Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives

Celebrating 25 Years of CGM, with Irl Hirsch, MD


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In celebration of the podcast surpassing 100 episodes, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, sit down for a special edition episode with Irl Hirsch, MD, professor of medicine at the University of Washington.

Discussion within the episode reflects on continuous glucose monitoring (CGM) and its revolutionary impact on diabetes care as well as its transformative history, beginning with its introduction by MiniMed in 1999.

Hirsch recounts his first CGM experience and how it fundamentally changed his approach to managing hypoglycemia and diabetes complications. The conversation transitions to pivotal milestones, such as the JDRF CGM study and the push for Medicare coverage, which advanced CGM accessibility and integrated it into diabetes care standards. Hirsch also highlights the evolution of CGM technology, including the adoption of factory calibration, non-invasive sensors, and over-the-counter options, while addressing challenges like patient misconceptions about device accuracy.

The trio also explore CGM’s potential beyond glucose monitoring, including ketone detection, that could revolutionize diabetes management and broader healthcare applications.

Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.Relevant disclosures for Hirsch include Abbott Diabetes Care, Roche, Hagar, Tandem, and Mannkind.

Chapters:
00:00 - Start
01:37 - Early Experiences with CGM
07:44 - Early Resistance and Advocacy 
14:33 - Impact of CGM Advances
25:32 - Emerging Metrics and Biomarkers Beyond A1C
31:01 - Future Directions in Glucose Monitoring

...more
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