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by caseyy
537 days ago
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The value is in clinical application though. For closed loop systems, making a clinical decision for insulin dosing every 5 minutes is life-changing, even if the dosage is 10% off. I’d say even with compression lows, most systems are self-balancing enough to produce better results than a self-monitoring person could. Besides, 10% off doesn’t often matter: At 0-70 mg/dl the pump should suspend insulin either way. At 110-600 mg/dl the pump should ensure enough IoB by bolus, increase basal, and monitor either way. In that 70-110mg/dl the 10% MARD kind of matters for clinical decision-making, but not much. 90mg/dl is about as healthy as 81 and 99. Patients are sometimes fussy by this inaccuracy but forget the tremendous benefit of trend indicators, let alone closed loop systems. Both of these have a much much larger positive impact to health than blood glucose being 10% above or below target impacts health negatively. CGM with <=10% MARD, whether in wrist form factor or sensor form, is good enough for treatment. Of course, same as most readers, I have my doubts about this article. |
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