First FULL day! Yesterday was hectic, but today promises to be the real test: the shuttle schedules, strategies for deciding on sessions to attend, too many good topics, exhibits, posters ... I was reminded quickly yesterday that some of the topics don't quite capture the scope of the discussion. With that in mind, my decision today was to attend a session on Continuous Glucose Monitoring: Clinical Issues. This turned out to be a good choice. The speakers put it all in perspective: the progress in diabetes care over th years, from insulin discovery to insulin analogs today; from urine testing (which was revolutionary in its day) fifty years ago, to multiple daily blood glucose checks in the 70s and 80s, to continuous glucose monitoring today. These advance of course lead to better care, hopefully better diabetes control and less complications.
All the speakers had studied use of CGMS in patients who had better clinical outcomes when CGMS was used, even over a short period of time. The unexpected piece of this session was the fact that patient education is still the cornerstone for successful application of these advances: for it was apparent from all the speakers that in the hands of the "wrong" patient, a CGMS device could be dangerous. Because it gives us more information, the tendency is to do something with that information. That could mean overtreatment, and consequently low blood sugars. Without education, more information is sometimes less helpful. To us educators, there is no "wrong" patient. Everyone is educable on his/her own level at the right time.