The Revolution in Continuous Glucose Monitoring for Diabetes

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Continuous glucose monitoring represents not only a game-changing intervention for diabetes, but also a model for more continuous digital monitoring of various person-generated data. Diabetologist and informaticist Aaron Neinstein will discuss the advances in CGM and their implications for the care of people with diabetes and for patients with other chronic diseases.

Speaker:
Aaron Neinstein, MD, is Associate Professor in the UCSF Health Division of Endocrinology, Vice President of Digital Health for UCSF Health, and Senior Director at the UCSF Center for Digital Health Innovation (CHDI). He helped lead UCSF’s ambulatory Epic EHR implementation; helped develop and deploy numerous digital health solutions transforming digital patient experience and virtual care delivery across UCSF; contributed research and advocacy to advance US federal health policy in interoperability and patient data access; and co-founded Tidepool, a nonprofit that created open-source software to empower people with diabetes. His multidisciplinary team at CDHI focuses on advancing patient experience and digital transformation of care delivery, including the use of telehealth and remote monitoring technologies to deliver more connected care. His clinical practice is focused on the care of people with diabetes.

Note: Closed captions will be available within 48-72 hours after posting.

Program
Bob Wachter: Introduction
00:03:15-00:40:14 – Aaron Neinstein (Associate Professor in the UCSF Health Division of Endocrinology, Vice President of Digital Health for UCSF Health, and Senior Director at the UCSF Center for Digital Health Innovation (CHDI))
00:40:14-00:58:56 – Q&A
Bob Wachter: Closing

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• December 9: Our Emerging Understanding of the Gut Microbiome in Health and Disease

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One of the latest advances in diabetes care is the continuous glucose monitor, a wearable device that provides updated glucose readings every five minutes for people with all types of diabetes. Diana Isaacs, PharmD answers your questions about this innovative technology.

Presenter:
Diana Isaacs, PharmD
Endocrine Clinical Pharmacist, CGM Program Coordinator, Cleveland
Clinic Diabetes Center

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39 Comments

  1. Linda Currie

    I love my cgm. I believe knowing and seeing the data let’s you see how different foods and activities affect glucose levels. You can see what is safe and not safe. Modify your food combination and maybe add or remove foods to keep numbers in range. It is a no brainer! ❤️❤️❤️

  2. Abbas mukhtar

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  9. Flora Dean

    Nice video, I diagnosed with T1 and use the FreeStyle Libre sensor with Blucon transmitter, I track blood glucose readings on watch and phone constantly and the phone beeps at night when the glucose is out of range.

  10. aeromodeller1

    One thing I have observed that was not mentioned in any of the books or classes is the synergic effect of insulin and exercise. If I have a high glucose and take a shot, it will go down a little. If I only exercise, it may go down a little. If I exercise vigorously, even with a shot, it will go up. I take it that this is a reaction of the liver to stress. But if I take a shot and go walk for an hour, the glucose comes down where I want it. I assume this is because the moderate exercise moves blood around, distributing the insulin. If the insulin stays in one place, it decays rapidly without getting to most of the cells that need it. I expect insulin decay is related to concentration. When it is widely distributed, it is less concentrated, so decays more slowly, and more of it is where it is needed.

    When I started the finger stick monitoring I learned a great deal about my glucose dynamics. I was able to adjust my insulin dosing and this led to a major improvement in control. We are taught a linear model, diabetes is not linear. When the CGMs first came out I took a class, but was told the devices were available only to people who had very poor control. My control is good, but could be better. Being able to examine those curves will give a much better understanding of glucose dynamics. Maybe the attitude has changed. I will ask again about getting a CGM.

  11. Charlie Moore

    Insightfull!1 i am type2 diabetic since 3-4 years, using freestyle libre 2 sensor currently with blucon transmitter, I like Blucon as a pocket-friendly CGM, Blucon has helped me with remote monitoring of glucose levels and adding my daily notes in the Linkblucon app to manage my eating habits too.

  12. Adebisi Aminat

    All thanks to (Dr Obulor) herbal protocol on YouTube we're I found what helped with my diabetes and HSV2 along with a vegan diet ✅

  13. sabine c

    T1D for 30+ years. 71 yrs old now, I received my CGM (Dexcom) 3 months ago and I love it. It's a game-changer. I wish I had figured this out before my eyesight suffered.

  14. Gregory Glavinovich

    eat correctly…..dont get fat………dont get diabetes in the first place

  15. Jullie Thomas

    Nice video, I have been using the FreeStyle libre sensor with Nightrider Blucon. It allows me to read my bloods without having to prick my fingers. I can see exactly the state of my bloods and what has happen. It provides a clear picture of how food and exercise affect my bloods. I feel I can control my diabetes a lot better.

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  17. 30 Second Bedtime Hacks

    New studies from Italy, New Zealand and even China show that type 2 diabetes and pre-diabetes can be managed (or possibly reversed) if you know how.

  18. Chris Petersen

    As someone with T1 (one of the 3-in-4 of us who get it as adults!), CGM is definitely life-changing, especially when combined with dynamic management techniques like Sugar Surfing that bring diabetes care from the 1970s into the 21st century. And for "alert fatigue", my biggest complaint is that I can't always silence them. Dynamic management and following trends means I've usually corrected my highs/lows at least 15 minutes before they happen, so the alarm isn't a surprise, just an annoyance. But I'll trade that for the piece of mind of knowing where my blood sugar is "going" — that 2 hour warmup time every 10 days on my Dexcom feels a bit like being blind.

