In February, the FDA approved the Eversense E3 for 180 day wear. That means you could have a CGM working – with no sensor changes needed – for up to six months. That’s been available in Europe for a while, but in the US it’s been a maximum of three months. As you’ll hear, the people at Eversense have even bigger goals.
This week, you'll hear from Senseonics Chief Medical Officer, Dr. Fran Kaufman. We get the basic info about the device, the plan for working with pump companies, a look ahead and much more. Imagine one year without a sensor change!
Dr. Kaufman is also a practicing endocrinologist and she’s been seeing patients for more than 40 years. She has a passion for this community and a lot to say about what truly helps patients thrive with diabetes.
This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
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Episode Transcription Below (or coming soon!)
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Stacey Simms 0:00
Diabetes Connections is brought to you by Dexcom. Take control of your diabetes and live life to the fullest with Dexcom and by Club 1921, where Diabetes Connections are made.
This is Diabetes Connections with Stacey Simms
This week Eversense is an implantable continuous glucose monitor. It just got FDA approval for a 180 day where that's six months with the dose sensor changes. Something else that makes it different. It can vibrate to let you know if you're low or high.
Dr. Fran Kaufman 0:39
And then people really, really enjoy that long term concept, as well as vibratory alerts. We've got people who work on the tarmac at the airport and they can't hear anything. So the only way they can actually do this is with the vibratory alerts.
Stacey Simms 0:52
That's the company's chief medical officer, Dr. Fran Kaufman, we go in depth on the Eversense system talking about how it all works, accuracy, and looking ahead to whether they'll partner with any insulin pumps for a closed loop. And they have big plans to make the system last even longer. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.
Welcome to another week of the show. Oh, we so glad to have you here. We aim to educate and inspire about diabetes with a focus on people who use insulin. If you are new, my son was diagnosed with type one right before he turned two that was back in 2006. He is now 17 years old. My husband lives with type two diabetes. I don't have diabetes, I have a background in broadcasting. And that is how you get the podcast.
And I have been doing this podcast since June of 2015. I looked back in the show archives. They're all on the website. You can use a search box to find what you're looking for. But I looked back and we first talked to Eversense in October of 2018. We actually talked about Eversense at that time, not with the company. I talked to Darryl Greene. He was one of the first people in the US to get the sensor implanted. He is a news anchor. And he did it for his show, he showed the video of the implant the whole thing. I will link that up in the show notes so you can hear what Darrell had to say at the time and see an early version of Eversenseit has changed a bit since then.
But as you will hear this week, it is subcutaneous it's just under the skin. And that is where the Dexcom or libre or Medtronic Guardian sensor lies, but you can't insert it yourself. It is a quick outpatient procedure. It's minor but it is still a procedure. The flip side that's it for six months, no supply orders, no changing sensors. My guest here to talk about it and answer a bunch of your questions is Dr. Fred Kaufman. She is the Chief Medical Officer of sin psionics. The company that makes Eversense she is a pediatric endocrinologist who still sees patients and I could take the whole episode to read off her accomplishments. She's been in practice for 40 years, director of the comprehensive childhood Diabetes Center and head of the Center for endocrinology, diabetes and metabolism at Children's Hospital Los Angeles, former president of the American Diabetes Association, chair of the National Diabetes Education Program, on and on. And she has authored over 250 Scientific manuscripts and numerous books. I love talking to people like Dr. Kaufman, because yes, she's a very accomplished woman. She obviously knows her stuff. But you will hear her passion for this community. She is really in it to help all patients living with diabetes.
Quick note, I realized, as I was listening back, I do that a lot with these interviews for editing and you know, editorial reasons, I didn't ask about the capacity to share the sensor data in real time, right share and follow for something like this, Eversense has had that for a while. They don't use the same terms. They call it Eversense Now. And that doesn't change with the three the latest iteration of Eversense does have the capacity for other people to follow the user’s numbers. And I know that's important to a lot of you. I didn't want to imply that it isn't available by leaving it out of this interview. So you don't hear about it. That's on me. But it is there.
Here's my interview with Dr. Kaufman.
Dr. Kaufman, thank you so much for joining me. There's so much to learn about this system. My listeners are very interested. Thanks for spending some time with us.
Dr. Fran Kaufman 4:30
Well, thanks for having me.
