Issue: November 2020
Source/Disclosures
Disclosures: Katselnik reports he receives speaking fees from Dexcom.
September 28, 2020
3 min read
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Professional device can encourage adoption of CGM as standard of care for diabetes

Issue: November 2020
Source/Disclosures
Disclosures: Katselnik reports he receives speaking fees from Dexcom.
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Technology advancements during the past 5 to 10 years have provided clinicians and patients with better ways to treat and manage diabetes. However, even with clinically proven outcomes, adoption of new technology remains relatively low.

The CDC reports that 34.2 million U.S. residents, or just more than 1 in 10, have diabetes, and a staggering 88 million American adults — approximately 1 in 3 — have prediabetes. Newly diagnosed cases of type 1 and type 2 diabetes have also significantly increased among U.S. youths, as diabetes continues to be a growing epidemic across the country.

Source: Adobe Stock

Although disease management has been difficult and cumbersome in the past, one of the most innovative technologies available for people with diabetes is a continuous glucose monitoring system, which uses a small, wearable sensor to regularly measure glucose. This device is placed on the abdomen and will send glucose levels wirelessly to a compatible smart device or receiver — giving users real-time glucose data without the need to prick their finger. The systems also offer customizable alerts and alarms to help users avoid dangerous low and high blood glucose events.

Daniel Katselnik

This technology can be a life-changing tool for people with diabetes, not only for improving glucose management and overall health, but also for easing the stress and anxiety associated with traditional diabetes management. For clinicians to provide their patients with the best care available, it is essential to start adopting CGM as the standard of care for all diabetes treatment plans.

As this technology continues to advance, clinicians have more CGM options than ever before to use with their patients, including professional-use CGM. Unlike personal CGM, which requires a prescription and is worn by patients indefinitely, professional CGM is clinic-owned and provided to patients to wear temporarily for a 10-day period — during which both the patient and clinician can examine key health insights to adjust therapy plans with more precision and customization. These insights also offer clinicians a better understanding of how patients can modify daily behavior based on the effects of variables such as food, exercise, stress and medication.

Professional CGM products give clinicians the ability to introduce CGM technology to their patients who are experiencing fluctuations in glucose levels, including people with diabetes, prediabetes or anyone who needs additional glucose monitoring. Professional CGM offers a way for health care providers to familiarize CGM-naive patients with the technology in a controlled and carefully guided environment before prescribing a personal CGM system.

Professional CGM systems are available from Abbott, Medtronic and Dexcom. The Dexcom G6 Pro, for example, is a single-use system that gathers real-time glucose data during a 10-day period and offers both a blinded and unblinded mode. In unblinded mode, patients can see their glucose levels in real time, similar to a personal CGM system; in blinded mode, patients are unable to view their glucose data in real time and instead review their results with their clinician retrospectively at the end of the 10-day session.

In addition to the everyday convenience to patients of real-time CGM, the major benefit of personal CGM for both patients and clinicians is the proven health improvements as a result of its use. The longest real-world study of CGM use in patients with type 1 diabetes, COMISAIR, revealed that CGM is superior to self-monitoring blood glucose in improving clinical outcomes, regardless of insulin delivery method. Patients showed an average increase of 5 hours per day of time in range, an average decrease of 1 hour per day of time below range and an average 1.3% decrease in HbA1c. Further, the results showed that long-term CGM use supports ongoing clinical benefits and reduces likeliness of health complications for people with type 1 diabetes.

For clinicians to provide their patients with the best care available, it is essential to prioritize the use of CGM for all patients with diabetes, even at initial diagnosis. Professional CGM systems give clinicians another way to introduce their patients to CGM while also obtaining important information and data to guide diabetes treatment plans. Clinicians must further educate themselves and their patients on the benefits of CGM technology for diabetes management and long-term health improvements.

For more information:

Daniel Katselnik, MD, is an endocrinologist at Diabetes and Metabolism Specialists in Texas. He can be reached at dkatselnik@diabetesandmetabolism.com.