  19. Mortimer

    I have had T1D for 59 years and was able to obtain a Dexcom CGM 3 years ago. My feeling is, NO! this is not data overload for me. I am absolutely thrilled to know my (interstitial) glucose level many times a day, whenever I want, multiple times. I monitor how different foods affect glucose level, how different types of exercise affect glucose, how stress and infections affect my glucose level, and so on. Bring on the data!!! I used to have serious hypoglycemia during the night several times a month, a fear that has now gone the way of the typewriter. I began with one injection/day in 1963 and constant hypo- and hyperglycemia because the Benedict's test we had was useless. I can still remember when I had a fasting blood draw one morning at the student health service, then received a frantic call fro the lab director that afternoon because my BG level was 21. Scary. So, the first diabetes revolution for me was in 1980 when I was able to use home glucose monitoring with the analog Ames reader. I couldn't believe I could know my BG level without having a venous blood draw. Since then technology has steadily improved, and now we have CGM. Onward and upward!

  20. JenZee

    This was so educational and made me more confident in my diabetes management. Thank you!!

  21. Lezlee FeetsGoddess

    Hi Diana, Hope you'll see this message. I'm a type 2 patient at ACMC which is part of the Cleveland Clinic. I just got a Libre 2 but haven't tried it yet as I'm undergoing Hyperbaric Oxygen at the wound clinic there. Do you know or can you find out if these sensors are safe to be worn in the HBO Chamber? I go in there every day and I know you're not allowed to take anything in there. Thank you.

  22. Carma Daria Companiona

    CGM (Libre 2) has made a H.U.G.E. difference in my diabetes (type 2) management. It gives me cause and effect information about how food, exercise, etc. affect my sugar levels. I was taking gliclazide but stopped because my sugar-management got to be so good that I no longer needed gliclazide, which, in fact, resulted in low blood sugar. I recommend cgm to absolutely everyone with diabetes. The finger-pricking meter absolutely did not give me enough information to be able to control my blood sugar levels.

  23. Henry Verghese

    CGM has helped me a lot to manage my diabetes so well without any stress and manage my work with more efficiency

  24. Donna Yoder

    An mlm sold my dad some “aloe Vera juice”, that took his blood sugar from 120 to 680 then too high to measure. I wish he’d lived long enough for this. It would have given us at least another decade wit him!

  25. Ikenna Abaraonye

    Sorry to bother but I'm a medical student undertaking an extra research year in endocrinology (with a specific interest in Diabetes management) at Imperial College London, I was wondering, do you have any papers you've written or starred in around this topic? Or some references to support some of the amazing facts you give during this talk. Very keen to hear back.

  26. Prof. Sameh Tawfik

    Thank you very much, ia PDF available?

  27. boatman222345

    Enjoyable presentation with much good information on CGM use and interpretation. I would, however,add that treating low bGs with "snacks" consisting of half sandwiches, etc. is almost guaranteed to result in high blood sugars and further difficulties. It's important to use predictable sources of rapidly absorbed CHO in treating low bGs such as glucose tab or sugar cubes. Over time it is possible to accurately estimate a precise amount of bG response to these sources of CHO whereas 1/2 sandwiches, apples, oranges, etc. produce very unpredictable bG increases and often result in hyperglycemia.

  28. Jasmine Ken

    Thanks for sharing the info. I prefer to use the Ambrosia Blucon with Libre, It helps me to get constant readings on my Apple Watch and iPhone, the alarms help me at night. It is a much more reliable and accurate cgm with a low cost. I loved!

  29. Wellness Secrets

    excellent content, presentation.

  30. Rene Shawn

    My A1c is now controlled with Libre sensor with Nightrider Blucon which helps me to know which food is affecting my health without scanning the sensor. This feature I guess is lacking in Libre alone.

  31. Alan Boo

    My sugars, a1c have been in very good control ever since I am using Blucon CGM with freestyle libre sensor. This CGM gives me great satisfaction

  32. Ethan Dsouza

    I have been using Blucon CGM, made in USA with freestyle libre pro sensor and thereafter I realised there is so much peace in my life

  33. Kartikey Mohan

    I'm using Blucon a wearable CGM device on top of my sensor which gives me readings every 5 minutes and alarms with numbers. Blucon helped me to lead a healthy and stress free life.

  34. Johanson Kemi

    I'm using Libre sensor which is pocket friendly as compare to the dexcom and other cgm devices. Also, to make it FCGM I'm using Nightrider of Ambrosia which gives me readings every 5 minutes without scanning the sensor also, it works standalone on my apple watch.

  35. Barbra

    Is there a way to get a copy of the low and high blood sugar chart you're showing. I went to the website but theirs does not look like the one you have on your board.

  36. Ayesha Maheshwari

    I've been using libre sensor for past 2 years with AMBROSIA'S blucon nightrider to get readings on watch and phone without scanning the sensor. Wether Libre 2 gives alarms but still we have to scan the sensor to get the bg value. with nightrider blucon we even don't to scan the sensro, it give HI/LO alarts without scanning the sensor. It's a complete CGM.

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