Stacey Simms 4:31
I would usually start by asking you to talk about the latest and greatest this FDA approval that came through. But let's back up just for a minute. For people who are not familiar. Can you take us through what the system consists of here kind of set the table of what we're talking about when we say ever since? Well, I'd
Dr. Fran Kaufman 4:48
love to because I think understanding the system really enables you to understand this new innovation we have with our Eversense three system, the overall Eversense CGM Is three components. It is a fully implanted sensor very small, it's about three millimeters by 13 millimeters, and it's placed under the skin in the subcutaneous space, which is where all the sensors are working. They're all measuring the same glucose values in that interstitial space in what we call the interstitial fluid. But this is placed minor office procedure done by healthcare providers that we train and certify, we also give them the tools to be able to do both the insertion. And then when the time comes the removal of the sensor and the insertion of the next sensor. That's the center. It is a fluorescent technology, all the other CGM systems are enzymatic. So that is another distinguishing feature for us, and then placed over the sensor with a very mild silicone-based adhesive is a transmitter and the transmitter through near field energy powers the center, and that enables the sensor to read the interstitial glucose, give it back to the transmitter, the transmitter then sends it to the app on your smartphone. And that's where you can visualize your glucose value. But our transmitter held in place, again with a very mild silicone-based adhesive. So there are fewer skin reactions, also has a very unique capability of on body vibratory alerts. So if you don't have to have your smartphone sitting in your lap, you want to run upstairs for something you want to run outside, you want to take a bike ride without your cell phone, then you will get the alerts right on body, the transmitter itself will vibrate. And you'll know whether you're going high or low with your glucose values. And that's a feature that many many people truly enjoy and appreciate. And then the app is pretty much like all the apps, you can view your glucose every five minutes, the arrows for the directional change of your glucose-to-glucose curve for the last three hours, six hours, whatever you'd like. And it also, of course, has alert both auditory as well as visual on the cell phone itself. So those are the three major components and lots that differentiate us.
Stacey Simms 7:16
Yeah, I let me go through a little bit of what you said kind of break it down even further, you mentioned that the sensor uses something different to measure glucose level this is based on light or fluorescence, can you kind of explain that a little bit more or as much as you can, some of its proprietary,
Dr. Fran Kaufman 7:34
you well, and then lay terms so that I can understand it. I am a physician at OSI you know not a an engineer. But essentially, this sensor is composed of a sensing surface where glucose attaches reversibly dependent on how much glucose the sensor is exposed to at that point in time. And of course, this interstitial fluid is moving. So you know it's bringing glucose continuously to the sensing surface. And then the power is to turn on little LEDs that light up that sensing surface in a full arrest by how much glucose is attached. And that fluorescence n is equal to the concentration of glucose.
Stacey Simms 8:18
Can you see that under your skin? Can you see that happening? Do like is there like a little light show going on?
Dr. Fran Kaufman 8:23
No. Other Yep. Could it be cool?
Stacey Simms 8:29
Maybe that's an add on feature for the future. I'd also heard this was a while ago. So this may have changed. I had heard that earlier iteration of this technology made it that it was sensitive to light. In other words, if you were exposing that site to sunlight a lot, it didn't work as well. Well. So
Dr. Fran Kaufman 8:45
there it rarely occurs. But there is something called an ambient light alert, if there is a lot of sun exposure. And this is mainly because that tape is peeling. So the sides of the transmitter are a little bit more exposed. It will pick up in ambient light tell you what can't reliably read the glucose and ask you to you know, either cover it or you know, get out of the sunlight.
Stacey Simms 9:09
Also, if, as I said, kind of going through it step by step of what you mentioned, let's talk a little bit more about how the transmitter connects. I saw someone on Instagram recently showing how it is, for lack of a better word seems very easy to Ristic she was kind of taking it on and off on and off quickly showing how easy and how different it is. Does that sound accurate? In other words, I think we're used to these devices staying on and we want to stick them as tight as humanly possible and then we rip them off like a really tight bandage. This is very different.
Dr. Fran Kaufman 9:40
Well this is very different so it's not holding the sensor in place right the sensor is fully implanted. So if this falls off, you do not lose a sensor. You just place it back on so the adhesive tape you know obviously sticks on one side to you on the other side to the transmitter and a few hit a door way or Your reference tumbling with your kids and a falls off, you can just place it right back on to that same adhesive. Or if you need a new adhesive, you know, there, you're just carrying a one little piece of adhesive in your purse or in your pocket. And that's all you really need to carry around with you.
Stacey Simms 10:16
I don't know if this will ring a bell with you. But it seems to me like your color forms, which were like kind of stickers, but kind of not you could take them on and off a few times. That's what this reminds me of.
