use of continuous glucose monitoring (cgm) in guiding ... · 9/17/2015  · • average blood...

USE OF CONTINUOUS

GLUCOSE MONITORING

(CGM) IN GUIDING

THERAPY

DIABETES ECHOSEPTEMBER 17, 2015

VERONICA BRADY, PHD, FNP-BC, BC-ADM, CDE

-Retrospective:

Usually blinded to patient.

Review data after patient has worn device for 3 - 7 days.

Download in office for review

Minimal patient training required

- Real-time:

Unblinded

Patient able to see receiver screen and encouraged to make changes

in behavior based on data on screen

Patient needs to be trained on insertion of device, meaning of alarms

and use of information obtained

HOW TO USE CGM IN PRACTICE

WHAT DOES IT ALL

MEAN?

Medtronic IPro DexCom G4 Platinum

WHAT DOES CGM DATA LOOK LIKE?

• Average blood glucose

• Time spent above, below and within target

• Glucose patterns related to exercise, meals

and insulin

• Undetected highs or lows

INFORMATION THAT CAN BE

OBTAINED FROM CGM

AVERAGE BLOOD GLUCOSE

AVERAGE BLOOD GLUCOSE

ANALYZING THE OUTPUT

(LOGBOOK)

UNDETECTED HIGHS

AND LOWS

B. H. LOG BOOK

B.H. CGMS RESULTS

B.H. CGMS RESULTS

Z.A. SMBG

Results

A.Z. CGMS RESULTS

MODAL DAY

A.Z. CGMS RESULTS

CGM is useful for detecting hypoglycemia in patients with

reported “hypoglycemia unawareness”.

CGM is a useful tool to determine glucose fluctuations (or

areas to target) in patients who are dif ficult to get to goal.

CGM can be used with or without an insulin pump.

CGM can be useful in patients with T1DM and T2DM.

Insertion of and interpretation of CGM results is a billable

service.

TAKE HOME MESSAGE