A nice IDEA but ……
There is no question that CGM is truly groundbreaking technology. We have written extensively on this subject noting not just how CGM will become the standard for glucose measurement but how when this data is acted upon it can lead to improvement in patient outcomes. Nothing new here. We have also noted that this market is not just growing but has room for multiple players. Again, no news here.
So, we were a little surprised that the American Association of Clinical Endocrinologists felt it necessary to come up with IDEA. IDEA stands for Innovating Decisions and Empowering Action in Diabetes. Per a post on the empoweryourhealth.org web site;
“Despite CGM’s capacity to provide “actionable” BG information to guide daily diabetes management (and thereby decrease the potential for devasting disease complications), widespread acceptance of CGM has been slow-going, some would suggest. There are a number of reasons for this.
First, each CGM device manufacturer has its own proprietary software and, thus, produces a different report. The resulting lack of uniformity and standardization in CGM reporting has created significant challenges for healthcare professionals and their patients in how to best use CGM-generated information to improve everyday diabetes care.
“Additionally, physicians don’t fully understand CGM use or think it may require too much effort, plus many people living with diabetes and their caregivers are not aware of the CGM technology, how it works and the many benefits it may provide them,” says Nancy J. D’Hondt, a clinical pharmacist and immediate past president of the American Association of Diabetes Educators (AADE).
That’s all about to change.
A collaborative of powerhouse organizations in the diabetes health care space is intent on taking CGM use to the next level, joining forces in an unprecedented effort to ensure all diabetes health care professionals and patients have the information and tools they need to make the most informed clinical decisions possible about CGM use.
Known simply as IDEA (Innovating Decisions and Empowering Action in Diabetes), the focus of the multi-year initiative is to create and deliver comprehensive, easy-to-understand educational/awareness materials and learning aids to stakeholders across the diabetes care spectrum, with materials designed for patients, diabetes specialists, primary care physicians, nurse practitioners and physician assistants, and educators such as registered nurses, pharmacists and certified diabetes educators. The materials will provide the uniformity necessary for CGM use to reach its full potential, notes D’Hondt, a member of the IDEA steering committee.”
While we applaud any effort to get CGM into the hands of more patients this is really much to do about nothing. The reality is the CGM market will continue to expand naturally and much of what IDEA is supposed to do will also happen naturally. To us IDEA is like throwing gasoline on a fire, it will only add to a fire that is burning. Let’s explain why;
1. Report uniformity is common complaint we hear from clinicians and we agree from a clinical perspective reporting uniformity would help. However, and we know physicians and clinicians don’t to hear this CGM is a CONSUMER device. That doesn’t mean the data is not valuable to physicians or clinicians it is. However, given how healthcare is changing, with everyone trying to drive cost out of the system, the target here is not the physician or clinician, it’s the patient.
2. Market forces will drive greater physician awareness and greater patient adoption. Dexcom, Abbott, Medtronic and all the CGM wannabes have a vested interest in seeing this happen.
3. Payors will drive greater adoption too as they hold the keys to the kingdom. Patient access to this technology like any diabetes technology is controlled by payors. We are just in the beginning stages of payors not just covering CGM but making this technology affordable and accessible to patients.
4. We know everyone hates when we say this but it’s not about the damn data it’s about what the patient does with the damn data. Here too market forces will help thanks to insulin dosing algorithms which will soon expand beyond insulin dosing. Just as CGM is transformative technology so too are these algorithms. We’ve said it before, and we’ll say it again it won’t be long before thanks to CGM and insulin dosing algorithms life will be much easier for insulin using patients. The real impact will be when these algorithms expand to non-insulin using patients when this happens the results have the potential to be astonishing.
5. Finally, and again everyone is going to hate when we say this, but you can lead a horse to water but you can’t make them drink. While it’s not PC to say this but the patient does bear some responsibility here as even with all the great things CGM and algorithms can do these great things will never happen if the patient doesn’t do their part. This too we suspect will change as these systems become more patient friendly and patients are incentivized in some way for achieving better outcomes. Once the patient has skin in the game this market will explode.
So yes, this is a nice IDEA and we do applaud AACE for their efforts as we too want greater CGM adoption. However, IDEA is like adding Khalil Mack to the Chicago Bears turning what was a pretty good defensive unit into a great defensive unit. Let’s hope this effort from AACE and the addition of Mr. Mack both bring what everyone wants better patient outcomes and a Superbowl Championship for our beloved Monsters of the Midway. GO BEARS!!!!!