Dr. Fran Kaufman 10:27
I'm not sure exactly know what you mean. But what what this is, is something that's very mild on the skin, we do ask you to replace it every day, take it off, clean the skin, let it breathe for a little bit while you're taking your shower, drying off and then place it right back on. So it's not that you have a piece of tape on for now what will be six months, you're changing that tape and letting the skin breathe. And of course, the tape is breathable as well.
Stacey Simms 10:55
That's a great point. I didn't want to imply that when I say take it on and off a bunch of times that it's more than a day. What changed recently, what did the FDA approve, that got everybody so excited?
Dr. Fran Kaufman 11:05
Well, we're like everybody, right? We are continuously innovating listening to the voice of our customer who is the person with diabetes healthcare provider. And one of the things we continuously heard was people want a sensor that lasts even longer. I mean, we're lasting 90 days in the US, it was already 180 days outside of the US. But for both, this is the next iteration for both. So this is our really, we call it a three because it's really our third sensor iteration. So some chemistry changed is you can imagine some of the other little minor things also changed. But the major change was in that sensing surface, allowing it to have a chemistry change that enables it to last really reliably for the six month time period. You know, whenever we put something in the body, the body reacts, and the way the body reacts to our sensor and the other sensors is it kind of oxidizes it, it surrounds it, it does a lot of other things to it. This chemistry change enables that reaction to be less significant over time, so that the sensing capability remains really excellent for a much longer period of time before we can get the six month indication. Talk to me a little
Stacey Simms 12:23
bit about the clinical trials that I'm sure were done for this when you're talking about six months. The questions my listeners had mostly about this was like, well, what could go wrong? Right? What if I want to get this taken out? Or what if it irritates me, it tell me a little bit about the people who've already done this.
Dr. Fran Kaufman 12:39
So there's our clinical trial, the promise trial that involved 181 individuals wearing actually more than one sensor for the most part. And then there's our vast really commercial experience both outside the US as well as the inside of the US where 1000s of patients have used the sensors. worse, worse, worst worst case scenario, you decide you don't want to have a CGM at all you can get it removed, or you could actually leave it in place till the time duration is up and get it removed, then there's really no compelling indication that you have to get it removed right away. If you don't want it or if it stops working. It actually is kind of okay as a permanent implant. Although that is not what we're asking people to do. We are asking them, as well as the FDA asking them to get it removed when the time comes. So that would be worst case scenario. For the most part, once it's placed in the skin, the skin is healed. Again, the mild adhesive on the scan, really, people enjoy it want it needed if but our system, rather than have no sensor at all, if you decide for a period of time, you don't want to wear the transmitter. Maybe you're getting married, maybe you're going to Hawaii and you willing to go without your CGM, which of course, for me and my patients, that would be a big no, no, then you can just take the transmitter off, charge it, then put it in a drawer and put it back on when you come back home. So it gives you that option. If you don't want to wear the transmitter to take it off for a period of time, or take it off, you know, an hour a day or two hours a day, whatever you'd like to do. There's a lot more flexibility because you're not losing the sensor at that point.
Stacey Simms 14:23
Yeah, talk to me about that, because I'm imagining and I've shared this on the show before my son is very interested in this, especially because of sports and wrestling in particular, he thought it would be so great to be able to take the transmitter on and off. Well, you haven't off. You've already mentioned the sensor will still alert you you know it'll vibrate.
Dr. Fran Kaufman 14:39
As soon as that transmitter is off. You do not get any sensor readings at all. So
Stacey Simms 14:45
my mistake. Yeah, my mistake. I thought for some reason it vibrated under the skin even without it.
Dr. Fran Kaufman 14:49
No, no, it's not the sensors not vibrating in your body. It's a transmitter on top of your skin that's vibrating.
Stacey Simms 14:55
Got it. Okay, talk to us a little bit about accuracy. What you found commercially as you mentioned clinical trials. I think my listeners are pretty familiar with Mark. But can you speak to that?
