CGM systems provide insight into the latter issue. Repeated alarms about highs and lows can drive patients crazy, Dr. Philis-Tsimikas said. “You might end up with alarm fatigue and annoyance. They might hit a 250, but they won’t want the alarm to go off, and they don’t want to be reminded of it,” she said. “And they might go down to 60-80 at night, but they don’t want to be woken up because they’re used to that range.”
Even if patients do pay attention to their diabetes devices, they may not take the proper action. Dr. Philis-Tsimikas pointed to a 2016 study that found adding an exercise-tracking device to traditional weight-loss intervention didn’t lead to more weight loss. In fact, those who used the device actually loss less weight. (JAMA. 2016;316[11]:1161-71)
The lesson? “There has to be a combination of some education together with the physiologic information,” she said. For now, the good news is that “we still have other options,” Dr. Philis-Tsimikas said. The newly released CGM system known as the Freestyle Libre, she said, is one alternative.
And she mentioned another technique that’s still around. You could call it Old Faithful: the low-tech, high-hassle but highly accurate finger stick.
Dr. Baers and Dr. Rice report no disclosures. Dr. Philis-Tsimikas has no disclosures but notes that Scripps Whittier Diabetes Institute receives grants and funding in the diabetes field and works with a number of drug makers and device makers. Mr. Ballinger discloses salary and equity from Cardiogram.
cenews@mdedge.com