The good news is that for most diabetics, your body will automatically wake you up for a hypo. It's a survival mechanism. But some people suffer from hypoglycemic unawareness, and their body doesn't wake them up.

Most diabetics have CGMs these days, though, and somebody like that should be setting hypo / hyper alarms so that either them or their partner wakes up.

(The problem there becomes false alarms and the subsequent alarm fatigue that results in you turning them all off.)

“Most diabetics have CGMs these days” - not where I come from :-(

You're right, the truth is probably actually that only a minority of T1Ds have CGMs. My post was a bit insensitive, not everyone has easy access to them.

What's even more frustrating is the disparity in who can get them and how even if they are cleared for use in your country. The author here points out that New Zealand's medical system doesn't always pay for CGMs, while the Australian system does. In Ireland, the Dexcom G6 system is available but the FreeStyle Libre 2, an updated version of the FreeStyle Libre with more frequent reads and better alarms (Libre vs Libre 2), is not.

CGMs are available over-the-counter, just like finger stick machines, in a variety of countries like Canada and Ireland. But in the United States a prescription is required for any CGM even if insurance doesn't pay for it and insurance generally only pays for it once you are actively on full-time insulin treatment, so type-2 diabetics can't avail of insurance to reduce the cost of potentially not needing to go on recurring insulin by getting a handle on being pre-diabetic. (Plus many doctors won't write a CGM Rx for someone who isn't type-1 or very symptomatic type-2. This has resulted in nutritionist businesses springing up whose purpose is to turn a credit card charge into a prescription for a CGM.)

But of course different countries have different regulatory systems, we all know that. This is to say that even when you find a system and method that has worked for others in your online community, that method might not be available to you, and it causes even more stress to have the idea, right or wrong, that a useful tool is just out of your grasp. And carbohydrates help you if you dare move between countries.

I was really surprised how difficult it is for competitors like levels to provide CGMs in the US.

Here in Europe we can simply get them from Abbot/Dexcom an ship them.

I can't make any promises, but I'm positive that I'll be able to develop a product that takes care of finding the correct insulin doses when giving activity and CGM data + meal information withing the next year's.

>The author here points out that New Zealand's medical system doesn't always pay for CGMs, while the Australian system does.

Only for under 21s, and only recently. Once you hit 21, the rug is pulled out from under you.

My province (Alberta) in Canada is just starting to cover CGM costa and only for under 18s.

https://www.cbc.ca/news/canada/edmonton/glucose-monitoring-d...

My doctor had to fight to get me one. I workout and was highly insulin sensitive (she made me workout less and gain some weight by doing less cardio - drives me nuts, I liked running). The insurance companies didn't want to fork over for the upfront cost, even though I had been to the hospital several times for low blood sugars. This included a stroke caused by a severe low blood sugar (yes, I lived alone at the time, pre CGM. Coworkers called a friend who had a key).

Granted this was 4 years ago, so I'm unsure how things have changed. The CGM is a game changer. I wish I had had it earlier. Would have kept me (hopefully) from a lot of issues and putting my friends and family through unnecessary pain.

Hi, do you live in the USA? I had a similar experience to you. I am considering doing a research project for grad school about patients in the USA who experienced insurance denials for CGMs.

I do live in the US. Yes. And actually, my endo is probably a better person to chat with. Let me drop her an email and see if she A) is allowed and B) has the time

sweet, thanks!

P.S. feel free to email me at [email protected] -- thanks

The alarm fatigue is no joke, and CGMs get less accurate the lower ones blood glucose goes, so false alarms on the low end are common.

My wife has a Tandem T:Slim and Dexcom G6 and she can't turn off the urgent low alarm. The alarms drive her totally crazy.

Though I'm happy to know at least the system will disable her basal rate if she's heading low.