Dr. Fran Kaufman 15:04
Absolutely. I have been in the field of diabetes since 1978. So I'm old. And I'm really proud of it. And I've seen so much what I started with animal insulin and urine testing. And obviously, what I've seen in my own career a lifetime is awe inspiring. Unfortunately, it hasn't gotten us all where we want to be, which is done with this disease all together. But it has made obviously management. So much more important, easier, better, difficult, whatever you want to say. But we do now have a lot of tools and technology that can improve people's management. One of them is CGM. And those early CGM, which I was involved with, when I was in academic medicine, as an investigator were wonderful, you couldn't rely on them to make a dose adjustment, for sure. But you could get patterns and trends and see what was kind of happening overnight, it was really an amazing advancement, then as the accuracy continued to get better for these devices, we were able to look at a point in time and say, That's what my glucose value is, I can dose off that glucose value, which of course is what you're able to do with our sensor. And then you got more and more accuracy. And now, that's what you know, really, your value is. So our accuracy is measured by Maher during our promise trial. And one of the issues we have to face is, the longer the duration the sensor last, the longer our clinical trials have to last. So if you got a sensor that last seven days, your trial seven days, if it last 14 days, your trials, 14 days, in the last 180 days, your trials, 180 days, and one day, we'll get up to 365. So we'll have these really long trials that will be arduous for the patient and our clinical investigators, and a long time to get the results. But so for the six month trial, people came in 10 times about 10 hours each time, we drove them high and low, so that we could get across the sensor life as well as across all the glucose values from 40 to 400. To see the accuracy of our EversenseII three system and the MAR turnout overall to be 8.5, which is excellent. We're really happy with that Mart, it's you know, it's among best in class for CGM center available. And as always, the mart is leased. On the first day, of course, we only have one first day every six months, whereas sensors it's every week or every 10 days or every 14 days. And then it really settles down and all the way till the end of sensor life. 180 days they are busy was at that point still below eight, below eight below eight. Wow, you know, you have to put all the seven days first. So we did first day seven, day 14, day 21, day 30, day 60, day 90 day 120 150 and 180 day evaluation. So when you put all those together, it turns out to be a mark of 8.5. And then of course it's in the hypo range, we had an excellent mark, also a little bit less than eight in the hyper we had an excellent Mark less than eight. So it really is a pretty excellent system.
Stacey Simms 18:24
Is it simplistic to assume that gets better as it goes? Or does it get better for a certain point, and then it gets a little higher? Well, actually,
Dr. Fran Kaufman 18:32
we could have assumed that. But it turns out it's highest at the beginning and then pretty much stayed around the low aids, high sevens the rest of the time period.
Stacey Simms 18:42
I'll confirm this. But I don't believe any other CGM in the US has a mark that is under eight. I don't know that you can talk about it like that, as you said it's 8.5 for the whole life of the sensor. But that's really interesting.
Dr. Fran Kaufman 18:54
Well, there are depending on the conditions and other things. There are some marks that are under eight as well. And does Mark need to be five is marking to be six, we're probably pretty close to good enough, or excellent enough in that eight range. You know, when we started March, the first month was I think 25. Yeah,
Stacey Simms 19:16
yeah, it's come a long way. Yeah. Talk to us about calibration. The system does need to be calibrated, but the E three less than before.
Dr. Fran Kaufman 19:24
Absolutely. So as you can imagine a sensor lasting 180 days and when we get to the year long sensor, we'll likely not ever be able to get away from any kind of calibration. Now we're hoping with 108 with a 365 Our year long sensor, which will be a real Mark change to some of the platform configurations that we might be able to only have to calibrate once a week. But right now we're at a calibration of for the first 21 days it's twice a day. So the first calibration is really easy. You wake up in the morning, you take the transmitter off, it does need to be charged. It takes about 10 to 15 minutes charge to take your shower, you clean your skin, it put the transmitter back on, and you do your calibration. And then 12 hours later, you need another calibration for the first 21 days. And then after that it's mainly one calibration a day.
Stacey Simms 20:20
I'm pausing because I'm intrigued. We'll have to come back later to the 365. Okay, we talked about what's next is the goal, ultimately, no calibration, or you've already kind of hinted that as it gets longer and longer where you don't anticipate with a year long sensor you anticipate continuing to have to have some kind but but once a month is the goal. Yeah, hello,
Dr. Fran Kaufman 20:38
once we start once a week, we're not exactly sure. But it's hard to imagine that we would have something that long, that would not require some calibration.
Stacey Simms 20:50
Let's talk a little bit about one of the biggest questions that my listeners sent in, which was, when will this work with my pump? Do you have any plan? I mean, I'm assuming you have plans in place. But I let you jump in, you already started to answer
Dr. Fran Kaufman 21:02
it. Yeah, well, that's obviously our goal, as well. And so we're working towards that I can't really give a timeframe because it's not just dependent on us. And as you can imagine, some of the companies coming out or are just trying to get their first product out that first iteration. So they'll be a bit of a lag, but we're doing everything we can to facilitate it. I do have
Stacey Simms 21:25
to be nosy I understand if you can answer this, any of the existing pump companies in the US on the table with you? Well, we help
Dr. Fran Kaufman 21:31
every pump come and he's going to be on the table with us when you know when the time comes.
