More Good News For CGM
According to a commentary in the most recent issue of the Journal of the American Medical Association (JAMA) entitled Beyond Hemoglobin A1c—Need for Additional Markers of Risk for Diabetic Microvascular Complications by Irl B. Hirsch, MD and Michael Brownlee, MD; “Increasing understanding about the mechanisms underlying glycemic variability and its potential deleterious consequences and determining how better to reduce the magnitude and frequency of glycemic spikes should become near-term priorities for translational and clinical type 1 diabetes research.”
Although it’s possible to determine glycemic variability using a conventional glucose monitor, it’s rather obvious the most effective method to gain this information is through the use of a continuous glucose monitor.
This commentary is also important as it’s just the latest in a long line of research that’s examining the role glycemic variability plays in diabetes management. As the commentary points out A1C is currently the standard by which most physicians determine whether their patients are achieving adequate control. Anyone who has seen Dr. Hirsch speak on the subject will recall a slide he uses that shows two patients with the exact same A1C results but with two completely different glycemic variability patterns. Several studies have noted that while patients may have the exact same A1C results, patients with tighter control and thus less glycemic variability experience fewer complications.
Prior to the introduction of continuous glucose monitoring there were several theories regarding the effect of glycemic variability but due to technological limitations it was difficult to determine exactly the nature of this effect. Thanks to the CGM physicians are gaining a better understanding of glycemic variability.
This news also reinforces Diabetic Investor’s belief that the CGM market is following the same path as the insulin pump did when insulin pumps were first introduced. Although insulin pumps were introduced before the landmark DCCT trial, the results of DCCT validated the benefits of intensive treatment and sales of insulin pumps began to climb. Diabetic Investor noted when CGM first became available wide spread adoption of this technology would not occur until studies could demonstrate the benefits of having all this data. The good news for companies like Dexcom (NASDAQ:DXCM) and Medtronic (NYSE:MDT) is that study results are finding more reasons for physicians to recommend this technology to their patients.
Although Diabetic Investor still believes that CGM will have little application in the non-insulin using space, with reimbursement improving we can see greater adoption beyond insulin pump patients to patients using multiple daily injection (MDI) therapy. Just as insulin pump sales improved as more study data became known so will CGM sales. News that surly is bringing a smile to the faces to the people at Dexcom and Medtronic.