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Product Review: Dexcom G7
After what felt like an eternity, I finally got my hands on the long-awaited Dexcom G7. FDA approved in December and available in retail pharmacies mid-February, Dexcom G7 promised to be a major upgrade from its predecessor. So is it worth the hype? Read on to get my take on the Dexcom G7 continuous glucose monitoring system. Dexcom G6 vs G7 I should disclaimer this product review by saying that I do not live with diabetes. I write from the perspective of someone that has relatively unremarkable glycemic activity. I don’t depend on CGM to manage my health. However, I…
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Three Surprising Changes to the 2023 ADA Standards of Care
Here are three surprising changes to the 2023 ADA standards of care.
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Product Review: Freestyle Libre 3
I finally got my hands on the long-awaited Freestyle Libre 3 continuous glucose monitoring system. FDA-approved in May, sensor kits are finally making their way through the pharmacy and DME supply chain. While there are certainly some kinks yet to be smoothed, the system is an overall improvement from Libre 2. Libre 2 vs Libre 3 Wearers of Freestyle Libre 3 will notice four key differences from the Libre 2, including sensor size, smartphone connectivity, sensory applicator, and over accuracy. Size The Libre 3 sensor is notably smaller, lighter and much more flexible when positioned on the back of the…
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Move Over A1c, Make Room for Time In Range
A hemoglobin A1c test (HbA1C) has long been the gold standard for diagnosis and treatment of diabetes. It’s cheap, quick, and easy to interpret. An A1c of 6.5% or greater is considered diagnostic criteria for diabetes, while 7.0% or less is regarded as controlled once diagnosed. Completed every 3-6 months, A1c is an accessible and affordable way to monitor long term glycemic control. Yet, A1c often fails to capture the nuance of day-to-day management for so many people living with diabetes. A sleepless night of lows (less than 70 mg/dL) followed by a frantic day of highs (greater than 180…
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Remission vs Reversal
I’d like to think we are at the cusp of finding a cure for diabetes. Given the immense day-to-day burden, it can’t come fast enough. Until then, it’s important to proactively manage blood sugars, macro- and microvascular changes, and long term complications. With early and aggressive intervention, it’s not impossible to achieve euglycemia in those with endogenous insulin production—usually Type 2 Diabetes (T2D). Substantial lifestyle change may even yield near “normal” glucose with little to no pharmacological intervention. While it is tempting to think of this process as a “reversal” of diabetes, a 2021 consensus report recommends the term “remission”…
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Diagnosing Type 1 Diabetes in Adults
The UK T1D Immunotherapy Consortium recently updated their guidance on diagnosing type 1 diabetes (T1D) in adults. This is particularly important as a large portion of new onset T1D in adults are misdiagnosed as Type 2 diabetes (T2D). An accurate diagnosis matters. It can shape selection and advancement of treatment, understanding of natural disease progression, and expectations around the efficacy of diet and lifestyle. Most importantly, a misdiagnosis can be incredibly frustrating and discouraging for patients. Clinical Features While there is no single feature that distinguishes T1D from T2D in adults, presence of the following parameters suggest the need…
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Nutrition Strategies for Managing Postprandial Glucose
Managing blood sugars after meals can be tough. The rise is often steep and unexpected, leaving individuals scrambling to intervene—more rapid-acting insulin, a brisk walk, a liter of water—sometimes even a call to the doctors office.
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The Value of the Diabetes Educator
Certified diabetes care and education specialists–or “diabetes educators”–bring unique skills to the care team. Beyond education, they support a holistic approach through individualized management, factoring in background, culture, environment, and access to resources.
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CDCES and Primary Care: A Healthy Partnership
It’s no secret that diabetes is on the rise. The CDC estimates that over 37 million Americans (or roughly 11% of the US population) have diabetes, while another 96 million live with prediabetes.¹ Combined, almost 50% of Americans live with some sort of metabolic dysfunction. At the same time, primary care providers are on the decline...
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DSME/T: The Gold Standard in Diabetes Education
Managing diabetes is a lot like caring for a newborn—relentlessly needy, impatient, and often irrational. It requires numerous daily decisions and a general high level of engagement and attention. I remember hearing at a professional conference that “if patients did everything their doctors asked of them it would take over 2.5 hours per day.” That’s a lot of time to be doing anything, let alone managing diabetes. To best equip patients with tools to manage diabetes, the American Diabetes Association (ADA), American Association of Diabetes Care and Education Specialist (ADCES), and the Academy for Nutrition and Dietetics (AND) have updated their…
