HELP HAS ARRIVED: HOW TO MASTER ADVANCED CALIBRATION TECHNIQUES

POINTERS & PEARLS

HELP HAS ARRIVED:

HOW TO MASTER ADVANCED CALIBRATION TECHNIQUES

BY ROY M. GIER, RN

How many times have you met with patients after starting them on the Enlite® sensor and the key concept of “calibration” dominates the session?

If you have ever wished you had some additional techniques in your arsenal to educate patients on sensor best practices, help has arrived. I am going to share with you some tips and tricks that will take your mastery of calibration techniques to expert levels—which you in turn can pass on to your patients.

CARELINK: A VITAL TEACHING AND CALIBRATION TOOL

In order for you and your patients to become experts on calibration, you should be conducting regular reviews of the reports generated by the CareLink® Personal Therapy Management software. The CareLink reports serve as virtual logbooks, so you can help patients accurately track their insulin intake and glucose levels, making it easier to compare any changes in glucose levels with daily activities such as meals and exercise routines. The charts and graphs included in the reports allow you and your patients to see changes visually, while tables provide detailed numeric values.

Having this valuable information at your fingertips can help you discover patterns and problems more easily and make therapy adjustments faster and more accurately than with meter software and logbooks alone. For example, the CareLink Daily Detail Reports show you exactly how your patients are using the MiniMed® 530G with Enlite® on a daily basis. This report will assist you in teaching your patients proper calibration techniques.

The information gleaned from CareLink reports can be leveraged to reinforce patients’ positive behaviors—such as responding to alarms appropriately—as well as areas that may need improvement.

BASIC CALIBRATION RULES

When teaching patients how to calibrate, be sure to establish a strong foundation based on the “must-dos.”

Let’s review the basic rules for calibration:

BASIC CALIBRATION RULES
  • Calibrate 3 to 4 times daily:
    • Before meals;
    • Before insulin;
    • Before bedtime;
    • When there are no arrows present on the display screen (stability).
      Note: Calibrating with 2 “down” arrows may decrease accuracy until the next calibration.
  • It’s important to enter blood glucose (BG) readings immediately after testing BG for accurate calibration. The Bayer CONTOUR®NEXT LINK meter will wirelessly transmit BG results to the pump. Accurate BG results will help to ensure accurate calibration of the sensor.
  • Calibration should take place when glucose levels are less likely to be changing rapidly—before meals, before insulin, and when there are no arrows present. In addition, calibrating before bedtime allows patients to sleep through the night without experiencing calibration reminder alarms. Be sure to remind your patients that the sensor needs a current calibration in order for glucose alarms to function correctly.
  • For more information on sensor calibration, refer patients to Medtronic Diabetes’ “Calibrating Your Sensor” tips.

MASTERING ADVANCED CALIBRATION TECHNIQUES

Once patients have mastered the basics, it’s time to move on to advanced techniques.

Advanced tips that will make you and your patients experts on calibration include:

  • Use 1 meter to calibrate. Using more than one meter to calibrate may result in inaccuracy. The CONTOUR®NEXT LINK meter is the only blood glucose meter labeled by the FDA as part of the MiniMed® 530G with Enlite® system. The same meter should be used consistently, especially for boluses and calibrations.
  • In the event of a calibration error, wait 15 minutes to recalibrate, wash hands, and recheck BG. Recalibrate if appropriate.
  • Less is more: Most of your patients should only need to calibrate 3 to 4 times per day. The sensor glucose reading is a 4-calibration average. Calibrating the sensor during a rapid rise or fall may confuse the algorithm, leading to unwanted alarms and sensor errors.

Now that you are armed with these tips, it’s time to put them into practice during your training and therapy review sessions. Good luck and happy training!

ANIMATED PATIENT VIDEO: THE D-FORCE DOES IT AGAIN!

To reinforce your calibration training with patients, you can share this MiniMed FUNdamentals animated video with them. This fun-focused “Sensor Glucose Values and Calibrating” video is part of a series featuring the MiniMed D-Force, with voice-overs from actual Medtronic patients. Each member of the D-Force represents a different type of patient from the D-Type Quiz: Busy Bee, Adventurer, Champion, D-tective, or Trendsetter. In this installment, members of the D-Force work together to troubleshoot issues that can affect accurate sensor calibration.

