The article does a good job of describing the growing use of continuous glucose monitors and how they may be helpful in diabetes care. Importantly, it makes clear that the efficacy of the device is not fully established, that insurance currently may not pay for it, and that there are significant limits on its practical application at this point.
The key shortcomings are a failure to provide details about research that has been done on the devices, and to put these devices in the context of a full glucose management regimen. The story falls short in explaining both the benefits and harms of the use of the devices. The article does not provide data that describe the extent of improved glucose control. And there is not one sentence anywhere in the summary of research to date that describes complications from the device such as skin reactions or infections, or even the failure rate associated with the device. Additionally, no information is provided about potential lifestyle and/or quality of life implications of using the device (e.g., does it work while the patient is doing water sports or sweating?).
The top of the story is also problematic. The first three paragraphs create an impression of rapid adoption and a step toward a futuristic "artificial pancreas." A reader of only the first three paragraphs may come away believing the device could be more significant than it is. A reference to the hoped-for system that senses and automatically adjusts glucose levels would have been more appropriate near the end of the story, not the beginning.
The article does an excellent job of stating the costs clearly, and exploring the issue of insurance coverage both currently and pending a current study. What the story did not make clear is that you still have to have the additional costs of a regular glucose monitor and strips available because the technology is not at a level yet where it is safe to believe the readings when they come out very high or low. So the sensor costs are on top of the $100 or so a month that it costs to do standard glucose monitoring. However, we’ll give the story the benefit of the doubt on this criterion.
The article does not provide data that describe the extent of improved glucose control.
The article discusses some shortcomings of the device:
But there is not one sentence anywhere in the summary of research to date that describes complications from the device such as skin reactions or infections, or even the failure rate associated with the device. Additionally, no information is provided about potential lifestyle and/or quality of life implications of using the device (e.g., does it work while the patient is doing water sports or sweating?).
The article provides a brief sketch of the inconclusive research on the devices. But it does not include sufficient detail on the studies to add crediblity and utility to the piece. A journal name or some measure of the device’s efficacy would have added value.
The third paragraph suggests that eventually anyone on insulin should consider this technology. We think that carries an element of disease-mongering. Anyone under good control with standard self monitoring of blood glucose does not need these sensors to prevent long term complications. The next paragraph limits the focus – for now – to the "most vulnerable patients" – but the combination of the future projection and the undocumented claim in the lead – that "Thousands of patients are switching" to these devices – is troublesome.
The article does a good job by quoting a researcher who is ambivalent about the utility of the device, and a researcher who describes its shortcomings, yet who uses it himself. The one anecdote describes a positive result, which in this context is helpful.
The article might have explored the funding of the forthcoming study being done to demonstrate efficacy for insurance coverage purposes. It’s possible that a device maker, or some interested party, is supporting that research.
The article accurately describes typical blood gluocose monitoring and the compliance issues it raises. But the reader would have been well served by a description of how even an advanced device like this is only part of a comprehensive glucose management regimen, which includes diet, exercise, and in some cases medication and insulin. A less knowledgeable reader might believe that the device is a complete solution for glucose management.
The article makes clear that continuous glucose monitors are not in wide use–that two models are available with a third in development.Still, the first sentence–stating "Thousands of patients" are switching to the new devices–may be technically accurate, but it risks overstating the rate of adoption. And the claim is not documented. Nonetheless we’ll give the story the benefit of the doubt on this criterion.
The story does a good job of explaining that the device is not entirely new but a growing phenomenon due partly to regulatory action. It forecasts potential growth pending further research.
There is no evidence the story relies on a press release from either the FDA or the manufacturer.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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