Role of the Diabetes Care and Education Specialist in CGM

Link to CME: Claim Credit - https://bit.ly/3dQPQwT .

Continuous glucose monitoring (CGM) is a great tool that improves clinical outcomes for people with diabetes; these individuals are often happy to get this new technology.

However, there can be some initial barriers that both people with diabetes and clinicians need to overcome.

BARRIER 1: Wearing something on the body so other people know the person has diabetes.

SOLUTION 1: Let the person see the size of different devices through demonstrations and show possible discreet places on the body where they can be worn.

• Consider starting with a professional CGM, owned by the clinic and borrowed by the individual for up to 14 days, so that he or she can get a feel for what it is like.
• Consider a CGM that can be integrated with a smart pen instead of an insulin pump, so the individual has only 1 device to wear.

BARRIER 2: Cost of the CGM.

SOLUTION 2: Find out insurance requirements to see if the CGM can be covered and what is required for coverage.

• A disposable sensor is a lower cost option. There are coupons available and some pharmacies sell for lower costs.
• Professional CGM is an underused insurance benefit that is often covered multiple times per year if used on a short- term basis.

BARRIER 3: Too much information from CGM can be overwhelming for the individual.

SOLUTION 3: Make sure alarms and alerts are set appropriately to avoid alarm fatigue—have the alerts go off when it matters most, like during hypoglycemia. Look at the device at key times only, like before meals, before bedtime, and before activities like exercising and driving, and utilize CGM to determine glycemic trends.

BARRIER 4: Clinicians are hesitant to embrace CGM technology.

SOLUTION 4: There are various resources available to help clinicians understand CGM technology and to assist in integrating CGM into their practice settings.

• Online tutorials, industry representatives, and diabetes care and education specialists can help clinicians understand how to start people with diabetes on CGM and how to interpret the data.
• CPT codes are now available to help support the cost of additional staff to train the individual on the devices and cover the cost of review and interpretation.

Presenters:
Carla Cox PhD, RD, FAADE
Certified Diabetes Educator and Clinical Dietitian
Mountain Vista Medicine 
South Jordan, Utah

Diana Isaacs PharmD, BCPS, BCACP, BC-ADM, CDE
Clinical Pharmacy Specialist/CGM Program Coordinator
Department of Endocrinology, Diabetes, and Metabolism
Cleveland Clinic Diabetes Center
Cleveland, Ohio

Provided by the Endocrine Society in collaboration with the ADCES.
Supported by an educational grant from Lilly.