Kidney Week Early 2025 Program - Diabetes Management for the Nephrology Care Team: New Technology and New Drugs-The Cutting Edge of Current CGM Technology

Video Transcription

Video Summary

Dr. Diana Isaacs reviews the “cutting edge” of continuous glucose monitoring (CGM). CGM measures glucose in interstitial fluid every 1–5 minutes (about 288 readings/day), offering far more insight than fingersticks, though readings can lag behind capillary glucose. CGM reveals missed hyperglycemia/hypoglycemia (including nocturnal events), provides real-time feedback, alerts, and data-sharing with caregivers, and complements the limitations of A1C as an average.<br /><br />She outlines CGM categories: professional (clinic-owned; now mainly Dexcom G6 Pro), personal CGM (most common due to improved coverage), and newer over-the-counter (OTC) CGM. Evidence supports CGM benefits: the MOBILE trial showed better A1C and time-in-range for people with type 2 diabetes on basal insulin, while large real-world studies show A1C reductions and fewer hospitalizations/ER visits even in non-insulin users—supporting broader coverage and ADA recommendations (offer devices widely, consider early initiation, and allow continued inpatient wear with fingerstick confirmation).<br /><br />Device updates include Libre “Plus” models and app-enabled real-time viewing, Dexcom G7 (fully disposable) with a 15-day version coming, Medtronic’s improved Simplera and Abbott/Medtronic “Instinct” sensor, and the implantable Eversense with vibration alerts (but requires charging and calibrations). OTC options (Stelo, Lingo) target non-insulin users, emphasize education, and lack hypoglycemia alerts.<br /><br />Practical pearls: confirm with fingerstick for suspected compression lows/symptom mismatch; manage adhesives and placement; tailor alarms to reduce fatigue; explain lag time with a “train on a hill” analogy; and improve workflow by connecting patients to platforms (Clarity/LibreView/Glooko) while EHR integration continues to evolve.

Asset Subtitle

Diana Isaacs

Meta Tag

Module DKD

Speaker Diana Isaacs

Keywords

continuous glucose monitoring (CGM)

Dexcom G7 and G6 Pro

FreeStyle Libre Plus

time in range (TIR)

MOBILE trial type 2 diabetes basal insulin

over-the-counter CGM (Stelo, Lingo)

CGM alerts and data sharing platforms (Clarity, LibreView, Glooko)