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Tim Dunn Part 1, FreeStyle Libre CGM

In part 1 of this Exclusive Interview, Tim Dunn discusses the various abstracts on CGM use as presented by Abbott in a talk with Diabetes in Control Publisher Steve Freed.

Tim Dunn, Ph.D., is the director of Clinical and Computational Research and an Abbott Volwiler Research Fellow.


Transcript of this video segment:

Freed: This is Steve Freed and we’re here at the 78th Scientific Sessions of the American Diabetes Association. And we have with us a very special guest, Tim Dunn, who’s Global Clinical Affairs for Abbott Diabetes. And Abbott is now involved with CGM, an exciting new product that’s really changing the way people look at diabetes, treat diabetes, and it has to do with just so many aspects, even emotional aspects of — every aspect of diabetes, so we’re going to talk about that. So, maybe you can give us a little bit about the data that Abbott is presenting here at ADA on their FreeStyle Libre and why it’s meaningful to patients.

Dunn: Great. Yeah, we’re really pleased; we’re presenting seven late breaking abstracts here at the conference, and really extending information about how the FreeStyle Libre system is really being engaged with the patients and really developing a lot of benefits to a broad range of patients. We really are committed to improving the system and making sure that it really delivers benefits to the patients who are really wanting a way to monitor their glucose, be aware of how they need to be managing their disease but also be freed from some of the hassles associated with diabetes management in the past, particularly routine finger-sticks. And so, the main topics we’ll be showing here are an expansion of our real world data, so we have access to voluntary uploads of the device, and our first presentation of that involved about 50,000 people’s readers. And now. here at the conference we’re up to over 250,000 readers. And even with this broader expanded data set we’re still seeing very similar patterns. namely that people are using a lot, they are scanning and checking their glucose a lot. And then also, those who scan more are associated with better glucose levels; more time in target, less time in hypoglycemia. So, that’s one big theme that we’re looking at. And another one is we obviously want to associate the better management and use of the device with long-term complications and so that’s through HbA1c markers. So, we have a meta analysis of 17 studies that is showing that when you look at these studies all in a group and analyze them for changes in HbA1c, we’re also demonstrating a significant drop of over a half percent of HbA1c across broad studies that included both type 1 and type 2 patients.

Another big focus for us has been to make CGM very affordable and accessible to people. And so, a new analysis showing here will be around the cost and the cost savings actually when you stack it up next to typical SMBG testing. So, one of the key highlights there is that compared to testing six times a day, which is sort of a range accepted by the ADA, they can save up to $120 per month using the FreeStyle Libre system instead. And then the final big area is those young adults and teenagers, that’s always been a historically difficult population to get engaged with glucose monitoring. And so, we do have a couple of studies that we’ve been able to look at or the investigators have been looking at in terms of the success with the system. And they’re again showing in this population, they are having good adoption and using the device and then also having benefits in terms of time and range and rejection of hypoglycemia.

Freed: And I’ll share a story with you that has a lot of impact when it comes to CGM. I was doing a presentation and I was out in the hall and one of the people there that were displaying products was a salesman who was selling insulin syringes. And we were talking about diabetes and he says, “Oh, I have diabetes,” and I said, “Gee, what was your blood sugar this morning?” And he said, “Well, I didn’t do it.” I said, “What was it yesterday?” and he said, “I didn’t do it yesterday.” I said, “When did you do it?” he says, “I do it once a day, every Thursday.” I said, “Why are you even checking your blood sugar?” One reading in 20 million seconds is meaningless, really it saves some money by not doing it. So, now you have a product basically– you have a type 2 patient, who doesn’t monitor as often as they should and that’s probably really most patients. And on top of that the doctors only tell to monitor their fasting blood sugars. They’ll eat whatever you want, just manage your fasting blood sugars with your basal insulin. And now, all of a sudden this drastic huge change. Now, they have a reading every few minutes if they want and they can see how their blood sugars are varied for their exercise, their emotional situations, their working situations. There’s so much more information that’s available to them now. How do patients react to that?

Dunn: It’s a good point that it reveals a lot more of the dynamics and complexity of the underlying glucose levels than typically people had seen either because they really weren’t testing very frequently or they tended to focus on the laboratory measurements that again aren’t going to reflect to the day-to-day or even hour-to-hour variability. We do try to encourage and educate patients around what their expectations should be and that they are going to see a lot more dynamics and ups and downs, then they might have been used to seeing with the finger-stick glucose. And then we’ve spent a lot of time focusing on how we present that data primarily for the clinician, but also for the patient in terms of summarizing it over the sensor, let’s say a week or two weeks of use of the device. And summarizing it in ways that we’ve gotten good feedback on, making sure people highlight the overall patterns, things they want to address in terms of highs and lows. And then, also specific instances particularly of low glucose and how to make sure those are attended to well. But it is an educational process for a lot of people to really be prepared for how much things can change depending on the different dynamics.

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