Discover and read the best of Twitter Threads about #CGM
Most recents (22)
1a) Welcome to a 🆕#accredited #tweetorial on the importance of time in range #TIR in #diabetes . . . with additional emphases on #primarycare and on practice in 🇨🇦.
#FOAMed #endotwitter #MedEd @MedTweetorials #nephtwitter #cardiotwitter
#FOAMed #endotwitter #MedEd @MedTweetorials #nephtwitter #cardiotwitter
1b) Hence we welcome2⃣ expert faculty from Canada: Ilana Halperin @ilanajhalperin, academic endocrinologist at @Sunnybrook and @uoftmedicine, and Noah Ivers @NoahIvers, #familydoc & researcher at Women's College Hospital @UofT 
2) Earn 0.75hr 🆓CE/#CME by following this🧵! This program is supported by an unrestricted educational grant from Sanofi Canada and is intended for #HCPs. Statement of accreditation & faculty disclosures at cardiometabolic-ce.com/disclosures/.
And so we begin . . .
And so we begin . . .
1) Welcome to our #accredited #tweetorial on clinical trial results and emerging data for treatment of Diabetes and CKD #DM in #CKD. I am Brian Rifkin MD, @brian_rifkin, from the Hattiesburg Clinic. #Nephtwitter #Medtwitter #FOAMed
2) This #accredited #tweetorial series on #kidneydisease #CKD is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance. It is not intended for US- or UK-based HCPs. Accreditation statement & faculty disclosures at ckd-ce.com/disclosures/.
3) This activity is accredited for #physicians #physicianassociates #nurses #NPs #pharmacists. Prior programs in this series, still eligible for CE/#CME, can be accessed at ckd-ce.com. FOLLOW US to learn from expert faculty!
1/ Curious about biohacking your blood sugar? We were too! Check out our new @NorthwellHealth @lenoxhill study, published today in @FrontNutrition #tweetorial 🧵
frontiersin.org/articles/10.33…
frontiersin.org/articles/10.33…
2/ There’s been a buzz about glucose tracking and how glucose levels can help us understand our health and metabolic response to the foods we eat
3/ Unfortunately, the science behind the buzz is limited. To add some perspective, we designed a prospective observational pilot study including non-diabetic participants with and without obesity to study the clinical utility of #ContinuousGlucoseMonitoring
12-week, open-label, randomized controlled trial. 126 participants with type 2 #diabetes (just 27% on basal insulin) were randomized 1:1 to either the intervention group (structured education + #CGM) or the control group (standard care with blood glucose monitoring).
The Self-Evaluation Of Unhealthy foods by Looking at postprandial glucose (SEOUL) algorithm was developed and applied to aid structured education in guiding patients to follow healthy eating behavior depending on the postprandial glycemic response.
Those assigned to CGM achieved average of 0.5% HbA1c reduction just by modifying their dietary behavior.
Diabetes Care 2022;45(10):2224–2230
doi.org/10.2337/dc22-0…
Diabetes Care 2022;45(10):2224–2230
doi.org/10.2337/dc22-0…
If you're in #Lomdon and have #T1D, you may be interested in this thread. It outlines the @NHSLdn_CN for Diabetes pan-London plan for #cgm access.
There are three linked documents and some commentary.
#GBDoc
/1
There are three linked documents and some commentary.
#GBDoc
/1
The first document is the written pathway, that outlines the suggested implementation of NG17 across London:
england.nhs.uk/london/wp-cont…
#CGM
#GBDoc
/2
england.nhs.uk/london/wp-cont…
#CGM
#GBDoc
/2
The second document is a list of systems, split into three lists.
List 1 is the "specialist rtCGM" that needs your clinic involvement.
List 2 is FP10 (on prescription) rtCGM.
List 3 is FP10 isCGM (scanned).
england.nhs.uk/london/wp-cont…
#CGM
#GBDoc
/3
List 1 is the "specialist rtCGM" that needs your clinic involvement.
List 2 is FP10 (on prescription) rtCGM.
