Continuous glucose monitoring—a good fit for primary care?

Continuous glucose monitoring is a complex task, even for physicians. Internists will have to step in to help endocrinologists manage the rising population of type 1 diabetics.

Research indicates that when continuous glucose monitoring is used with an insulin pump in patients with type 1 diabetes, glucose targets are easier to achieve. But insurers can be reluctant to reimburse for this relatively new technology, and its use can claim a good deal of primary care physicians' already limited time. In addition, patients often have difficulty adhering to the complexities of proper use. Both physicians and patients need to be motivated and vigilant in order to realize good outcomes. In our cover story, Charlotte Huff talks to experts about the intricacies of continuous glucose monitoring and whether and how to incorporate it into your daily practice.

House calls are sometimes considered a thing of the past in health care, but in fact they may be more common, and more rewarding, than some physicians realize. Doctors who make home visits report an increased flexibility in scheduling and a better understanding of the barriers patients face in trying to keep themselves healthy. Independence at Home, a new pilot project that's part of the recently passed Affordable Care Act, will look to bolster this care model in coming years by using interdisciplinary teams to care for complicated patients at home. ACP Internist looks into what's involved in making a house call and how interested physicians can balance the pros and cons.

Our latest installment of Mindful Medicine, by Jerome Groopman, FACP, and Pamela Hartzband, FACP, discusses the challenges of making accurate diagnoses when patients withhold what they consider embarrassing or shameful health information. We're also launching a new column this issue on medical education, featuring “do it yourself” simulators from ACP's own Waxman Learning Center. In this issue, learn how to create a simulated abscess.

If you have comments on these stories, or on any other topics, please send them along. We always enjoy hearing from you.


Jennifer Kearney-Strouse