Stacey Simms 21:35
And what would have to happen. Is there another designation? Is it IC GM that you all need to get?
Dr. Fran Kaufman 21:40
It's pretty much IC GM. And then of course, even once you get that you've got to do some coordination with the pump companies open the API, how do they talk to each other, it is a bit away. But we're working on it, trust me.
Stacey Simms 21:55
My husband was joking last night, when I was telling him we were going to speak and he was like, gosh, all then they need to implant the pump. Because I put it all under the skin. I was like, you know what you're getting ahead of yourself. Like let's,
Dr. Fran Kaufman 22:05
you know, it is interesting, when you talk to cardiologists, you know, everything they have is implanted. When you talk to endocrinologist, they're not quite as familiar with the concept of implanting things. And the reason the implant makes so much sense is is one is you can't knock it off, it's obviously easy to put in and to retrieve, and it takes some of the burden. You may have to calibrate. But you don't have to change sensors every week or every other week. And it takes you don't have to order things anymore. So there's a trade off on our goal, which is to make life easier, more simple for people with diabetes. So that implant does in and of itself make things in a different framework, where I just don't have to, I travel, I don't have take anything but my little adhesive patches, versus somebody otherwise has to take a half their suitcase full of sensors.
Stacey Simms 22:59
Yeah. You mentioned endocrinologist and the implant? How is the physician training going? And Pardon my ignorance? Is it an endocrinologist that you trained to do this? Is it another kind of Doctor Who puts it in?
Dr. Fran Kaufman 23:09
Well, if the answer is yes to all of that, so endocrinologists have come forth and been interested in learning how to do it, you were not the only implantable drug or the you know, system that they have. They've got the implantable birth control. So some that are very, very interested love during the procedure kind of gets back to why they wanted to be physicians. And then others of course, who don't feel they want to really do it. So they're, they refer their patients to somebody who is doing it. So it mainly endocrinologist, we've got dermatologists, primary care, you name it, and they are there, as well as not just physicians and osteopathic doctors, but also nurse practitioners and physician's assistants do it as well.
Stacey Simms 23:53
I remember when we first started talking about this a few years ago, there were very few doctors who did it. I remember talking to our endo here, he was like, I don't know anybody in Charlotte, I'm imagining that that is changed. Do you have any numbers? Or how people would find out if it's done in their area?
Dr. Fran Kaufman 24:07
Well, absolutely, we can help them find out if it's done in their area if their own physician isn't doing it. But we certainly have picked up more and more physicians when a patient comes to the doctor and says, you know, hey, you know about this, I saw it, I'm really captivated by some of its qualities and differentiators. And the doc says, I don't know much let me contact and they contact us. We talked about, you know what it would be like to become a procedure list. And many of them say yes, so we have been able to increase the number of people learning how to do the procedure, particularly in some of the large groups and the large practices. A lot of them just really enjoy that aspect of medicine that they hadn't done maybe for a while and certainly the new endocrinologists coming out they're much more technology based than people my generation. What Chris wants to be my generation of retired do not intend to do. They want to have a procedure, they want to be able to break up the day, and many of them in their practices, you know, do it like Wednesday afternoons or Friday mornings, to accommodate their patients. And of course, they get reimbursed for that part of their time part of their, you know, they need to be trained, it's a way to be a little closer to your patients in some way. A couple of that clinicians have told me, it's enhanced my relationship with some of my patients, when you know, we have that opportunity for me to really impact in this significant way. Yeah,
Stacey Simms 25:33
that makes sense. You mentioned supplies, I was also thinking about costs when you said that, because write anything with a surgical procedure, even though it's very minor is going to have a cost associated with it. But I was assumed that's balanced out by as you said, you're not ordering supplies, you're not getting new stuff. Every couple of weeks. Can you talk a little bit about the insurance side of this is this well covered,
Dr. Fran Kaufman 25:53
it is well covered, we'd like it to be universally covered. We're working towards that as well. As you can imagine, we have a whole group of people, some insights, and CX mainly with our partner associate diabetes care, who is our partner in the sales and marketing of the Eversense CGM systems. And now of course, very, very excited about having Eversensethe three, so they're, they're working hard with the payers as well. Medicare pays for it. I think we have over 200 million covered lives. And we're hoping to be able to continue to have every insurance company cover this. Now if your insurance company doesn't cover it, there's appeals that can occur. And for the most part, those appeals work because the insurance company realizes the benefit of patients having CGM and we're, you know, really differentiated. So who's a patient who wants to use an implanted CGM, somebody who you know just travels a lot and doesn't want to worry about reordering, just want to put something in themselves, for whatever reason, dexterity cognitive, just don't like taking out all those needles and looking at them and putting things in themselves. And then people really, really enjoy that long term concept, as well as vibratory alerts, we've got people who work on the tarmac at the airport, and they can't hear anything. So the only way they can actually do this is with the vibratory alerts, do you really have somebody
Stacey Simms 27:18
who's works at an airport like that? We do. That's just fabulous.
