use of continuous glucose monitoring (cgm) in guiding ... · 9/17/2015 · • average blood...
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USE OF CONTINUOUS
GLUCOSE MONITORING
(CGM) IN GUIDING
THERAPY
DIABETES ECHOSEPTEMBER 17, 2015
VERONICA BRADY, PHD, FNP-BC, BC-ADM, CDE
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-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
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WHAT DOES IT ALL
MEAN?
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Medtronic IPro DexCom G4 Platinum
WHAT DOES CGM DATA LOOK LIKE?
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• 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
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AVERAGE BLOOD GLUCOSE
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AVERAGE BLOOD GLUCOSE
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ANALYZING THE OUTPUT
(LOGBOOK)
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UNDETECTED HIGHS
AND LOWS
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B. H. LOG BOOK
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B.H. CGMS RESULTS
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B.H. CGMS RESULTS
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Z.A. SMBG
Results
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A.Z. CGMS RESULTS
MODAL DAY
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A.Z. CGMS RESULTS
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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
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