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Elizabeth Buschur Part 5, CGM with Pregnant and Adolescent Patients

In this Exclusive Interview during the AACE meeting in Austin, Texas, Dr. Elizabeth Buschur talks with Diabetes in Control Publisher Steve Freed and answers the question, what is the most useful purpose of using a CGM for pregnant patients?

Dr. Elizabeth Buschur, MD is an assistant professor at The Ohio State University in Columbus, Ohio. She has implemented and is the director of the Diabetes Transition Clinic at the Nationwide Children’s Hospital as well as the Endocrine Disorders in Pregnancy Clinic at The Ohio State University.

Transcript of this video segment:

Steve: What is the most useful purpose of using a CGM for pregnant patients? Studies have shown… in that we’re seeing not so much improvement of blood sugars, but we are seeing a reduction in hypoglycemia, which is the major factor in CGM and obviously that’s something that’s good, but why do you think we haven’t seen an improvement, per se, in HbA1c values as much as we thought we would see?

Dr. Buschur: That’s a good question. I think some of it has to do with newer or more rapid-acting insulins that may be on the horizon here. So there is some timing of bolus delivery to match a meal and things like that, that glucoses do rise with a normal diet that has carbohydrates at a meal, but I think the trends of hypoglycemia reduction are not quite there. But if you really talk to the patients, they do tell you, “You know, I’m catching my blood sugar going up in the 200s rather than it reaching very, very high values.” Especially some of those patients that maybe were not checking as frequently as recommended previously. They find the CGM very, very helpful.

Steve: Now, do you deal with young adolescents also?

Dr. Buschur: I do.

Steve: I would think that a CGM would be more important to their parents than it is to them.

Dr. Buschur: That’s true.

Steve: They can live without it but their parents want that information to protect their children. How do you deal with the young adolescent when such situation come up?

Dr. Buschur: It’s a tricky situation for sure. I have had one family in particular that required their child to get a CGM before going off to college but that child was under 18 years old. An then other instances are when parents are begging their college children to share the data with them and the student is saying, “No way.” So if the person is over 18 years old, it’s a hard decision. It’s not my place to force them to share it with whoever.

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