Dr. Fran Kaufman 27:23
And these are some of the people who have come forth. And you know, they're our ambassadors. Somebody works in an elevator shaft and can't have anything big on their body. And this enables them to be down there and still feel the vibratory alert,
Stacey Simms 27:38
I have a bunch of questions that are more forward looking. But before we kind of move on to that, I'd be curious what you have learned. I mean, the system has been around in a shorter wear form since 2016, in Europe, and I'm curious, what has changed? or what have you learned from the people who have used it?
Dr. Fran Kaufman 27:56
Well, what's been really interesting is once somebody gets their second sensor, they're hooked for life. You know, there are some who use it, and then meal wasn't right for them. The same with other CGM, the same with pumps the same with any kind of technology. But once somebody said, I like my first one, let me get a second one, then they're pretty much hooked for life. And what are they want, they want longer duration, with the same level of accuracy, people really appreciate the accuracy of our system. As a result, they continue to use it. We've got patients on their 10th 15th I don't even know how many sensors, some of them I've had they've were on early and have never left.
Stacey Simms 28:36
Does it always go in the same place? Is it always on the arm and then they just kind of switch back and forth to either arm? They do.
Dr. Fran Kaufman 28:42
And I'm probably the only one who can say this and say I'm a physician. There are of course as always off label use of things.
Stacey Simms 28:51
Okay, we will leave that there. But very interesting. This might be a very dumb question. Can you go through airport sensors with this, you know, the the different devices, metal detectors, all that kind of stuff?
Dr. Fran Kaufman 29:02
You can you can even have a MRI, you know, the other sensors need to be removed for an MRI, but you must remove the transmitter.
Stacey Simms 29:09
Got it? That's interesting, and MRI and X rays and all that. Yep. Without the transmitter on, you've already mentioned that the the goal here is longer were one whole year. That's something that you all are working toward. I'm curious to, again, not to bring this personal or anything. My son is not yet 18. And he's been talking about this for a while, are you looking into pediatrics,
Dr. Fran Kaufman 29:31
we are looking to be there too. So we're hoping to have our 365 Day sensor in clinical trial in 2022. It's our hope we're working towards it. And that will have a pediatric component.
Stacey Simms 29:46
You've already alluded to the fact that you've been in diabetes for a while, you know, you worked directly with patients. I'm curious, could you give us some perspective on this? I mean, there are some people that look at a device like Eversenseand say yes, give me I want that, you know, for my child for myself. This is terrific. There are others who are squeamish about it can't possibly think about it just aren't interested. I'm curious when you were thinking about your patients, you know, how do you talk to them about things like this? Do you see patients anymore?
Dr. Fran Kaufman 30:12
I do see patients, I couldn't imagine not seeing patients. And I have, I will admit, I've been very unusual and that I've been out of my academic practice since 2009. And I'm still seeing my same patients and picking up some new ones here and there. You know, everybody has what they think is going to work for them. They try things, maybe it does work, maybe it doesn't work. But what I think what kind of captivates somebody about Eversenseis that it is long term, no longer does the patient have to worry about reordering and where they're going to be on Saturday, because they've got to change their sensor. And what happens if the sensor comes out early, where's the, you know, all those kinds of issues. So with a fully implantable sensor, it's there, and it's in there, lots of people like that as kind of really reducing some of the burden of diabetes for them. You know, once they hear about that, and they hear about, you know, if I want to I can take off the transmitter without sacrificing I like the idea, I don't have to have my phone with me all the time. I mean, just all these advantages kind of Captivate many, many people. And as a result, they want that opportunity. And once they have it and they see those advantages, they stick with it, for the most part, it has to be the right person I you know, we are by no means saying that 90% of people who are on intensive insulin management should be using ever since. But probably 1015 20% should be. And when you look at really kind of what the recommendations are now as a healthcare provider for me to manage my patients on intensive insulin, it's hard to imagine doing it without a CGM. That means you know, there's 1.6 million type ones they all likely need to CGM. 3 million type twos likely need a CGM, with all that number of patients, there need to be choices, there need to be differentiators, not just the same over and over again, whether it's seven days, or 10 days or 14 days. And that's really where we're kind of captivating the healthcare provider, as well as captivating the patient, I'd love for
Stacey Simms 32:17
you to come back on perhaps without, with maybe half the Eversensehat on and what I'm getting at is to talk to somebody like yourself, who has been in this world for so long, who has seen a lot of changes, who has adapted with and help their patients take advantage of all of the changes that have come through, I feel like it's an opportunity to really kind of dig into more about diabetes. So hope you don't mind if I call you again in the future.
