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Emerging CGM Systems in Diabetes Management
Dr Diana Isaacs reviews the significance of Eversense’s recent approval for a 180-day indication and the potential role of Dexcom G7 in the diabetes treatment landscape.
Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES: I want to take a moment to talk about Eversense’s recent 180-day approval for their CGM [continuous glucose monitor] because this is remarkable. It’s the only device that’s an implantable sensor. The previous version was 90 days. It’s a quick in-office procedure to implant it, and then that sensor stays there. There’s an outer transmitter that is placed over it. Going to 180 days is remarkable because that means it cuts down on those office visits to only 2 times a year. This is an appealing option for many patients, because being able to reduce the process of having to insert the sensor is nice.
The other key thing is people like the option to be able to detach. When you’re wearing a CGM, with most of the others, you can’t take it on and off. Once you place the sensor, if you take it off, you have to put on a new sensor, which is an additional cost and an additional process of the warm-up period. It’s not practical to do that. But with Eversense, you can take it on and off, which is very appealing, especially for active people who want to have that flexibility. The other interesting thing about the Eversense 180-day wear is that it cuts down on the calibrations. With the 90-day, it’s basically a calibration every 12 hours. With the 180-day, it’s every 12 hours for the first 21 days and then once every 24 hours after that. Those are big enhancements. We’re going to see more people interested in the uptake based on these new enhancements with Eversense.
Speaking of new technology and CGMs, we also have the Dexcom G7 on the horizon. The clinical trial data were recently published on that showing the accuracy. One of the enhancements with it is the warm-up time. The current warm-up time with the Dexcom G6 is 2 hours, which isn’t bad. It just means you don’t see the readings for the first 2 hours of wear. But with the G7, it’s cut down to less than 30 minutes, which is going to be nice. The other thing is it’s smaller. It will be smaller than the current G6.
Perhaps the best enhancement of all is that it’s a fully disposable transmitter sensor. It’s more similar to what we’re used to with the Freestyle Libre 2 System, where it’s all a disposable system. When you’re done, you discard it and put a new one on. That’s how the G7 will be. There won’t be this additional transmitter that you have to save that you used for 3 months. All of that will be discarded and you will place a new one on. These enhancements will be very nice. I’d anticipate that when G7 becomes approved—it has been submitted to the FDA [Food and Drug Administration]—that it will likely end up replacing the current G6 system for the future.
Transcript Edited for Clarity
Man With Newly Diagnosed Type 2 Diabetes: What HbA1c Goal-And How to Get There?
May 8th 2013The patient, an active 49-year-old man, had an HbA1c of 8.6 after diabetes was first diagnosed. It’s now 7.6 with metformin and lifestyle measures. Is the current A1c goal adequate, or should you treat more aggressively?
