Dr. Steven Edelman talks with Diabetes in Control Publisher Steve Freed during the ADA 77th Scientific Session in San Diego about using CGMs with people with type 2.
Dr. Steven Edelman, Founder, Director, and Chairman of the Board of the nonprofit organization Taking Control of Your Diabetes, is a Professor of Medicine in the Division of Endocrinology, Diabetes and Metabolism at the University of California, San Diego and the Veterans Affairs Healthcare System of San Diego. He is also a 10-time winner of the San Diego Magazine Top Doctors in San Diego Award.
Transcript of this video segment:
Steve Freed: The new technologies that they’re coming out with just blow your mind. We have driverless cars. I know you drive a nice car.
Dr. Edelman: How do you know that?
Steve Freed: I saw a photograph. It’s yellow too.
Dr. Edelman: That’s my old Porsche. I have a used Range Rover now, because I ride my bike. But thank you, it is a nice car.
Steve Freed: But, technology is changing, we’re talking about smart insulins. Where you give yourself an injection and it knows when to release it. The CGM came along and it’s a huge breakthrough, certainly for type 1s, there’s no question, because insulin is a dangerous. You can take a look at it and you can predict it and so forth. But what about for type 2s, the CGM? What are your thoughts in using that as an educational tool?
Dr. Edelman: Yeah, I love that question. I think CGM for type 2s can be fantastic. I’m looking at the whole spectrum, from prediabetes, oral agents, oral agents basal, MDI pump. I think, obviously, when they become more accessible, less expensive, easy to apply, easy to use, maybe not so many bells and whistles. But just think for someone with prediabetes. It’s going to really motivate them, they’re going to see the consequences of their actions in terms of exercise and what they eat. Same with oral agents, same with basal insulin to help titrate that basal insulin appropriately, a big problem in the United States. And, then of course, MDI and pumps, you get benefits like type 1. I think the key for type 2 is this. I know I’m right on this. You’re going to have to engage the patient to look at the number and then do something with the number. So, it’s all about engagement. We use CGM, we have a bunch of loaner ones. I want to make a big point, unblinded. I hate blinded CGM. If you had type 2, Steve, would you like to wear this thing and not even see what’s going on? I’m not going to take it back to my doctor, make another appointment and say “What’d you do Tuesday morning three weeks ago at 9 o’clock.” And say “Oh, I had a bagel or something”. You know what, patients need to see it. I won’t get off on that tangent. It comes down to activating the patient. I’m a believer that we really need to go unblinded, not blinded. I understand a lot of these companies like Abbot, need to come out with a professional version first, but that’s just an FDA requirement, they understand.