They use the ADA recommendation range for comparison purposes. The ADA recommends keeping HBA1c below 7% and TIR over 70%. With closed-loop it is over 90%, so clearly better control. Even for an anecdotal report.3.9 to 10 is kind of a big window. ...
The Unannounced Meal mode referred to in the article is a bit of a misnomer. The user still notifies the system an hour before eating so insulin delivery can start increasing in time. Lyumjev and Fiasp may be a bit faster, but it still takes a long time for subcutaneously infused insulin to have an effect. This is a limiting reality, and there is no way around it.
Put simply, they don't. The manufacturers provide two pieces of information. Half life and a duration under clamp. The duration under clamp is the observable time of action. Half life indicates the real time in system. It is this latter that creates the long tails that need to be accounted for to reduce hypo risk.Interesting that they use much longer insulin duration times than manufacturer specifications. It is an important parameter for the algorithms and something pumpers have been questioning for a while. The industry is going to have to adapt to this need for accurate and meaningful data.
Not really. As @MarkMunday pointed out, the real limiting factor is the insulin effect and clearance, in terms of responsiveness, and yes, the 3.9-10 is provided to give a comparison aligned with the international consensus on time in range guidelines.3.9 to 10 is kind of a big window. I’d bet the limitation variables was cgm and it’s responsiveness. If cgm could eventually sample blood, I bet that window could be more reliably narrowed.
I am confused. What are are you trying to say here?Yet another claim for a closed loop system that avoided testing it at a level of physical activity which cannot be fueled mainly by fat.
No. Turns out that Lyumjev is about 10 minutes faster to peak and the tail seems to disappear fully at 5 hours, compared to about 7 for Fiasp.What’s the benefit of Lyumjev compared to Fiasp? Are they not basically the same speed and duration?
Thanks for the unhelpful and irrelevant comment.Yet another claim for a closed loop system that avoided testing it at a level of physical activity which cannot be fueled mainly by fat.
We use 3.9-10 because it's the agreed standard and allows a reasonable comparison with the metrics provided by commercial offerings. As his paper says, he tends to look at the 70-140 as being more pertinent, and a higher time in that range would be more normal.I have higher expectations than 3.9 to 10 mmols. It’s a bench mark, but I want to be better than that. I would hope that someday with better technology (better insulin, and better/faster more real-time test loop) we could achieve something closer to normal.
I’ve always wanted to be normal, so that’s my goal.
I’ve got a flat line on a cgm that regularly says my number range from 3.9 to 6.0. I do this manually. This isn't from a closed loop system. I don’t really trust the cgm- it’s slow, and the numbers vary. A meter can quickly tell me reality. But this is why I think 3.9 to 10 is a big window.
I’m still hoping for the smart insulin assembly, where in the presence of high blood sugar encapsulated insulin will release itself. Then it’s just a matter of us having enough of the encapsulated insulin onboard. I think this would be a game changer- insulin that only goes to work when it’s needed and no need for a test loop. (SIA II)
I have only recently been diagnosed and was rushed to hospital last week with very high numbers, I am recovering now and what I am finding is that I struggle getting any lower than 5.0. It makes me feel very shakey, I think it may just be because I have been running high for months before diagnosisI have higher expectations than 3.9 to 10 mmols. It’s a bench mark, but I want to be better than that. I would hope that someday with better technology (better insulin, and better/faster more real-time test loop) we could achieve something closer to normal.
I’ve always wanted to be normal, so that’s my goal.
I’ve got a flat line on a cgm that regularly says my number range from 3.9 to 6.0. I do this manually. This isn't from a closed loop system. I don’t really trust the cgm- it’s slow, and the numbers vary. A meter can quickly tell me reality. But this is why I think 3.9 to 10 is a big window.
I’m still hoping for the smart insulin assembly, where in the presence of high blood sugar encapsulated insulin will release itself. Then it’s just a matter of us having enough of the encapsulated insulin onboard. I think this would be a game changer- insulin that only goes to work when it’s needed and no need for a test loop. (SIA II)
I have only recently been diagnosed and was rushed to hospital last week with very high numbers, I am recovering now and what I am finding is that I struggle getting any lower than 5.0. It makes me feel very shakey, I think it may just be because I have been running high for months before diagnosis
I think it may just be because I have been running high for months before diagnosis
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