and probably for all medical devices in general. Other causes include never setting the meter's clock in the first place, daylight savings adjustments, and who knows what else. Come to think of it, I still don't think I have ever set the clock on a VCR. Then we worked with patients in our first studies and found out how frequently numbers were transposed/omitted/forged, etc...
Our patent pending BioTimeSync™ feature has solved the clock accuracy problem around timestamps and our 'always-on' data collection technique (GlucoMON®-ADMS) has solved most of the issues around inaccurate values. I say most because there are teenagers who use these meters and give a teen a medical device and you can bet they'll find a way to beat the system. I will not divulge those 101 ways to fool your parents here however. Those little gems are best left unpublished!
The original post is still available online at http://diabetech.blogspot.com/2006/05/what-world-needs-now-is-accurate-data.html