How do you get started with Personal CGM in your office?

How do you get started with Personal CGM in your office?

Four Steps:
  1. Identify candidates
  2. Set expectations
  3. Start patient on CGM
  4. Follow-up

 

How do you get started with Personal CGM in your office?

Patient Selection for Personal CGM

Personal CGM can benefit a broad range of patients with diabetes. A task force of the American Association of Clinical Endocrinologists published a CGM consensus statement identifying the following candidates for Personal CGM:


Patients with type 1:
  • with hypoglycemia unawareness or frequent hypoglycemia.
  • whose A1C is above target or with excess glucose variability
  • who require lowering A1C without increased hypoglycemia
  • who are pregnant or during preconception

How do you get started with Personal CGM in your office?

Personal CGM Effort

Common patient misconceptions about Personal CGM

  • No training required
  • Personal CGM requires training and practice (like learning a sport or driving)
  • No more BG meter readings
  • Personal CGM does not replace BG meter
  • BG meter and Personal CGM readings should match exactly
  • Personal CGM will not always match BG meter readings

How do you get started with Personal CGM in your office?

Setting Expectations

 

Once patients adopt Personal CGM into their lives, what is the most common reason they won't give it up?

 

  • Daily biofeedback leads to accumulation of lessons resulting in improved glucose control and quality of life
  • Learning real-time lessons every day to apply tomorrow
  • Patients will work through technical and therapy lessons as long as they expect them

How do you get started with Personal CGM in your office?

In Conclusion:

  • Personal CGM and pumps can lower A1C without increasing hypoglycemic events1,2
  • MDI to Pump: 0.5% A1C Reduction
  • BG meter to Personal CGM: 0.6% A1C Reduction
  • (MDI + BG meter) to (Pump + Personal CGM): 1.2% A1C Reduction
  • Personal CGM provides live3 feedback to facilitate decision-making
  • Glucose reading (every 5 min.)
  • Trends
  • High and Low alerts
  • Personal CGM unlocks advanced technologies
  • CareLink for therapy management
  • Connected Care for care-partners
  • Artificial Pancreas
  • To successfully implement Personal CGM in your office
  • Establish a protocol for selecting patients for Personal CGM
  • Set expectations before prescribing
  • Patients will experience Technical and Therapeutic frustrations
  • Personal CGM requires learning new skills

1The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. The New Engl J Med. 2008;359:1464-1476.
2Raccah D, et al. Incremental value of continuous glucose monitoring when starting pump therapy in patients with poorly controlled Type 1 diabetes. Diabetes Care. 2009;32(12)245-2250.
3A confirmatory fingerstick is required prior to making adjustments to diabetes therapy.
4Keenan DB, et al. Accuracy of a new Real-Time Continuous Glucose Monitoring algorithm. J Diab Sci Tech. 2010;111-118.