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Bruce Bode Part 7, CGM Impact on Diabetes Treatment

Dr. Bruce Bode talks with Diabetes in Control Publisher Steve Freed during the ADA 77th Scientific Session in San Diego about his work with type 2 diabetes patients.

Dr. Bruce Bode, MD, FACE  is a professor of medicine at Emory University School of Medicine in Atlanta, GA. He has a strong affinity for working with children and young adults with diabetes and is considered one of the leading experts in the world on insulin delivery and glucose sensing. He is very active in clinical research on new diabetes products including pharmacological agents to prevent diabetes and control glucose and new insulins and glucose sensors.

Transcript of this video segment:

Steve Freed:  So where are you right now when it comes to type 2s? Maybe not on insulin, just maybe on oral medications as far as using maybe the Libre system or even the Dexcom system. If they’re willing to pay cash, because most insurance companies aren’t going to pay for it?

Dr. Bode: So, we do professional CGM and we give them a Dexcom or an Abbott Libre Flash, so if you aren’t at goal and we don’t know what’s going on, we need to figure out is it meal excursions, is it just one meal when you binge? Or is it overnight? Is it the liver putting out too much glucose? Once we figure when they’re going high, we can figure out what best drug we should use, or behavior change.  So, if it’s just three times a week they’re going up to 400, you say, well what are you doing, they say I have a bad problem, I eat a whole box of Oreos with ice cream, but only three times a week. I say why don’t we give you insulin for that if you can’t do it? CGM will give you a good profile of what’s happening at all times.

Steve Freed:  If you had your druthers, would all your diabetic patients be wearing some kind of CGM? With all the wristbands and all the motion detectors?

Dr. Bode:  I think if you have the ability and as you know, Google is getting into this and other companies. Obviously, these people like data. They like to know what data is going on. I think if you look at your phone and know what your sugar is at all times, you can make educated changes in your behavior to eat healthy. If you exercise, you say “every time I exercise I’m down in the 90s, when I’m not exercising I’m 120.” Maybe it will get people to exercise and stay fit. If they do that, not only do they live longer and healthier, from a health care standpoint, there’s a marked reduction in total cost of care.

Steve Freed:  So it’s really a change in the way you practice medicine?

Dr. Bode: Yes, it is, it’s been changing it for a long time and we’re right on the front at all times.

Steve Freed:  So if you had to say, it’s been very positive for you?

Dr. Bode:  Yes, it’s been very positive. The advances in technology, not only in pumps, but we also have better insulins. We have better glucose testing machines, especially CGM. We have better oral agents coming out. There’s many things happening. We’re even working on an oral GLP-1. Things like that. These are all game changers that are going to help everyone improve diabetes care.

Steve Freed:  So you spend how much of your time in the research aspect and studies, compared to sitting with patients?

Dr. Bode:  Every day I sit with patients. If I’m in the office, I’ll see typically I never see more than 12 to 15 patients a day. I do half-hour follow-up, hour for new. In between that I have 11 research coordinators full-time. I have a research director. I also have working with us, we have five endocrinologists and we have 11 physician-assistants and nurse practitioners. We have a lot of people and we keep people busy and every year we have more people coming to see us for diabetes. If they’re ever interested in a research trial, if they’re a candidate and they’re willing to do it, we have a trial for them.

Steve Freed: I thank you for your time. If I could, I’d have you sit here for a couple of days. I could come up with a lot more questions. Hopefully we’ll see you at AACE, I presume?

Dr. Bode: Thanks for an interesting conversation/