COMING SOON: A BETTER CONNECTION TO DIABETES CARE

Be sure to let your patients know about the MiniMed® Connect, an innovative tool for mobile devices that will be available starting this fall. The MiniMed Connect links the MiniMed insulin pump and continuous glucose monitor (CGM) to your patients’ iPhone® or iPod touch®, allowing you—and your patients—online access to their CareLink® data anywhere, anytime.

INSURANCE NEWS YOU CAN USE

With most patients relying on insurance coverage for insulin pump therapy and CGM, access and reimbursement are top of mind for patients as well as their care teams. With that in mind, we wanted to share with you some exciting news about a new Medtronic Diabetes ICD-10 tool as well as an update on expanding coverage. In turn, we hope you will pay it forward by passing this important information on to the providers and front office staff in your practice.

  • Medtronic Diabetes has developed a “Crosswalk Tool” to help ease the transition from ICD-9 to ICD-10. Healthcare professionals (HCPs) will be able to enter an ICD-9 code into the Medtronic Diabetes Crosswalk Tool. Where there’s a match, the equivalent ICD-10 code will be available. If there is no 1:1 match, HCPs can visit a coding resource such as the American Hospital Association’s Coding Clinic® website at www.codingclinicadvisor.com for additional guidance.
  • For patients with commercial health insurance who are candidates for sensor-augmented pump (SAP) therapy, it’s important to stay up-to-date on plans that are now offering coverage that may not have in the past. Nearly ALL (99.5%) commercial plans now cover the MiniMed® 530G with Enlite® for qualified patients, giving them access to the only diabetes management system with Threshold Suspend® technology. Meanwhile, efforts continue to obtain CGM coverage for Medicare patients—see related article in this issue.

SOURCES
CareLink® Personal Therapy Management software. Medtronic Diabetes. http://www.medtronicdiabetes.com/treatment-and-products/carelink-personal-diabetes-software. Accessed May 19, 2015.

ContourNextPRO: CONTOUR®NEXT LINK communicates wirelessly with Medtronic insulin devices for seamless integration. Bayer Diabetes Care. http://www.contournextpro.com/Blood-Glucose-Monitoring/NEXTProducts/CONTOUR-Next-Link. Accessed June 22, 2015.

Sensors & transmitters: Calibrating your sensor. Medtronic Diabetes. https://www.medtronicdiabetes.com/customer-support/sensors-and-transmitters-support/calibration-sensor. Accessed May 19, 2015.

How to increase sensor glucose accuracy and when to calibrate your MiniMed insulin pump [YouTube video]. Medtronic Diabetes. https://www.youtube.com/watch?v=CIJsdmzkG9o. Accessed May 19, 2015.

What’s your D-type? Medtronic Diabetes Facebook page. https://www.facebook.com/medtronicdiabetes/app_676985679042024. Accessed May 19, 2015.

When to calibrate the Enlite® CGM sensor [YouTube video]. Medtronic Diabetes. https://www.youtube.com/watch?v=Mq1dFylnNvU. Accessed May 26, 2015. Introducing MiniMed® Connect. Medtronic Diabetes. http://www.medtronicdiabetes.com/treatment-and-products/minimed-connect. Accessed June 17, 2015.

Crosswalk-Medtronic: ICD-10 compliance. Medtronic Diabetes Professional website. http://www.professional.medtronicdiabetes.com/crosswalk. Accessed June 30, 2015.

AHA Coding Clinic® Advisor. American Hospital Association. http://www.codingclinicadvisor.com. Accessed June 30, 2015.

Roy M. Gier, RN, is a senior diabetes clinical manager with Medtronic Diabetes in Eastern Ohio and Northern West Virginia. Since joining the company more than 5 years ago, he has trained more than 900 patients. Roy has a passion for educating and training, most recently becoming certified as an Enlite® sensor specialist for the Ohio district. In this role, he assists team members with advanced sensor concepts to educate and train patients using the Enlite sensor.