Monthly Archives: April 2016

Dexcom G5 -a class leader – the number means more in context


I was privileged to attend the launch of the dexcom G5 which is a first and a world leader in terms of continuous monitoring. I so value companies that will only put out a product of excellence and quality. The MARD of the G5 is 9% what this means in layman terms is that it is the most accurate sensor on the market worldwide. MARD is a way to measure accuracy. For interest sake the MARD of the glucometers at large is around this mark and slightly lower. However some other continuous monitoring can go up to 15% or higher. The value of continuous monitoring is in its accuracy.

Why would you use a continuous monitor that is not as accurate as possible?

Most patients “react” to the number on the screen, however only the G5 has registration to “allow” patients to do this, without checking with a finger prick. In other words the number on the screen in context of the graph on the screen as well as the arrows going up down or staying constant allow you as a patient to “do” something before you are very low or very high – allow you so to speak to “stay in range”.

Prelimary studies show that the combination of either MDI (multiple daily injections) or CSI (continuous subcutaneous insulin infusion) with continuous monitoring (accurate) gets patients to a better A1c than without continuous monitoring. The point is that the number in context of your life and where you have come from and are headed to allow you to make decisions that previously were made in an almost russian roulette fashion.

Knowledge is power and technology can change lives. Living with type 1 diabetes is no joke and having your organs damaged by high sugars is a real danger. This tool not only gives you your life back but prevents end organ damage in a big way.

Thanks Dexcom for your dedication to excellence, to accuracy and to most of all to changing the lives of our diabetic community at large.G5-2G5

Knowing your number in context is not only educational but life and quality of life saving.

A1c – what does it mean?


What does the A1 c mean?

Definition : 3 month average of sugar, i.e. it totals up all the blood sugars over a 3 month period and gives and average value. Little more complex than that it is a blood test that piggy back off the “metabolism” so to speak of the red blood cell.

The more well controlled the A1c the more the post prandial is contributing. The higher the A1c in other words more out of control the more the fasting is contributing.

There is a big difference between fasting sugars and post-prandial (after a meal) sugars and how they affect things. Also think about this if you consistently go very low and very high you may well have a beautiful A1c and think you are great when actually you are not!

Glycemic variability is a BIG problem.

I would far rather my patients ran an a1c slightly higher with less variability.

So is it worth doing? I honestly feel that the A1c gives us some information, however for myself I feel the download is far more useful in type 1 diabetics and that I am able to tweak therapy far more accurately with a download or a CGMS.

For type 2’s it is a good test to follow, i.e. a trend. Is it going up or is it coming down or is it stable so to speak.

What is A1c – it’s an average and it has its uses but context is everything and for type 1’s glycemic variability is the difference between health and illness.

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Bono and justice and yet few seem to really take cogniscience


I recently watched a brilliant TED talk where Bono delineates the current “fires” in Africa and how the west essentially is watching.

It is always interesting to hear the opinion of a non-native to africa and often surprises me how much more sympathetic than even our own “native” -meaning born here- politicians and players are to the plight of the poor. And by and large Africa’s main bleeding to death literally is happening amongst it’s vast poor.

Even more poignant in light of the panama papers.

MMMmm, I really do wonder how the powers that be justify to themselves the awful treatment of their own. IT is one thing to treat your enemies badly, quite another to treat your kin poorly. Or as Ghandi puts it you can tell a lot about a person as to how they treat animals. Sometimes the poor are treated worse than neglected animals.

This may seem inflammatory, but when we inspect for the truth of the matter, what is the truth of the matter?

Bono describes himself as a very annoying thing – a rockstar with a cause. But why is it that there are some folk on earth that are concerned with justice whilst others seem to trample it in the daylight.

Just or not, we will indeed all be judged at the time designated for such. Each will respond for themselves.

On a daily basis I have the privilege of “treating” people and possibly helping on a physical and hopefully deeper level. The hardest moments are those where “treatment” seems to be withheld for no real or good reason and the person left for poorer – physically and sometimes mentally and sometimes even no longer.

I do wish more people would “hear” the justice message and respond. If only every 4th person did the world would be a better place. Small small can make a difference. I can hear the cries as if a constant scream and yet some don’t seem to hear at all. The boko haram girls in Nigeria are one small example – a gaping gaping wound bleeding to death in the hearts of their parents and the international community gape and stare blankly. Because those girls don’t open up an oil field?? How can Bin Ladin be “found” and these many girls be “lost”???

Justice continues to press my buttons, and I mourn at the lack of it pressing many others 😦

 

 

Discovery wellness day 9 April


Get to gold in one swoop !

9 am Saturday, booking essential – 343 1826

Pay the biokineticist and the dietician on the day as well as the Quarry nursing sister, but get to gold!

Lucky draw as well as a free towel and bottle to first 30 to book.

vitality wellness