List 3 is FP10 isCGM (scanned).
england.nhs.uk/london/wp-cont…
#CGM
#GBDoc
/3
Digitalization in Diabetes Education and Care:
'We know that autoimmunity starts way before #T1D diagnosis - if screened. We learnt that #cpeptide might not be relevant thanks to models'
-Dr A. Galderisi
#ISPAD #ISPAD2022 #dedoc°voices
#patientvoice #payitforward @dedocORG 1/n
'We know that autoimmunity starts way before #T1D diagnosis - if screened. We learnt that #cpeptide might not be relevant thanks to models'
-Dr A. Galderisi
#ISPAD #ISPAD2022 #dedoc°voices
#patientvoice #payitforward @dedocORG 1/n
Digitalization in Diabetes Education and Care:
'We can find heterogeneity in #T1D even before diagnosis. Important to individualise treatment.'-Dr A. Galderisi
Yes, every #PwD has their own #diabetes.
#ISPAD #ISPAD2022 #dedoc°voices
#nothingaboutuswithoutus @dedocORG 2/n
'We can find heterogeneity in #T1D even before diagnosis. Important to individualise treatment.'-Dr A. Galderisi
Yes, every #PwD has their own #diabetes.
#ISPAD #ISPAD2022 #dedoc°voices
#nothingaboutuswithoutus @dedocORG 2/n
Digitalization in #diabetes Education and Care:
'#TIR and #BG daily variability matter though we still look at the big picture. #AI can help us understand further.'
-Dr A. Galderisi
#ISPAD #ISPAD2022 #dedoc°voices
#patientvoice #payitforward @dedocORG 3/n
'#TIR and #BG daily variability matter though we still look at the big picture. #AI can help us understand further.'
-Dr A. Galderisi
#ISPAD #ISPAD2022 #dedoc°voices
#patientvoice #payitforward @dedocORG 3/n
Are we becoming robots? #AID systems for everyone with #T1D:
'#CGM is the Archimedean point of #diabetes technology. This is when the idea of closing the loop really emerged.'
-Moshe Phillip
#EASD2022 #dedoc°voices #nothingaboutuswithoutus @EASDnews @dedocORG 1/n
'#CGM is the Archimedean point of #diabetes technology. This is when the idea of closing the loop really emerged.'
-Moshe Phillip
#EASD2022 #dedoc°voices #nothingaboutuswithoutus @EASDnews @dedocORG 1/n
via @NYTimes
nytimes.com/2022/08/09/hea…
I have not watched this documentary yet. As someone who lives w/ #Type1Diabetes I have a few immediate thoughts based on this article.
nytimes.com/2022/08/09/hea…
I have not watched this documentary yet. As someone who lives w/ #Type1Diabetes I have a few immediate thoughts based on this article.
If I had a dollar for every “expert” in the field who told me it would be 5 years until there is a cure…
Some of you are reading this right now.
You were wrong & are still wrong. And as the article brings up it is psychologically exhausting & harmful. Stop.
Some of you are reading this right now.
You were wrong & are still wrong. And as the article brings up it is psychologically exhausting & harmful. Stop.
T1 & T2 diabetes are very different diseases.
They can coexist.
Pathophysiology of both is complex.
I have lost close friends & family to complications of both types. Including my sister. I am now raising her kids.
T1 is far less common & many wish it had a different name.
They can coexist.
Pathophysiology of both is complex.
I have lost close friends & family to complications of both types. Including my sister. I am now raising her kids.
T1 is far less common & many wish it had a different name.
Starting day 2 #AACE2022 with @ArchanaSadhu talking to us about #diabetes technologies in 2022 #endotwitter
Look how far we have come in #diabetes technology and there is still a lot more to go #AACE2022. #CGM technology has been a game changer and the accuracy continues to improve with each generation
So what's new in the pipeline for #diabetes technology? Let me tell you starting with #dexcom G7. It will be smaller with a better MARD, better warm up and ALL-IN-ONE applicator and transmitter! Just pending FDA review #AACE2022 #endotwitter #medtwitter
14-day comparisons! Photo 1 (2/27-3/12) is the baseline. #2 (3/13-3/26) is full #closedloop with Humalog and #DynamicISF. #3 (4/20-5/03) is full closed loop w/a 50/50 Humalog/Lyumjev mix. Best results with faster insulin. TIR gains are minimal (starting from a high baseline). 1/?
