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quotes from Darryl CGMS

Discussion in 'Continuous Glucose Sensing' started by fredntan2, Jun 15, 2009.

  1. Jacob'sDad

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    I think this is the second time a CGMS question I posted may have gotten lost in the shuffle, which is unfortunate.:(
     
  2. lil'Man'sMom

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    I think at this point, with this thread, lots of post are getting lost in the "shuffle". Probably better off starting a new thread.:cwds:

    let this one go to it's final resting place...finally!
     
  3. Darryl

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    Lauren,

    I think what you do and what we do is similar, just that our alarm ranges are different.
    It is fantastic that your daughter has been on a CGM through all of her teenage years.
    I didn't even know CGM's were available (even in pre-market testing) 5 years ago. If
    my dd's ranges need to be set higher when she is a teenager, that will be fine with us.
    We will never set any goal that she can not achieve.

    When I post our way of doing things, it is only to share that some things that we didn't
    all learn in D-school are in fact a possibility, but not to imply in any way whatsoever that
    our particular techniques or alarm ranges or the tools we use are the best solution for
    anyone else.
     
  4. Darryl

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    Dave,

    I searched and I found it!

    We use one ISF because we haven't noticed any difference in ISF no matter what time of day.
    After making thousands of corrections at all times of day I can be pretty sure of this!

    Conversely, we definitely need a different IC ratio in the morning, afternoon, and evening.

    Which is interesting, now that I think about it... this implies that her insulin resistance is
    constant, but her BG-to-Carb ratio is what is changing. Not what I would expect, but it
    appears to be the case.



     
  5. Jacob'sDad

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    We have adopted the acronym BCR for the BG to carb ratio and I have often wondered whether BCR is the constant or ISF. It can be one or the other or neither but not both.

    It seems logical that 1 gram of carbohydrate would raise BG less in the middle of the day when a person is more active. It also seems logical that the middle of the day carb ratio would be higher as well. In this case the raise in carb ratio and the drop in BCR would cancel out resulting in the same ISF as during another time of day!

    Here's a simple example: Let's say Jacob has an dinner carb ratio of 1:14 and a BCR at that time of 8. His ISF is therefore 112 (14 x 8)
    Now let's say lunch his carb ratio is 1:16 and his BCR at that time is 7. His ISF is therefore 112 (16 x 7).

    See? Both ISFs are the same but BCR changes.:)

    I'm still not convinced that ISF is ALWAYS the same. I think insulin resistance might play havoc with it around breakfast time and at night both carb ratio and BCR seem to be higher for Jacob resulting in a much higher ISF during the night.
     
  6. twodoor2

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    Wow, it's been forever since I posted here. Interesting thread.

    I think as you age, and as you get heavier and less insulin sensitive, the ISF can generally be the same.

    Darryl, since your daughter is 11 (if I recall), it is likely that she could have the same ISF, in particular if her basal requirements vary throughout the day to combat periods of higher glucose output or insulin resistance.

    As my daughter gets heavier, she's a large six year old and not insulin sensitive at all, her ISF's are also getting closer to being a similar value throughout the day.

    I should also state that having a lower BCR will probably keep your ISF's a bit closer in size throughout the day.
     
    Last edited: Jun 26, 2009

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