Dr. Fran Kaufman 32:39
I'd love to I'll probably have a little bit of a bonnet on for what we
Stacey Simms 32:45
can make that that's fine. We can go with that. But before I let you go here, let me ask you about it. I don't know if you've seen new patients anymore. But when you talk to your patients, you know, I assume I'm just picturing. Gosh, I know I'm not trying to butter you up, I promise but lucky patients, right, they've got an endo, who's passionate, who really cares about this, who's really you know, we were lucky to have one as well like that, when you're talking to your patients these days. So much technology has changed in just the last five years and so much more cool stuff is coming. I assume you don't just focus on that tech, right? You're not just hey, here's a CGM go home. Can you give us kind of a peek into what you think makes a really good start or really good continuation? Or I guess it's a really good plan for people living with type one right now?
Dr. Fran Kaufman 33:29
Yeah, well, I mean, yeah, probably the most important thing is to find support. Nobody can do this alone, ever. I don't care how old you are. I don't care how independent you think you are. And whether that support is with your healthcare team, with your family members. I mean, it's all the better when it's multi faceted. I'm very involved with my patients, they all have my home phone number call me whenever they want text me all day long, mainly because it's such a burden that we transfer over to them on a we teach them we do this diabetes education, you know, stay in this lane, don't go too high. Don't go too low. Don't eat that. Don't you know, don't do this. And it's hard. And they really need support. So you know, camps, groups, your podcast. I mean, what a difference all this makes. And I really had to say what's the biggest difference I've seen over my career, it's that we've gotten diabetes into the open, people aren't hiding it anymore. And as a result, it's part of normal life. And it's trials and tribulations, the time it takes isn't as difficult when people can see the benefit and feel that support in their community, their parents, their friends, their spouse, their co workers. And I think for the most part, people are fascinated by the technology when you show it to them when I patient show it to them very interested in helping out however they can. And that's to me the biggest change when I First of my career, we spend so much time trying to tell people not to hide diabetes. When I patient told me the other day, she's just got a new job, she brought her co workers together, show them her sensor, her meter her glucagon. And, you know, kind of felt it was a badge of honor that they offered to learn about, uh, to help her if need be. And she felt, you know, kind of automatically brought into a community of people who care and I think the vast, vast, vast majority of people do care. And then of course, the technology is just the advances have been monumental, since I've been met, began my career patients being involved in their care doing what needs to be done, looking towards the future, understanding their own lab tests, coming with questions. I mean, that's that's where the fun is. I was in clinic yesterday, I saw a relatively new patient, he's about nine. And you know, the father is the fact what he's has learned. These two parents have learned in a short period of time, I rivals what my fellows can learn.
Stacey Simms 36:07
You know, I said, I was going to ask you this one question and let you go. But I have to follow up with Why are you still working? You said, I'm never going to retire. You already said that. You're like, that's it? Why are you so passionate about this?
Dr. Fran Kaufman 36:18
Well, first of all, I'm in my early 70s, which is the new 40s I think, I feel great. And I have spent so much of my career getting to where I am and the understanding, I personally have that, what would I do all day? Why wouldn't I want to continue to do whatever I can. And that's just how I am, I guess, and what my friends have retired, and they're happy, and they're doing what they need to be doing. I mean, the beauty of my end of the age spectrum is that you can do what you want. There's no I have to go to school, or I should get married, and I got to get a job. I mean, by this time, you get to do what you want. Finally,
Stacey Simms 36:58
where are we lucky? This is what you want to do. Gosh, thank you so much for joining me. I'd love to have you back. You can bring your bonnet, and we'll work
Dr. Fran Kaufman 37:05
it out. Okay,
Stacey Simms 37:06
thank you so much.