What jumps out at me are the reductions in variability. Also, the Lyumjev/Humalog results probably would have been even higher TIR and less variable had the restaurant not messed up last night, delivering basically a whole chicken rather than the 2 chicken burritos I ordered. 2/?
Common conditions in full #closedloop- basically no manual boluses. Even if a meal sent me close to 300 (16.7). Manual boluses were only applied when the loop was not running (comms failures, #CGM warmup, etc) maybe 2/week. No carb counting at all. Ate when hungry. 3/?
“Doctor, what should be my targets for Hba1c, Fasting and Post meal (PP) glucose?”
Many of our friends with Diabetes have this question. I will try to explain in the thread below.
#Diabetes #GlycemicTargets #HbA1c (1/n)
Many of our friends with Diabetes have this question. I will try to explain in the thread below.
#Diabetes #GlycemicTargets #HbA1c (1/n)
HbA1c should be done at least 2 times a year if goals are met and glucose control is stable,
Done more often if goals not met or there is change in the medicines.
A1c goal for many non pregnant adults is < 7% without any significant hypoglycaemia.
#Diabetes #HbA1c (2/n)
Done more often if goals not met or there is change in the medicines.
A1c goal for many non pregnant adults is < 7% without any significant hypoglycaemia.
#Diabetes #HbA1c (2/n)
Tighter HbA1c goals ( less than 7%) may be considered in some.
Less stringent goals (less than 8%) may be appropriate in pts with limited life expectancy or side effect of drugs.
Individualisation of glycemic targets is a must. It’s not a one size fits all criteria.
(3/n)
Less stringent goals (less than 8%) may be appropriate in pts with limited life expectancy or side effect of drugs.
Individualisation of glycemic targets is a must. It’s not a one size fits all criteria.
(3/n)
Three days. Three #CGM plots. Difference 100g sweet potato early, late, and absent
THREAD
Daily Average Macros: 1967 kCal
Grams: 25% Fat, 57% Pro, 18% Carbs
kCals: 43% Fat, 44% Pro, 14% Carbs
100g sweet potato: 20g carbs, 4.2g sugars/net
THREAD
Daily Average Macros: 1967 kCal
Grams: 25% Fat, 57% Pro, 18% Carbs
kCals: 43% Fat, 44% Pro, 14% Carbs
100g sweet potato: 20g carbs, 4.2g sugars/net
#1 Sweet potato first thing (9am for me) along with 4-6oz burger, then main meal around 1pm.
High peak, brief hypo, quickly returns to baseline.
High peak, brief hypo, quickly returns to baseline.
#2 No sweet potato. 4-6oz burger around 9am, then main meal around 1pm.
Much flatter response. 20g fewer carbs than the other two days.
Much flatter response. 20g fewer carbs than the other two days.
Looks like another low-fat heart-healthy diabetic special tray!
Potatoes and sugar syrup fruit. So sad. Sorry for your loss Sean.
Sample menu is vegan and all carbs:
#GatedEating Week 14
Cumulative change: -15.5 lbs
Weekly change: -3.5 lbs
Back on track. Extended fasts seem to do the trick. It takes at least 48 hours to see any drop in typical BG levels, and a rise in ketones. With all this fasting, #CGM Daily Patterns graphs are quite flat.
Cumulative change: -15.5 lbs
Weekly change: -3.5 lbs
Back on track. Extended fasts seem to do the trick. It takes at least 48 hours to see any drop in typical BG levels, and a rise in ketones. With all this fasting, #CGM Daily Patterns graphs are quite flat.
#CGM Daily Patterns
7-day
14-day
30-day
During considerable fasting, zero carb some days, 4-8g other days, and deliberate weight loss.
7-day
14-day
30-day
During considerable fasting, zero carb some days, 4-8g other days, and deliberate weight loss.
This week's weigh day "of record" will be Thursday, rather than Friday. It's not because I'm going to (carb) binge on Thanksgiving. I'm long past that habit now. Rather, I usually feast on Fridays. This week I'm shifting forward one day is all to align with family day of thanks.
@Insulet is working on #Omnipod5, their #closedloop system connected to the #DexcomG6 #CGM. The PDM will be similar to #DASH.
