Technology in Diabetes

The following are links and educational videos to a number of sites that we believe are both useful and credible. At Central Valley Endocrinology, we diagnose early Peripheral Arterial  Disease and  Early Autonomic Nervous System Dysfunction.


Abbott Diabetes Care Inc. 
Freestyle Libre Helpline 1-855-632-8658 
Monday through Friday 5 AM - 5 PM PST (excluding holidays)
Available for LibreLink App

FreeStyle Libre System

The FreeStyle Libre system measures glucose levels through a small sensor applied to the back of your upper arm. It provides real-time glucose readings for up to 14 days, both day and night. The scanner can also read glucose levels through clothing, making testing discreet and convenient.

The FreeStyle Libre system provides three critical pieces of data with each scan:

  • A real-time glucose result.
  • An eight-hour historical trend.
  • A directional trend arrow showing where glucose levels are headed.
  • No alarms/alerts
  • Zero Finger sticks


The touch-screen reader also holds up to 90 days of data, which allows people to track their glucose levels over time. 
https://www.freestylelibre.us/
https://myfreestyle.ca/en/products/libre/video 

Included in the testing process are:

  • Sudomotor function analysis (skin response).
  • Deep breathing exercises involving postural changes.
  • Photoplethysmography (PPG) estimates blood flow to the skin on a fingertip using infrared light.
  • Ankle Brachial Index with pneumoplethysmography detects atherosclerosis in the lower limbs.

TM Flow ANS screening may be recommended for individuals with:

  • Postural Tachycardia Syndrome
  • Syncope
  • Numbness in the hands or feet
  • Chronic pain in the feet
  • Pre-diabetes or diabetes
  • Resting tachycardia
  • Insulin resistance
  • Impaired glucose tolerance

TM FLOW System - What Is TM Flow? 

Autonomic nervous system function affects the entire body. When a primary or secondary disorder alters any aspect of ANS behavior, several symptoms may develop in various systems of the body. Such symptoms include urinary incontinence or a dramatic drop in blood pressure upon standing from a seating position. TM Flow is an innovative platform that provides your doctor with valuable information regarding your autonomic nervous system and the potential degradation of function resultant from a chronic health condition such as diabetes. Autonomic nervous system testing has historically involved several measurements. We obtain each measurement independently through specific modalities such as a sweat test. TM Flow combines technologies so multiple measurements may be obtained in one painless and straightforward process. TM Flow also assesses the broad functionality of the autonomic nervous system in a few short minutes, revealing critical clinical data that supports the earliest possible diagnosis and treatment of secondary concerns related to health conditions like erratic blood glucose. 

There are several situations in which autonomic nervous system testing is appropriate. The TM Flow automated system expedites the process, so patients do not have to spend any more time than necessary in the office. Currently, ANS testing is deemed medically appropriate when a patient displays signs of autonomic dysfunction and routine laboratory testing and clinical data do not provide enough evidence for an accurate diagnosis.

ANS testing may be used to investigate a variety of conditions, including:

  • Fibromyalgia
  • Cardiac dysrhythmia
  • Hypertension
  • Allergic conditions
  • Sleep apnea
  • Chronic fatigue syndrome

These are just a few examples of symptoms and conditions for which ANS may be advised. In addition to initial diagnosis, TM Flow may also provide useful clinical information regarding the efficacy of medical therapy.

UNDERSTANDING PERIPHERAL ARTERIAL DISEASE TESTING

Understanding Peripheral Arterial Disease Testing and results. A visual explanation of the ankle brachial pressure index can assess the severity of atherosclerosis in patients with peripheral vascular disease.

What Does Autonomic Nervous System (ANS) Testing Show?

There are three parts to the nervous system: sensory, motor, and autonomic. It is the autonomic system that is responsible for internal functions, including sweating, blood flow, and blood pressure. By carefully observing the responses of the autonomic system during specific testing, it is possible for our team to discover the origin of dizziness, syncope, and other symptoms. 

ANS testing can also:

  • Identify the stage of autonomic neuropathy
  • Identify the stage of autonomic dysfunction
  • Explain why the autonomic system responds as it does to environmental conditions
  • Identify diabetic autonomic neuropathy
  • Assess autonomic response to medical therapies

TM Flow Risks

Enter your The non-invasive nature of TM Flow ANS testing provides a safe, comfortable, and convenient method of assessing patient risks and overall health.

TM Flow Benefits

Innovative diagnostic tools aid physicians treating chronic and potentially severe medical conditions. TM Flow represents a significant advancement in the diagnosis and treatment of numerous concerning health conditions, both primary and secondary. For example, one of the benefits of TM Flow is the detection of cardiac autonomic neuropathy (CAN), a common diabetic complication. CAN have historically been under diagnosed. TM Flow provides the data that we need to assess this risk as well as others.

Diabetic neuropathy is another condition for which improved testing has been needed. Typically, the screening for diabetic neuropathy has been mostly subjective, based on patient input. Advanced technology is much more objective and therefore enables us to reach a more accurate clinical understanding of a patient’s health and risk factors.

Dysfunction in the autonomic system also indicates that nerves are sick. Nerves that are sick eventually die. Early testing that involves objective ANS assessment affords us the best opportunity to treat disease proactively.

Insulin Pump Therapy

People with Type 1 Diabetes need to take insulin to manage their blood sugar levels. Those with Type 2 Diabetes may need to use insulin to control their blood sugars. There are three options to administer insulin: per injection with syringe/insulin pen through a needle, inhaled insulin per inhaler, and the use of an insulin pump through an infusion set.An insulin pump is a small-computerized device. The pump delivers insulin to control your blood sugar levels through a tube or wireless system. Using a pump is another means for insulin delivery but it is not required.

