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Re: [IP] Re: AACE 2011 Guidelines



 Possibly the main reason that they are downgrading the CGMS is the fact that it
is relatively an unknown. As successful as many of us have been with it, really
nobody knows
 how good it, but us. In the AACE 2001 correspondence that is pretty much what
they are saying. When I went in to the Hospital last july and had my hip
replaced again
 I talked to Drs Nurses and Technicians and for the most part, they knew nothing
about the CGMS. It's fairly new and the Medical Profession treats it as a new
gadget.

 Probably the main thing holding its use back is the cost. Most Diabetics I know
won't touch it because their insurance does not cover it. This year I will be
getting my 50 year
 medal which indicates that I am a fairly long time Diabetic. When I first heard
of the CGMS three or four years ago, I was so desperate after all the many years
of problems caused by being a Type 1 that I bought and paid cash for a CGM. It
was for me an act of desperation. Being a new device nobody seemed to know much
about it, and that caused problems at first. My Doctors were leery of it! Now
after using a CGMS since 2008 my Endo congratulate me for my good control with
my Hba1c 165. Not only that but despite being in my 80's,
 I am able to feel good again despite all those miserable past years, thanks to
the CGMS.

 Why don't more Diabetics do what I did? Just go buy it! I keep reading about
people having seizures, unexpected low's, feeling tired etc. Considering today's
dollars the cost of a CGMS really is not all that much. A starter kit including
10 sensors cost about $1100.00. They say to change them every three days yet
most people use them once every week or two. Just like the testing lancets, they
say to use a new one for every test, how many people actually do that? The
sensors cost about 41 bucks each and last say a week. Looking at
individual spending on non necessities, the cost is little. 

 There will be many objections to what I have just said and admittedly what I am
saying is incomplete. But I say anything is better than going through life
unnecessarily suffering
 the many side effects of Diabetes. One other thing about all this is the fact
that for many it would be deductable on their Federal Income Tax.

 One last note on this is that I personally have only one thing to gain from
this. That is the satisfaction of possibly getting others to do what I did,
enabling them to avoid experiencing all the problems I had in past years as a T1
Diabetic.
 Richard

On Apr 10, 2011, at 8:43 AM, Jerry Smith wrote:

> I received the following reply from an endocrinologist who was a contributor
> to the American Association of Clinical Endocrinologists (AACE) 2011
> Guidelines:
> 
> Dear Mr. Smith:
 > Lori forwarded your message to me. First of all, I gratefully acknowledge
your
> interest in the new AACE diabetes guidelines. I understand your feeling only
> too well, having quite a few patients in my private practice using their CGM
> successfully for many years. The issue at hand is that guidelines issued by
> any society are quite different from state of the art reviews etc. As you can
 > see from the methodology employed in the AACE (and any other) guidelines
they,
> by definition, are evidence driven. What that means is that there have to be
> randomized prospective trials on the subject before clear-cut recommendations
> for practitioners can be made. For continuous glucose monitoring these are
> only now beginning to appear (see, for example, the trial reported in the
> April 2011 issue of Diabetes Care). I have no doubt that once sufficient
> peer-reviewed evidence of benefits of continuous glucose sensors appear, AACE
> will strengthen the recommendations. In the
> meantime,  please see the AACE position statement on continuous glucose
> monitoring (not guidelines) which we published last Fall in Endocrine
> Practice. Thank you once more for your kind consideration.
> 
> Any comments?
> 
> Jerry Smith
> Rochester, NY
> .
.
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