Having reviewed the data that my Libre has generated over the weekend (and for these purposes the Libre is a cgm), I put forward the hypothesis in the title.
From my admittedly small sample size of one, since I started with the Libre I can see that my average glucose level has reduced, my likelihood of having a hypo has reduced and ability to maintain an optimum glucose level, measured by variance, has improved. I have not changed my insulin delivery method. It is still MDI.
I further postulate that with CGM, the Hba1c is redundant, as the data set available to a clinician (and user) is substantially better and more complete.
My final postulation is that equipping diabetics, who meet appropriate criteria, with CGM rather than pumps, would be a more effective way of improving glucose level optimisation. I’m not saying that pumps don’t have a place. I believe they do, but I believe that CGM offers a more effective route to diabetes management, for both HCPs and the diabetic themself. And what does “appropriate criteria” mean? Simply that those who qualify for a pump on the NHS now should probably qualify for CGM, and that those who demonstrate an ability/desire to manage their diabetes effectively should also qualify.
Why do I believe this? I think the key benefit to the end user of CGM is a psychological one. Personally I want to keep my BG level within the target zone. It’s a target and I want to hit it. Secondly, there is no hiding from rogue high readings, whether deliberately induced or not. If you can see them, you can see the damage you are doing yourself.
Then there is the practical side. The two most critical being that you are able to observe and treat highs and lows before they fully happen and that patterns are significantly easier to spot and do something about. And when you are doing something, you have a full set of data to see the effects.
This is why I think CGM is something that should be available via the NHS to reduce the likelihood of diabetic complications, especially in Type 1s.
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