Comments on: The Role of A1c in Light of CGMS http://challengediabetes.diabetech.net/2007/10/24/the-role-of-a1c-in-light-of-cgms/ Thoughts about current approaches to managing diabetes Thu, 11 Mar 2010 21:20:49 +0000 http://wordpress.org/?v=2.6.1 By: Kevin http://challengediabetes.diabetech.net/2007/10/24/the-role-of-a1c-in-light-of-cgms/#comment-11901 Kevin Thu, 25 Oct 2007 16:05:11 +0000 http://challengediabetes.diabetech.net/2007/10/24/the-role-of-a1c-in-light-of-cgms/#comment-11901 On the accuracy front, there are lots of choices people can make if they only knew which tools are accurate and which are less accurate. For example, our HomeCheck A1c is always within 0.1 and the closest you can get to a True A1c. Likewise, some meters are more accurate than others (ie - Wavesense and Ascenscia). Pump vs. MDI. People who weigh their food on a scale vs. people who never weigh their food or double check the accuracy of packaged foods (especially for breakfast foods when they are insulin resistant and require more insulin/carb.). My point in this post is that as we move into a world of real-time inputs and real-time decisions, we need to find at least one highly accurate beacon in our personal diabetes care technology toolkit that tethers cgms calibration and behavioral feedback to something akin to True North (vs. false magnetic based indications of the North Pole). Without this highly accurate anchor point, there is no way to relate cause and effect and major errors will be made much like the arctic explorer who forgets to calibrate his GPS antenna (http://tinyurl.com/yprxrp) before heading off on the expedition. On the accuracy front, there are lots of choices people can make if they only knew which tools are accurate and which are less accurate. For example, our HomeCheck A1c is always within 0.1 and the closest you can get to a True A1c. Likewise, some meters are more accurate than others (ie - Wavesense and Ascenscia). Pump vs. MDI. People who weigh their food on a scale vs. people who never weigh their food or double check the accuracy of packaged foods (especially for breakfast foods when they are insulin resistant and require more insulin/carb.).

My point in this post is that as we move into a world of real-time inputs and real-time decisions, we need to find at least one highly accurate beacon in our personal diabetes care technology toolkit that tethers cgms calibration and behavioral feedback to something akin to True North (vs. false magnetic based indications of the North Pole).

Without this highly accurate anchor point, there is no way to relate cause and effect and major errors will be made much like the arctic explorer who forgets to calibrate his GPS antenna (http://tinyurl.com/yprxrp) before heading off on the expedition.

]]> By: Bernard Farrell http://challengediabetes.diabetech.net/2007/10/24/the-role-of-a1c-in-light-of-cgms/#comment-11900 Bernard Farrell Thu, 25 Oct 2007 14:53:59 +0000 http://challengediabetes.diabetech.net/2007/10/24/the-role-of-a1c-in-light-of-cgms/#comment-11900 Kevin Interesting thoughts about the ways in which we, and caregivers, evaluate how we're doing. There's really no good answer here, I think. I don't even like to think about the +/- difference, mostly because it's too depressing. In the light of other guidance, I have to assume it's true. Which I know it isn't. Oh well. Maybe the next generation devices will get closer to real values. Though that won't really help us interpret the myriad of values and put them to good long term use. Kevin

Interesting thoughts about the ways in which we, and caregivers, evaluate how we’re doing. There’s really no good answer here, I think.

I don’t even like to think about the +/- difference, mostly because it’s too depressing. In the light of other guidance, I have to assume it’s true. Which I know it isn’t. Oh well. Maybe the next generation devices will get closer to real values. Though that won’t really help us interpret the myriad of values and put them to good long term use.

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