So here's an interesting one that I've identified after nearly six months using a hybrid closed loop. I've noticed how my hypo awareness has changed. And what I really mean by changed is "Improved". At clinic appointments, the meeting with the DSN always involves what I think is known as the "Gold" questionnaire, where they ask about things like Hypo awareness.
What I noted on the scoring was that for the last few visits, I always put the awareness level at around 3.8mmol/l. I've noticed that this is no longer the case.
Over the past six months, by use of a closed loop, my time in range has gone up from around 78% to nearly 90%, and more importantly, my time spent below 3.9 has dropped from 7% to 2%. Whilst my Hba1C has remained more or less the same, the standard deviation of my levels has dropped from 36% of my mean glucose level to 31% of mean (39% of media to 33% of median).
And the result? My hypo awareness level has risen. Where before I could sit for ages at 4.0-4.2 quite happily, this is no longer the case. I feel the impending low now at this level, even if I am sitting there for a long time. It's quite disconcerting as I'm not showing as low on the finger pricks. I've done a quick straw poll amongst loopers and although it was only a small sample, the majority have reflected similar results.
So what's the point of this topic? Well, aside from pointing out a huge benefit of using a form of hybrid closed loop, it appears that if you can pull your time in range up percentage wise and reduce your glycaemic variation, hypo awareness improves. This isn't new news, but it seems to work whether you were hypo unaware or not. And that's the point. If you are struggling with lack of awareness of hypos, it's worth putting the effort in to reduce the number and overall variation. Badger your HCPs for CGM to help. It seems to make a world of difference.
What I noted on the scoring was that for the last few visits, I always put the awareness level at around 3.8mmol/l. I've noticed that this is no longer the case.
Over the past six months, by use of a closed loop, my time in range has gone up from around 78% to nearly 90%, and more importantly, my time spent below 3.9 has dropped from 7% to 2%. Whilst my Hba1C has remained more or less the same, the standard deviation of my levels has dropped from 36% of my mean glucose level to 31% of mean (39% of media to 33% of median).
And the result? My hypo awareness level has risen. Where before I could sit for ages at 4.0-4.2 quite happily, this is no longer the case. I feel the impending low now at this level, even if I am sitting there for a long time. It's quite disconcerting as I'm not showing as low on the finger pricks. I've done a quick straw poll amongst loopers and although it was only a small sample, the majority have reflected similar results.
So what's the point of this topic? Well, aside from pointing out a huge benefit of using a form of hybrid closed loop, it appears that if you can pull your time in range up percentage wise and reduce your glycaemic variation, hypo awareness improves. This isn't new news, but it seems to work whether you were hypo unaware or not. And that's the point. If you are struggling with lack of awareness of hypos, it's worth putting the effort in to reduce the number and overall variation. Badger your HCPs for CGM to help. It seems to make a world of difference.