#dedoc° #dedocvoices #EASD2020 #EASD
@EASDnews #NothingAboutUsWithoutUs
#dedoc° #dedocvoices #EASD2020 #EASD
@EASDnews #NothingAboutUsWithoutUs
@Insulet travaille sur #Omnipod5, leur système de #bouclefermée connecté au #DexcomG6. Le PDM sera similaire à #DASH.
#dedoc° #dedocvoices #EASD2020 #EASD
@EASDnews #NothingAboutUsWithoutUs
#dedoc° #dedocvoices #EASD2020 #EASD
@EASDnews #NothingAboutUsWithoutUs
#T2RevFoodCGM #keto #CGM #ketoAF
A thread on two diets with differences in WHAT and WHEN to eat.
Low-fat, three meals plus snacks (my HistoricDiet™)
vs
Low-carb, 4 hour TRF (time restricted feeding)
A thread on two diets with differences in WHAT and WHEN to eat.
Low-fat, three meals plus snacks (my HistoricDiet™)
vs
Low-carb, 4 hour TRF (time restricted feeding)
There is a lot of chatter on social media debating whether a low-carb/keto diet can improve health, and perhaps prevent certain disease. Much of this chatter turns out to be covert vegan disdain for consuming animal products, which confounds any discussion of the real question:
Does consuming less carbohydrate improve health and prevent or reduce the severity of long term chronic disease? We can't really know for sure given the prohibitions against conducting RCTs to find out. IRBs won't approve such trials. Subjects would never actually comply.
I’m level 37 ✨✨✨
Celebrating that I’ve been keeping myself alive - and well - for the last 37 years living with type 1. This month marks my #Diaversay. As I don’t know the exact day of my #diagnosis - it was at the beginning of the summer break - I have decided it's July 7 🎉
Celebrating that I’ve been keeping myself alive - and well - for the last 37 years living with type 1. This month marks my #Diaversay. As I don’t know the exact day of my #diagnosis - it was at the beginning of the summer break - I have decided it's July 7 🎉
I had been having the usual symptoms for some time before I arrived at my grand parents for the holidays: weight loss, unquenchable thirst, constant peeing. My grandma realised something was wrong and took me to the GP.
#type1diabetes #invisibleillness #diagnosis
#type1diabetes #invisibleillness #diagnosis
#CGM update THREAD
I've been #LCHF since 2014, and KetoAF for nearly two years. I am still prone to growing a spare tire and hypertension, two conditions indicative of metabolic syndrome. The other MS markers are good: My blood glucose (90) and TRIGs (60) are lower, and HDL is
I've been #LCHF since 2014, and KetoAF for nearly two years. I am still prone to growing a spare tire and hypertension, two conditions indicative of metabolic syndrome. The other MS markers are good: My blood glucose (90) and TRIGs (60) are lower, and HDL is
higher (62). I've wanted to use a CGM for a while, to track BG on a OMAD KetoAF diet, and to see how adding in some carbs affects BG levels. I assumed BG would rise after eating, the question is how far and for how long? Then, during a carbohydrate assault, how far and for
how long does BG rise? I'm also interested in the theory that abstaining chronically from all but 20g carbohydrate per day, I've become psychologically insulin resistant and somewhat unable to handle carbs (as @CarnivoreMD suggests). The second question: Does introducing a
Menschen mit Diabetes haben oft einen schweren Verlauf, wenn sie an #COVID-19 erkranken. Grund genug für die Diabetes-Schwerpunktpraxis, den persönlichen Kontakt auf ein Minimum zu reduzieren. Video-Sprechstunden dienen als Ersatz.(1/11)
Man kann den Kontakt halten, kann gemeinsam die BZ- oder #CGM-Werte betrachten.
