There are many discussions regarding who is the “right person” to use CGM. Healthcare professionals (HCPs), diabetes care and education specialists (DCES) and people living with diabetes (PWD) all have different experiences relating to what might be true and what might not be true. We know there are barriers that impact technology adoption, and we also know through survey data that HCPs and PWD do not always align on these barriers to technology use.1 For example, in a survey, 46% of clinicians thought PWD do not understand what to do with the information from continuous glucose monitors (CGMs) or the features of the devices; but, less than 5% of PWD agreed. 1 And, while 35% of PWD reported they do not like having diabetes devices on their bodies, twice as many, 64% of HCPs reported that was an issue1. Finally, 24% of clinicians, one quarter of the respondents, thought that PWD do not want more information about their diabetes, however, only 2% of PWD agreed with this statement. 1 We also see in the literature that there is a perception that only some people “deserve” technology like real-time CGM (RT-CGM) and that some HCPs may be considered “gatekeepers”, only offering CGM to certain PWD based on their age, educational level, socioeconomic status etc. However, in the MOBILE study2 that enrolled a very diverse cohort of people living with type 2 diabetes, only using basal insulin, randomized to RT-CGM or BGM, there was very high usage of CGM and significantly improved outcomes in the CGM arm of the trial. This study shows that a diverse population can benefit from RT-CGM. One of the interesting outcomes of the MOBILE trial is that people using basal insulin only improved outcomes, as there is sentiment that only people on pumps and multiple daily injections of insulin can benefit from RT-CGM. An interesting fact is that between the BGM and RT-CGM groups there were no significant differences in treatment or medication changes; so, the hypothesis is that PWD were making changes to their food and activity or even simply taking their medications more often.3 To learn more about myths, barriers and facts related to CGM use, listen to this podcast where our panel will discuss the most common myths heard from both HCPs and PWDs and share some practical tips on how you can more effectively communicate the appropriate use of CGM. By the end of the podcast we hope you will be empowered to advocate for the use of CGM for your patients living with diabetes. References 1. Tanenbaum ML, Adams RN, Hanes SJ, et al. Optimal Use of Diabetes Devices: Clinician Perspectives on Barriers and Adherence to Device Use. Journal of Diabetes Science and Technology. 2017;11(3):484-492. doi:10.1177/1932296816688010 2. Martens T et al. Effect of Continuous Glucose Monitoring on Glycemic Control in Patients with Type 2 Diabetes Treated With Basal Insulin: A Randomized Clinical Trial. JAMA. 2021 Jun 8;325(22):2262-2272. doi: 10.1001/jama.2021.7444. 3. Peak M, Broadening Access to Continuous Glucose Monitoring for Patients With Type 2 Diabetes. JAMA. 2021 Jun 8;325(22) doi:10.1001/jama.2021.7444. Speakers: NIcole Bereolos, PhD, MPH, MSCP, CDCES, FADCES Clinical Psychologists, Diabetes Care and Education Specialist Bereolos, PhD, PLLC McKinney, TX Mark Heyman, PhD, CDCES Clinical Psychologist, Diabetes Care and Education Specialist CEO, Center for Diabetes and Mental Health San Diego, CA Moderator Deborah Greenwood, PhD, RN, BC-ADM, CDCES, FADCES Senior Manager, Clinical Education, Dexcom San Diego, CA
Professional continuous glucose monitoring (CGM) can be a valuable teaching tool for people with diabetes and has shown to help them reach their glycemic targets and promote positive health behavior change.* Listen to Aimée from Steady Health (now Carbon Health) describe her experience of starting CGM at the initial diabetes visit that sets everyone up for success. She shares that when using CGM first her patients are more prepared and look forward to their visits. *Longo R. and Sperling S. Personal Versus Professional Continuous Glucose Monitoring: When to Use Which on Whom. Diabetes Spectrum. 2019. 32(3):183-193.