Continuous Glucose Monitors by fbj34537


									Continuous Glucose Monitors
State of the Art 2008

Lois G. Jovanovic, MD, FACE • AACE Task Force Member Re Joint Collaboration with JDRF
Aaron J. Kowalski, PhD • JDRF Research Director, Artificial Pancreas Project

The past year has seen a dramatic increase of interest in the utilization of con-   As discussed at the forum, there are still major obstacles that need to be ad-
tinuous glucose monitors (cgm). Endocrinologists have embraced the concept          dressed to ensure that cgm devices are able to fulfill their promise. During
that increased glucose data on a daily basis is necessary in order to advise        the forum, Dr. Wilson pointed out that while adults often have plenty of
people with diabetes on their optimal insulin dosage. The American Associa-         “real estate” to wear multiple devices, it is not always the same case with his
tion of Clinical Endocrinologists (aace) and the Juvenile Diabetes Research         pediatric patients. Dr. Einhorn made a similar observation in some adults.
Foundation (jdrf ), understand the importance of this need, and have been           Smaller devices with better “form factors” will make cgm more accessible to a
working together to advocate for more patient access and better physician           wider range of people. A significant issue that was discussed, which aace and
reimbursement for these promising devices. This article will highlight some         jdrf are working to address, is the challenge of reimbursement of cgm de-
of the concerns and obstacles that aace and jdrf are addressing as a united         vices and the services that physicians provide to incorporate them into their
                                                     team in an effort to move      clinics. While we have made significant strides in the early phases, there is
“More literature has been published over the field forward for bet-                 not widespread coverage for patients or physicians. The aace/jdrf Task Force
the past year to indicate that CGM use ter diabetes outcomes.                       is examining ways to harness the strengths of our respective organizations to
leads to reduced A1c levels, less time spent                At the recent aace      help increase reimbursement – both to patients and to physicians – and allow
                                                     Seventeenth Annual Meet-       better access to these technologies sooner.
in the hypoglycemic and hyperglycemic ing and Clinical Congress                         In 2008, three continuous glucose monitors are currently fda approved
ranges, and more time spent in target in Orlando, aace and                          and available to patients. More and more physicians are prescribing these
glucose ranges.”                                     jdrf partnered for the         devices and patients are deriving significant benefits, and there is increasing
                                                     second year in a row to        evidence in published literature that supports the benefits of these tools. The
host the joint scientific forum, “Translating Hope into Reality: Continuous         future seems bright, as big steps are being made towards combining continu-
Glucose Sensing.” Drs. Bruce Bode, Darrell Wilson and Dan Einhorn, expert           ous glucose monitors with insulin pumps in an automated or semi-automat-
in intensive insulin delivery in both pediatric and adult diabetology, pro-                                                              ed fashion to develop an
                                                                                    “The AACE /JDRF Task Force is examin-
vided upto-date perspectives on their experiences using continuousglucose                                                                artificial pancreas. Work-
monitors, both in the clinical trial arena and in their everyday practices. The     ing ways to harness the strengths of our ing together, aace and
presentations were very promising, and the addition of continuous glucose           respective organizations to help increase jdrf can bring the process
monitoring to the treatment protocol can help people with diabetes make                                                                  further forward on all
                                                                                    reimbursement - both to patients and
better decisions, which will lead to better diabetes outcomes. More litera-                                                              fronts. Make plans to at-
ture has been published over the past year to indicate that cgm use leads to        to physiciansand allow better access to tend the aace Eighteenth
reduced A1c levels, less time spent in the hypoglycemic and hyperglycemic           these technologies sooner.”                          Annual Meeting and Clin-
ranges, and more time spent in target glucose ranges. Most encouraging-                                                                  ical Congress in Houston,
ly, the devices are well tolerated. The jdrf is sponsoring an independently         Texas, where exciting updates to the jdrf randomized trial are scheduled to
funded, randomized trial, comprised of 450 people that will further add to          be presented. For the latest updates, subscribe to jdrf ’s Emerging Technolo-
the evidence base. It is hoped that the six-month randomized outcome will           gies newsletter at tfm
be reported in the near future and presented at the aace Eighteenth Annual
Meeting and Clinical Congress in May 2009.

Article from The First Messenger vol 18, no 5 • September/October 2008

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