ABER: Viele Patienten scheuen sich, ihre Daten in die Cloud zu stellen. Gibt es eine Alternative?(2/11)
ABER: Viele Patienten scheuen sich, ihre Daten in die Cloud zu stellen. Gibt es eine Alternative?(2/11)
Zumindest bei CGM-Geräten kann man die Daten NICHT lokal auslesen und speichern und z.B. per Mail an die Praxis zu schicken. Wenn der Medtronic-Server ausfällt — das ist nicht selten —, können meine Patienten keine Daten mit mir teilen.(3/11)
Gif 1 ..The early days is the fun days 😜🕺💃
#LSD movie
@ashish30sharma was such a cute in it 💕
#AshishSharma
#LSD movie
@ashish30sharma was such a cute in it 💕
#AshishSharma
Gif 2: The Badass 💥 Bhayaji 🔥🔫
Though it was @ashish30sharma First Role in ITV but turned to be one of his best and one of my favorites ❤️..He rocked it 💥👏
#GKD #Ashishsharma
Though it was @ashish30sharma First Role in ITV but turned to be one of his best and one of my favorites ❤️..He rocked it 💥👏
#GKD #Ashishsharma
I’ve been “lent” a #cgm (continuous glucose monitor) so I’m fascinated to see what I can learn over the next 2 wks about how my life affects my sugar
I’m NOT diabetic or pre-diabetic and plan to monitor the impact of different foods and activities
@grahamsphillips @Diabetescouk
I’m NOT diabetic or pre-diabetic and plan to monitor the impact of different foods and activities
@grahamsphillips @Diabetescouk
1st observation is that application of #cgm is painless and adherence to skin is secure
Surprised my ave glucose is 6.3mmol/l
3 x glucose by finger prick finds #cgm over-reads by 0.9-1.5mmol/l (have allowed for 10min delay in #cgm but assumes sticks accurate) 🤔
@DrScottMurray
Surprised my ave glucose is 6.3mmol/l
3 x glucose by finger prick finds #cgm over-reads by 0.9-1.5mmol/l (have allowed for 10min delay in #cgm but assumes sticks accurate) 🤔
@DrScottMurray
Effect of exercise: 50min hard interval session running in the pinewoods shoots my glucose up to 9.8 from 5.9 just before I set off. In <1 hour it’s back to 5.9
Conclusion: Exercise puts my sugar up. Surprised at this but @lowcarbGP noticed the same
Conclusion: Exercise puts my sugar up. Surprised at this but @lowcarbGP noticed the same
@lowcarbGP @grahamsphillips @LowCarbProgram @SamFeltham @DocRunner1 @ProfTimNoakes @FructoseNo @RaceToTheStones @LowCarbSurge @longevity_pro @drtroystapleton @cadiulus @CampbellMurdoch @JeffryGerberMD @FatEmperor @SBakerMD @russwinn66 Just for you @lowcarbGP and for science: after 18h fast I took the #bananachallenge 😳
1pm Glu from 3.7 to 5.6 over 60min and made me hungry+++
Second ‘hump’ after 2pm was the other half #couldntresist
1pm Glu from 3.7 to 5.6 over 60min and made me hungry+++
Second ‘hump’ after 2pm was the other half #couldntresist
@lowcarbGP @grahamsphillips @LowCarbProgram @SamFeltham @DocRunner1 @ProfTimNoakes @FructoseNo @RaceToTheStones @LowCarbSurge @longevity_pro @drtroystapleton @cadiulus @CampbellMurdoch @JeffryGerberMD @FatEmperor @SBakerMD @russwinn66 And in further exciting news:
50:50 mix of heavy cream with @Breyers #lowcarb ice-cream is both delish and #flatlineish
I’m not one for treats (and don’t wish to re-awaken my sugar-cravings) but this is good to know #cgm
50:50 mix of heavy cream with @Breyers #lowcarb ice-cream is both delish and #flatlineish
I’m not one for treats (and don’t wish to re-awaken my sugar-cravings) but this is good to know #cgm
@lowcarbGP @grahamsphillips @LowCarbProgram @SamFeltham @DocRunner1 @ProfTimNoakes @FructoseNo @RaceToTheStones @LowCarbSurge @longevity_pro @drtroystapleton @cadiulus @CampbellMurdoch @JeffryGerberMD @FatEmperor @SBakerMD @russwinn66 And after tomorrow’s #runandfast I shall be testing this trusted #runningfuel:
22g CHO as maltodextrin/60ml
Recommended dose 1-3x per hour
I’d need ?20x for 100k (that’s 1200ml to carry/digest) 😳
22g CHO as maltodextrin/60ml
Recommended dose 1-3x per hour
I’d need ?20x for 100k (that’s 1200ml to carry/digest) 😳
