Dr Iain Cranstone Abbott FreeStyle Libre

KITLIVING

SENSING A CHANGE

Dr Iain Cranston looks at the behaviour

change impact of using sensors.

"The impact of modern continuous glucose monitoring technology on

testing behaviour has been dramatic over the last two-to-three years.

There has been the emergence into the market of the first 'affordable'

device in the form of Abbott's FreeStyle Libre Flash glucose monitoring

sensor, as well as the incorporation of CGM data into the first 'hybrid

closed loop' device, Medtronic's 670g. There has also been the growth

of the #wearenotwaiting movement and the creation of self-programmed

closed-loop systems, also referred to as DIYAPS (do-it-yourself artificial

pancreas systems).

"In my view, the FreeStyle Libre and its production of 'on demand'

CGM (in the form of Libre's Flash data) is the innovation that has had by

far the most far-reaching impact across the Type 1 diabetes population in

terms of behaviour change. From an 'ideal' of someone doing between six

and 10 blood tests daily, users of the device have generally doubled, tripled

or even quadrupled the number of times they view their glucose data each

day. The key difference in this being that the data is now being used to

maintain glucose levels in range rather than (as was often the case with

people self-monitoring their blood glucose) to identify times when it was

out of range and then take action to correct it.

"This change in glucose viewing can be seen as the behavioural

equivalent of motorway driving, where the 'good driver' monitors the road

and their position on it every five-six seconds, expecting their lane position

to be reasonable and so making only very small or no changes in steering

to maintain it. Motorway 'rumble strips' act as an alarm on either side of the

lane, and the good driver hopes never to have the unsettling experience

of crossing over them.

"How does the good driver decide how often to look ahead at the road?

Experience tends to develop this action as a sub-conscious process done

based on the risk involved in not doing so - i.e. running into unforeseen

trouble. The same process can be developed in response to the directional

arrows produced along with the digital display of glucose level on the Libre

reader (or phone) screen. A horizontal arrow suggests control is likely to be

maintained for 60mins, diagonal for 30mins and vertical for 15mins, making

these the default re-test intervals for an individual wishing to maintain 'in

target' control. Users are motivated to swipe the sensor often in order to

pick up data that confirms that they are, as it were, driving well."

*Dr Iain Cranston is a diabetes consultant at Portsmouth Diabetes and

Endocrine Centre and is a director of the AGP Clinical Academy, which provides

educational materials, training and guidance on the use and interpretation of

the Ambulatory Glucose Profile (AGP). www.agpclinical.org

Before

After Data shows a wider range of glucose

variation and lower time-in-range

before sensor use compared to after.

Index

  1. Desang diabetes magazine diabetes information
  2. Abbott Freestyle Libre, Flash Glucose Monitoring, blood testing without lancets
  3. Desang diabetes magazine diabetes information, Sue Marshall
  4. Desang diabetes magazine diabetes news
  5. Omnipod Insulet insulin pump with insulin pods, podders
  6. Desang diabetes magazine diabetes news
  7. Dexcom CGM, continuous glucose monitoring
  8. Input diabetes, help to get diabetes technology, access to diabetes technology
  9. Ypsomed MyLife Diabetes care insulin infusion systems
  10. diabetes technology
  11. Ascensia Contour Next One Diabetes blood test meters
  12. Desang diabetes magazine diabetes news
  13. DRWF wellness days, diabetes research and wellness foundation
  14. Desang diabetes food news, tea and coffee news
  15. Diabetes food news, tea and coffee, the black farmer, Waitrose, Huskup
  16. Diabetes food news, tea and coffee, the black farmer, Waitrose, Huskup
  17. Medtrum A6 Touchcare patch pump and CGM in harmony
  18. Desang diabetes news report, the NHS Long Term Plan, Robin Hewings Diabetes UK
  19. Page 0019
  20. Desang magazine overview of CGM sensor technologies
  21. Desang magazine overview of CGM sensor technologies
  22. The CGM sensor scene 2019
  23. The CGM sensor scene 2019
  24. Page 0024
  25. Dr Iain Cranstone Abbott FreeStyle Libre
  26. Winter sleep report, the Sleep Council
  27. Winter sleep report, the Sleep Council
  28. Winter sleep report, the Sleep Council
  29. Winter sleep report, the Sleep Guru Anandi, Brian Keane The Fitness Mindset
  30. My Diabetes Kit Adrian Long
  31. My Diabetes Kit Adrian Long, Abbott FreeStyle Libre
  32. My Diabetes Kit Adrian Long
  33. Now Patient repeat prescription delivery service
  34. Diabetes food news, Seasonal Soups by Frazer Reid, Kitchen Press
  35. Medtronic Minimed 670G hybrid closed loop insulin pump
  36. Diabetes food news, Making Carbs Count, nutrion of grapefruit
  37. Diabetes food news, Making Carbs Count, nutrion of grapefruit
  38. Accu-Chek Insight insulin pump
  39. Accu-Chek Insight insulin pump
  40. Free diabetes magazine, living with diabetes, the diabetic diet, carb counting

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