CLC Evidence Based Practice Project: Intervention Presentation on Diabetes

Continuous Glucose Monitors are groundbreaking in the management of diabetic patients. It allows for real time monitoring of glucose, increasing the prevention of hyperglycemic and hypoglycemic events. CGMs allow to produce glucose profiles and the individualization of treatment plans for patients. However, there is a downfall in the management of diabetes with CGMs. They have been statistically proven to be not be consistent with capillary glucose checks but have been considered close enough to use for diabetic treatment. CGMs are expensive and are not readily available even though they have been on the market for over a decade. Some insurance companies will not cover the cost and many patients will not put the time or effort into completing immense amounts of paperwork when they can otherwise just check their sugar periodically throughout the day. Many patients do enjoy CGM’s being that they do not need to prick their fingers multiple times a day or worry about what their blood glucose levels are. The education provided for CGMs appears to be inadequate and should be more specific to patient education, rather than physician or diabetic educator education. Patients need to understand the everyday use, how to respond to alarms, read the screen, and interpret the values they receive. CGMs have not been proven to be the most effective in Type 2 Diabetics. According to Petrie, studies and clinical trials suggested that adults with type 1 diabetes who wear a CGM can improve their glycemic control without increasing their risk of a hypoglycemic episode. It also went on to state that those who are already at their target HbA1c can monitor and maintain control while reducing their risk of hypoglycemic episodes as well (Petrie, et al., 2017). In clinical trials, there was no decrease in HgbA1C but there was a decrease in overall hypoglycemic time. CGMs can be lifesaving for children and fragile diabetics who must be monitored very closely to prevent hospitalization and other comorbidities. Remote monitoring of CGMs is becoming commercially available and could be the lifesaving moment for these patients. Having a parent or guardian receive real time readings from the CGM could alarm them for potentially life-threatening, dangerous events where they can intervene before the worst happens. CGMs are an amazing piece of technology that could continue to improve the lives of diabetics, however more clinical trials need to be completed with an increase in the availability and decrease in cost of these devices. When in the hospital, nurses are required to check their patients blood glucose manually by utilizing a glucometer. However, when patients are discharged home, CGM’s are essential in maintaining their blood glucose levels and preventing hyperglycemic and hypoglycemic events.

2

Type 2 diabetics and CGM’s

Not widely used in Type 2 Diabetics

Decreased Hypoglycemic episodes