Common Pump System Features:

  • 24 hour toll-free helpline
  • Waterproof protection
  • Internal Safety checks
  • Child safety lock out button
  • Individualized programming
  • Advance bolus options
  • Temporary basal rates options
  • Programmable reminders
  • Downloadable
  • Low battery/insulin warning
  • Active insulin time
  • Color screen with auto-brightness
  • Easy to use menu and buttons
  • Right-or left-handed orientated



Dexcom Technical Support
Available 24 hours a day; 7 days a week 1-844-607-8398
https://www.dexcom.com/continuous-glucose-monitoring

Dexcom

The Dexcom G6 provides real-time glucose readings every five minutes and allows you to see how your blood sugars are trending up to 10 days. This slim sensor can be applied to the back of your upper arm and abdomen. The glucose reading will be transmitted to your smart device or a compatible pump.

The Dexcom G6 system provides current and historical data in addition:

  • Zero Finger sticks 
  • Slim, water-resistant wearable 
  • Smart Device compatibility 
  • Customizable alerts and alarms
  • Allows sharing data

Dexcom Care 
(CGM Training, software downloads and tutorials)
1-877-339-2664 
Monday through Friday 6 AM - 7 PM PST 
Saturday 6 AM – 2:30 PM PST 
(All hours subject to change) 
 Available for Dexcom G6 App
patientcare@dexcom.com

Medtronic - The MiniMed 670G System

  • System requires Continuous Glucose Monitor (CGM) with Sensor 3 and Guardian Link 3 Transmitter.
  • Smart Guard Technology
  • Suspends basal (insulin) delivery to prevent low blood sugars up to 2 hours. Automatically resumes basal delivery if blood sugars are trending upward. 
  • Finger sticks are required for calibration and mealtime tests. In addition when promoted by sensor.
  • Bolus Wizard Calculator
  • Recommends a precise bolus dose based on your blood sugar and/or carb intake. Helps prevent insulin stacking.
  • Predicative Alerts
  • Alerts 30 minutes ahead of trending high or low blood sugars.
  • If no sensor is desired then the pump will deliver individual program for the basal and bolus insulin needs (refer to bolus wizard calculator). 
  • Requires one AA alkaline battery

Enter Innovative diagnostic tools aid physicians treating chronic and potentially severe medical conditions. TM Flow represents a significant advancement in the diagnosis and treatment of numerous concerning health conditions, both primary and secondary. 

For example, one of the benefits of TM Flow is the detection of cardiac autonomic neuropathy (CAN), a common diabetic complication. CAN have historically been under diagnosed. TM Flow provides the data that we need to assess this risk as well as others.

Diabetic neuropathy is another condition for which improved testing has been needed. Typically, the screening for diabetic neuropathy has been mostly subjective, based on patient input. Advanced technology is much more objective and therefore enables us to reach a more accurate clinical understanding of a patient’s health and risk factors.

Dysfunction in the autonomic system also indicates that nerves are sick. Nerves that are sick eventually die. Early testing that involves objective ANS assessment affords us the best opportunity to treat disease proactively.

https://www.medtronicdiabetes.com/products/minimed-670g-insulin-pump-system

Tandem - t:slim X2 Insulin Pump

  • Basal IQ Technology
  • Zero Finger sticks required for calibrations or mealtime tests when using Dexcom G6 Continuous Glucose Monitoring (CGM).
  • Reduces the frequency of low blood sugars by predicting glucose levels 30 minutes ahead and suspending insulin delivery if blood sugar is expected to drop below 80 mg/dL.
  • Suspends for maximum of 2 hours but can automatically resume your basal insulin if blood sugars are trending upwards.
  • Unique features to Tandem System
  • Large Touchscreen
  • Rechargeable battery
  • Micro-USB Port for data transfer
  • Remote feature software updates as available approved by FDA
  • Slim and small
  • Waterproof


Tandem Diabetes Care 1-877-801-6901
Available 24 hours a day; 7 days a week
www.tandemdiabetes.com
Available for t:simulator Appt here

Omni Pod - The Omnipod DASH System

  • A tubeless, waterproof pod with built-in bolus calculator. 
  • Simplify Carb Counting
  • Integrated CalorieKing food library with nutrition facts for over 80,000 foods.
  • Adjustable basal rates and delivers bolus doses quickly and easily.
  • Handheld personal diabetes manager (PDM) that you use to wirelessly program your insulin delivery.
  • If interested test drive free Omnipod Demo App.

https://www.myomnipod.com/DASH
Omnipod Customer Care

1-800-591-3455 Available 24 hours a day; 7 days a week
Available for Omnipod DISPLAY, Omnipod VIEW, Omnipod iPhone widgets
https://www.myomnipod.com/podder_support

At CVE, we support our patients by providing patient resources and information. We recognize that patients are better able to manager their own health when they are informed.

About

Central Valley Endocrinology began serving the Kings and Tulare County communities in 2007 when Prem Sahasranam, M.D. (Dr. Sahas) saw that the San Joaquin Valley had a need for an Endocrinologist. After spending years in New York City and Southern California, Dr. Sahas and his family moved to Central California.

Office Hours

We are open weekdays from 9AM - 5PM.
We are closed on all national holidays.

Additional Locations

My Diabetes Tutor

Central Valley Endocrinology

Contacts

515 W Grangeville Blvd
Hanford, CA 93230
P: (559) 587-1100
F: (559) 587-9044
Open 9AM - 5PM


                    1124 N Chinowth
                    Suite 102  Visalia, CA
                    P: (559) 713-6869 
                    F: (559) 713-6042
           Open 9AM - 5PM, closed Mondays

Copyright © 2019, Central Valley Endocrinology. All Rights Reserved.The information on this site should not be considered to be a personal medical advice; this site should be used for informational purposes only. Nothing can replace the relationship you have with a physician.