You're listening to Diabetes Connections with Stacey Simms.
More information about Eversense three at diabetes connections.com. Wherever you are listening, there should be extensive show notes. If not, you can always go back to diabetes connections.com. And check out the episode homepage,
I reached out to Darryl Greene, the gentleman that I spoke to a couple of years ago to get his thoughts on what he thinks of the system now. So I'm going to report back and let you know what he thinks if he's still using it. And if you are using EversenseI'd love to hear from you as well, I will also link up a couple of reviews that were in the community a couple of years ago for an earlier version. But if you are in Europe, perhaps you've been using the 180 day for a while or you're newer, you want to use the E three in the US as it rolls out. Let me know I'd love to follow up because there's so much curiosity about this system. And for so many people, it comes down to the actual procedure. Right, once it's in, people seem to love it. The questions people have are about how does the procedure go is easy to find a doctor is it easy to get it removed. So I'd love to hear from you if you have experience in that way.
All right. Coming up, I want to give you a sneak peek into what we're talking about next week. And that is all about Pixar is Turning Red. And boy, I'm so excited about the show I have for you. But first Diabetes Connections is brought to you by Dexcom. And when we first started with Dexcom, and that was in December of 2013, long time ago now, shared follow ups were not an option. They hadn't released that technology yet. I know that using sharing follow makes a big difference. I think it's really important though, to talk to the person you're following or sharing with and get comfortable with how you want to use the system. Even if you're following your young child. I mean, Benny was nine when we started with that. These are great conversations to have and they change over time. What number are you going to text your kid at how long you're going to wait to call your spouse that sort of thing. And that way the whole system gives everybody real peace of mind. I have loved helping Benny with any blood glucose issues using the data from the whole day and night. And not just one moment. Internet connectivity is required to access separate Dexcom follow app to learn more, go to diabetes connections.com and click on the Dexcom logo.
Next week's episode is one I cannot wait to share with you it is all about Pixar’s Turning Red. If you're not familiar, the plot of this movie has nothing to do with diabetes. It's all about adolescents. You know there's a girl she turns into a giant panda red panda when she gets excited and then she has to become to turn back unto herself. I don't know any more than that because I haven't seen the movie yet. But I do know is as you've seen if you see the trailers that there are two what they call background characters with diabetes technology. And as soon as we saw that trailer, there were two of them that were released. Actually, the diabetes community went bananas. And I used some of my contacts to reach out to Pixar. So I have an interview with the person at Pixar who is responsible for this.
I've seen a lot of interesting rumors online. It is not John Lasseter, he is no longer with Pixar. He is the former CEO there and he has a child with type blenders probably an adult now, he was responsible for developing Elsa in Frozen from a bad guy. She was supposed to be real villain in that movie to a much more sympathetic character with powers she could control because Lasseter saw a parallel to diabetes in that character. His son has diabetes. It's something that he didn't choose, right didn't want, but it's a part of him. And it doesn't make them bad. And he saw that parallel and Elsa and it helped guide the character. And I'll link that up. He's talked about that publicly before if you're not familiar with that story, but it wasn't him. And it wasn't a person on set or a voice actor who had a child with type one. I can't tell you more because it is embargoed until a little bit closer to the movies release. But I am going to put the episode out early.
So here's how the schedule is gonna go. We're gonna have in the news that will be Wednesday live on social media, I do it you can watch it on Facebook, LinkedIn, YouTube and Instagram. And that becomes an audio only episode that will be released on Friday. And then on Sunday, March 6, I will be releasing the following weeks long format interview episode in advance of the march 11th release of turning red. If you follow or subscribe to the show different podcast apps use different terminology, you will get it no problem it'll automatically come to you if you follow me on social media. You'll see it if you subscribe to the newsletter. If you don't, that's the best way really to keep in touch with me off of social media, you can subscribe just by going to diabetes connections.com and scrolling all the way down or the pop up will come up but the the newsletter will go out to remind you so I'm really excited about that. I'm thrilled to have had this interview and to get more insight and I hope we've made a new friend for the show. I know she listens I'm rubbish even say that but I hope she sticks around.
Alright, that'll do it. Thanks as always to my editor John Bukenas from audio editing solutions. And thank you so much for listening. A lot coming by we'll see you back here soon Until then be kind to yourself.
Benny 42:23
Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged