I’m Type 1 and I agree with him. Injections are not a problem worth solving for me. It’s the constant mental grind of tight-rope walking blood sugar through balancing food, insulin, exercise, and random body events (that you never quite figure out) that is the problem.

Blood sugar testing is an annoyance, but the main problem is not the actual test, but the inadequacy if testing your sugars a few times a day as a method of control. There we do have solutions coming out; the latest generation of continuous blood glucose monitors are life-changingly good.

I've been using Dexcom now for two years, and it finally helped me to really understand certain weird things about my blood glucose, after having a type1 diabetes over 20 years.

a) The morning peak is a dawn phenomenon. Solved with a higher basal setting 3 hours before waking up.

b) Going to sleep with a 100 mg/dl and waking up in the middle of the night with a glucose of 300 mg/dl? Usually because eating fatty and heavy food for dinner. Depending on your meal, a 150% temporary basal or if looping, letting the oref1 super multi bolus to take care of it.

c) Having a cold and suddenly there is no way to keep your glucose levels down? I use AndroidAPS's profile multipliers here. Last time I was sick I set the multiplier to 160%, which means more basal, more insulin for carbs and correction.

d) Doing sports? Get the insulin on board settings right in AndroidAPS, and try to do exercise only when the IoB is back to the base level. Use 0% TBR if needed.

And still I have an alarm almost every night for a hypo/hyper. Soon closing my loop and letting the automation take care of the nightly surprises. It used to work great with my Accu-Chek Combo pump until the pump broke. Now hopefully getting a Dana RS soon, so I can automate lots of things for the software to take care of.

I’ve been using Dexcom for about 6 months, and it’s taught me that the situation was utterly hopeless without it. I’ve figured out a few patterns like the huge nighttime sugar spike with fatty dinners, but overall I have unpredictable reactions to food and even moderate activity. Like you, I have usually spikes in the morning without eating, but sometimes dips.

The CGM has allowed me to be more like a reaction machine. Going up? Injection. Heading close to to low? A few sips of juice. I can be more aggressive with my dosing know I can see those lows coming. It’s a huge cognitive load off, and has taking my control from poor to excellent.

But yeah, those night time alarms, huh? I’ll close the loop when it’s all done with my phone.

Oh yeah. More than two beers in the evening: hypos in the morning, either 4am or sometimes when I woke up around noon.

Also instead of taking sugar when going low, try using a system that counts your basal rates to the IoB. Then after a meal you start going down a bit too early, you turn the TBR to 0%. Loop or AndroidAPS helps with this a lot.

Yes, and many of them have failed. Pfizer's inhaled insulin was a flop and MannKind's isn't doing well. They were positioned as "no more needles!" and what they realized is that it's not enough to get people to switch.

I think people who don't need to inject don't realize how benign it really is: I'm not diabetic, but I did need to give myself 3/daily subcut injections (same style as insulin) for a month after an injury. It was absolute agony for the first week or so; often I'd need to psyche myself up for a good 15 minutes before injecting. But by the end of the process it was a 15 second endeavor that I didn't mind in the slightest.