George Grunberger, MD, FACP: The Implications of CGM on Cardiovascular Disease


Dr. Grunberger believes that the improved time in range brought on by continual glucose monitoring could lead to a reduction in hypoglycemia and risk of cardiovascular events, as well as promising monetary benefits for patients and payers.

Over the decades, the standard of care for managing glucose in patients had expanded to include continuous glucose monitoring.

A far cry from the previously used urine tests and finger prick tests, this wearable device has become 1 of the most common strategies for the management of diabetes and could have potential benefits in the cardiovascular field.

“Well, I think the whole point is that by now the continuous glucose monitoring in people with diabetes is basically the standard of care, and slowly but surely more and more people, especially once on intensive insulin therapy, are using continuous glucose monitoring to see what's going on,” George Grunberger MD, FACP, chairman of Grunberger Diabetes Institute in Bloomfield Hills, Michigan said. “And clearly, it's a completely new way to look at patients’ lives with diabetes.”

In a presentation at The Metabolic Institute of America’s (TMIOA) 2021 Heart in Diabetes sessions in New York, NY, Grunberger spoke of the values of continuous glucose monitoring, as well as advancements that could be made to improve upon the burdens patients face in the cardiovascular area.

“The issue which we’re addressing here is: fine, now we have millions of people around the world using this technology, so what is it good for?” Grunberger said. “Because in the end, the payers and of course clinicians and patients will appreciate technology only if it brings better outcomes.”

Of the myriad of complications associated with diabetes, hypoglycemia has remained one of the most prominent.

Promisingly, new data suggested that the process of continuous glucose monitoring resulted in an increased time in range for patients with diabetes, which in turn could lead to a desired 40% decrease of hypoglycemia in patients with diabetes.

The average time in range for patients with diabetes nationally was about 50%, but current data show that continuous glucose monitoring has the potential to increase time in range to 80%.

The cardiovascular implications were also noted.

“There's some early data to show that increased time in range is associated with decreased overall mortality and decrease incidence of cardiovascular mortality,” Grunberger said. “Also, there is some early data showing that increased time and range is associated with improved peripheral nerve function. So, hopefully neuropathy, too.”

Considering the long-term benefits, Grunberger believed that continuous glucose monitoring could be used to decrease human suffering and save patients and payers money.

“If you convert into US dollars, the potential 10-year savings in the US are between $6.7 to $9.2 billion if people actually achieve those improved glycemic results using (continual glucose monitoring),” Grunberger said. “So hopefully, that will turn some heads.”

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