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The Diabetes UK Professional Conference kicks off today

tim2000s

tim2000s

Expert
Retired Moderator
Messages
8,936
Location
London
Type of diabetes
Type 1
Treatment type
Other
Sadly I'm not a professional Diabetes care person, in spite of being a professional person with Diabetes, so going is tricky! I'll try and post any interesting updates I see from Twitter, Facebook, etc, into this topic though.
 
Number of the GBDOC currently in the training for Young Diabetogloists and Endocrinologists and Nick Oliver has just confirmed that high glycaemic osciillation is worse than prolonged highs for cell damage due to Oxidative stress and endothelial damage. So try and stay low and level, rather than low and swingy. Avoid high where possible and try and avoid high/low/high/low cycle. (Not from the conference but the cells that are worst affected by oxidative stress are the nerves, kidneys and retinal cells).

So what are the best strategies for reducing the swings? Not just CGM and Tech. I think diet has a part to play!
 
Tim, did he cite any new evidence ?
"While it may seem intuitive that increased glucose variability will lead to acceleration in the development of micro- and macrovascular complications in diabetes, compelling clinical evidence that this is the case remains elusive"
Glycemic Variability: Both sides of the story, (Cerellio and Kilpatrick, 2013) http://care.diabetesjournals.org/content/36/Supplement_2/S272.full
 
tim2000s said:
Sadly I'm not a professional Diabetes care person, in spite of being a professional person with Diabetes, so going is tricky! I'll try and post any interesting updates I see from Twitter, Facebook, etc, into this topic though.
Click to expand...
It starts on Wednesday :)
 
phoenix said:
Tim, did he cite any new evidence ?
"While it may seem intuitive that increased glucose variability will lead to acceleration in the development of micro- and macrovascular complications in diabetes, compelling clinical evidence that this is the case remains elusive"
Glycemic Variability: Both sides of the story, (Cerellio and Kilpatrick, 2013) http://care.diabetesjournals.org/content/36/Supplement_2/S272.full
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Was apparently talking specifically about micro-vascular. Looking at nervous system, retinal and kidneys. Slightly different spin. I've asked for the data - will hopefully get a copy of the slides @phoenix. Macro-Vascular seems to be ignored. Doesn't look like particularly new data though although a quick web search does seem to show additional research since 2013 linking the two. Couple of articles below.

http://online.liebertpub.com/doi/abs/10.1089/dia.2013.0205

http://www.sciencedirect.com/science/article/pii/S1056872714003675
 
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We've also learned in one session that Nick Oliver considers pumps proactive and CGM reactive, however the reality is that both are as proactive as the user (twitter discussion on topic).

Also, a number of the young uns have been given forced hypos to understand the sensation. The hash tag was #feedme.
 
tim2000s said:
Number of the GBDOC currently in the training for Young Diabetogloists and Endocrinologists and Nick Oliver has just confirmed that high glycaemic osciillation is worse than prolonged highs for cell damage due to Oxidative stress and endothelial damage. So try and stay low and level, rather than low and swingy. Avoid high where possible and try and avoid high/low/high/low cycle. (Not from the conference but the cells that are worst affected by oxidative stress are the nerves, kidneys and retinal cells).

So what are the best strategies for reducing the swings? Not just CGM and Tech. I think diet has a part to play!
Click to expand...


What was the definition of 'high' in the oscillation, and the prolonged highs? Where any numbers mentioned?
 
tim2000s said:
Number of the GBDOC currently in the training for Young Diabetogloists and Endocrinologists and Nick Oliver has just confirmed that high glycaemic osciillation is worse than prolonged highs for cell damage due to Oxidative stress and endothelial damage. So try and stay low and level, rather than low and swingy. Avoid high where possible and try and avoid high/low/high/low cycle. (Not from the conference but the cells that are worst affected by oxidative stress are the nerves, kidneys and retinal cells).

So what are the best strategies for reducing the swings? Not just CGM and Tech. I think diet has a part to play!
Click to expand...

US RH ers know this already. Flat line through diet is the best way to feeling good!
 
SunnyExpat said:
What was the definition of 'high' in the oscillation, and the prolonged highs? Where any numbers mentioned?
Click to expand...
Example given shows high as ranging 4-20 and low as ranging 7-10. Also stated that higher average with lower variability better than lower average with higher variability.
 
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nosher8355 said:
US RH ers know this already. Flat line through diet is the best way to feeling good!
Click to expand...
You already have insulin though. Balancing low carb on its own much more straightforward than balancing food plus exogenous insulin.
 
tim2000s said:
You already have insulin though. Balancing low carb on its own much more straightforward than balancing food plus exogenous insulin.
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Having too much is just as bad! Haven't you ever injected too much or got the balance wrong?
And I'm grateful that I don't have to inject, count carbs etc!:angelic:;)
 
tim2000s said:
Sadly I'm not a professional Diabetes care person, in spite of being a professional person with Diabetes, so going is tricky! I'll try and post any interesting updates I see from Twitter, Facebook, etc, into this topic though.
Click to expand...

In the days of the old BDA, some years before i was diagnosed, there was not a split between professional and the person with diabetes, and there were open meetings. The change to separate meetings was, i feel, a mistake. I don't like this split, and don't think it enhances empowerment. We are professional diabetes care people, with an everyday part time diabetes care job (with no holidays, and no retirement!)
 
ann34+ said:
In the days of the old BDA, some years before i was diagnosed, there was not a split between professional and the person with diabetes, and there were open meetings. The change to separate meetings was, i feel, a mistake. I don't like this split, and don't think it enhances empowerment. We are professional diabetes care people, with an everyday part time diabetes care job (with no holidays, and no retirement!)
Click to expand...
This is predominantly down to the regulations that stipulate that the pharma companies cannot talk to patients in the UK (or Europe I think). As a result, patients are not supposed to go.

I and others apparently caused rather a lot of issues with this at the Diabetes Professional Care conference in November.

@Administrator can you catch up with Paul from TeamBG/GBDOC at the conference and corner someone from Diabetes UK to speak with the regulator and get these rules modified? Or I'll just have to set up a company that I call healthcare of some description so I can be "professional" in my provision of healthcare.
 
tim2000s said:
Number of the GBDOC currently in the training for Young Diabetogloists and Endocrinologists and Nick Oliver has just confirmed that high glycaemic osciillation is worse than prolonged highs for cell damage due to Oxidative stress and endothelial damage. So try and stay low and level, rather than low and swingy. Avoid high where possible and try and avoid high/low/high/low cycle. (Not from the conference but the cells that are worst affected by oxidative stress are the nerves, kidneys and retinal cells).

So what are the best strategies for reducing the swings? Not just CGM and Tech. I think diet has a part to play!
Click to expand...

If the conference doesn't begin until tomorrow, is this from a pre-meeting going on?
 
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