It’s been about one year since the approval of OTC CGM devices. People can now purchase these devices online without a prescription, making CGM accessible to nearly everyone.
At ADA Scientific Sessions, Dr. David Ahn and I will debate the accessibility of all this data in a session titled, Over-the-counter continuous glucose monitoring-data for all or a disaster waiting to happen?
What are the highlights that attendees should take away from your presentation?
I am on the side of data for all, so I will argue strongly that having access to this data is transformative. An estimated 97.6 million U.S. adults live with prediabetes, but unfortunately, 8 out of 10 people do not know that they have this condition. While CGM data isn’t used for diagnosis, it can prompt someone to follow up with their clinician and receive a formal diagnosis and education.
CGM is the standard of care for type 1 diabetes and insulin-using type 2 diabetes and offers many benefits to those with diabetes on non-insulin medications. Requiring a prescription can sometimes be a barrier to obtaining, which can be overcome through OTC access.
There was a time when this technology was withheld from patients due to fear by health care providers that the data would be overwhelming, even in people with type 1 diabetes, where it is lifesaving!
We are now hearing similar concerns about OTC accessibility, that the data may be too overwhelming and complicated.
But is it a disaster waiting to happen?
Dr. Ahn will try to convince the audience that there are many concerns with the wide accessibility of these devices. The CGM metrics, especially the glucose management indicator (GMI) are not validated for people without diabetes. People may see readings under 70, prompting more health care utilization when this can be normal for someone without diabetes. A person could see a glucose elevation from a high-intensity workout or may eat unhealthy food and not see glucose rise and come up with incorrect conclusions on healthy behaviors.
However, I would argue that this means we should continue to do more research. Fortunately, the research is being done. Endocrinology leaders like Dr. Viral Shah are leading efforts to determine what normal glucose levels look like in people without diabetes and redefining the formulas for the GMI.
It is important to note that the current OTC devices available do not have alerts for hypoglycemia and are not intended for people taking insulin or drugs that could cause hypoglycemia, like sulfonylureas.
What else would you like attendees to know about your presentation?
You must attend our session to find out who will be the ultimate winner of the debate. Regardless of who wins, education is essential. The OTC devices have education embedded in their respective mobile apps. This is a great start and should be further supplemented by education on healthy lifestyle behaviors from the health care team.
Dr. Isaacs has received honoraria from Dexcom and Abbott
Image by rob dobi / Getty
