Diabetes is a silent epidemic. The CDC (U.S. Centers for Disease Control and Prevention) estimates that 34.5 percent of U.S. adults have prediabetes and 10.5 percent of all Americans have diabetes. And of the close to 90 million people with prediabetes in the United States, 85 percent aren’t aware they are at risk.
Why are we here?
Early-onset diabetes and prediabetes are “silent” but deadly risks in the long run, often asymptomatic and easy to ignore.
The current guidelines from the U.S. Preventive Services Task Force recommend screening for prediabetes with a fasting glucose and/or an Hba1c test every three years. However, the numbers above clearly show that these guidelines are woefully insufficient to stop the ticking time bomb of metabolic risk in the American population.
To address this problem, we recently announced the launch of our Metabolic Health Assessment program, which leverages continuous glucose monitoring (CGM) technology to identify people who have a high risk for diabetes and then guides them to appropriate care. Through the seamless integration of hardware, software, and in-person and virtual care, Carbon Health is the first primary care provider to create a broadly accessible risk-assessment program integrated with CGM that identifies at-risk patients and connects them to primary care and endocrinologists.
As with many problems in healthcare, this situation is as much a behavioral problem as it is a problem of biology. Many of us are wired to focus on the here and now, while future risks and consequences are difficult to take into account.
How can we hijack this short-term mindset?
We do it by giving people much richer data, in the here and now, about how their body is doing — much more than a blood test every three years can tell them. And we believe the time has come to bring more tools like CGM devices to the fight against diabetes.
The first CGM devices were approved by the FDA in 1999, more than 20 years ago. In that time, tremendous innovation has improved accuracy and performance and lowered costs for people with diabetes. The size and cost of modern CGM devices have made the technology accessible to many more people than the original technology, which was focused on people with type 1 diabetes.
CGM devices measure interstitial glucose concentrations every 5 to 15 minutes, allowing the observation of glucose variability patterns during an entire day. Perhaps you have seen a friend or family member use a CGM device to manage their diabetes or someone who has worn one for novelty’s sake. The best way to describe what it feels like is to say it provides a dashboard that shows you what’s going on inside your body. For a first-time user, it’s striking to observe and learn from clear data showing how your body responds, in the moment, to different foods and activities, to sleep, and to stress.
There is often an epiphany that strikes first-time users — for instance, “When I eat this kind of food, my glucose levels skyrocket.” This is one of the most powerful dimensions of CGM — a tight feedback loop for a person about their health, and a behavioral awakening about metabolic risk that may not have been obvious before.
While a number of consumer applications that work with CGM devices for purportedly better nutrition or fitness have emerged, we believe that there is tremendous power in connecting the data from these devices with primary care providers. Armed with this data, a Carbon Health provider will have the resolving power of the Hubble Telescope, identifying subtle changes that may indicate risks earlier than current clinical assessments can.
The Carbon Health Metabolic Health Assessment is our latest omnichannel initiative, seamlessly integrating hardware, software, and care for people who are at risk for diabetes. For the first time, anyone at risk of diabetes (based on the American Diabetes Association’s risk assessment test) can be prescribed a CGM device and enrolled in a primary care–led assessment that includes full interpretation of their CGM data and the development of a personalized care plan. This service is available to eligible patients without fees or subscriptions other than the cost of the primary care visit.
Throughout the course of the two-week assessment, patients enrolled in the program will be provided a series of “life experiments” to try with their CGM device; guidance for tracking food, activity, glucose readings, and medication; and best practices and tips for getting the most out of the experience. After the assessment period, a provider will discuss the patient’s data with them and educate them about blood sugar management and healthy blood glucose levels.
The goals are to bring much richer data to the primary care encounter, identify and act on prediabetes risks that are often unknown, and motivate positive changes in our patients’ lifestyles. Wearing a CGM device once a year might allow the average person to stay on top of their health and understand their risk factors for metabolic disease. If just a small percent of people at risk are activated and adopt different habits, we can make a significant dent in the number of new diabetes diagnoses over time.
We invite you to try CGM and experience a different kind of primary care at Carbon Health.
Carbon Health provides expert diabetes care. If you’re a California resident, learn more about how a CGM device can help you better manage diabetes from the comfort of home. Schedule a free 15-minute eligibility check.
Carbon Health’s medical content is reviewed and approved by healthcare professionals before it is published, but it is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Talk to your healthcare provider about questions you may have regarding your health or a medical condition, and before making changes to your healthcare routine.
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