November is National Diabetes Awareness Month. The Veterans Memorial Hospital Diabetes Education Program offers continuous glucose monitoring (CGM) as an outpatient service. The Freestyle Libre Pro System offers the option of continuous glucose monitoring for 3 to 14 days. This system helps health care providers fine-tune their patients’ diabetes treatment plan, giving patients optimal control of their diabetes and their life.
Continuous glucose monitoring is used to determine what a patient’s blood glucose levels are every 15 minutes, 24 hours a day, even while they sleep. When the data is downloaded, the information is able to be transferred onto graphs, which can show the healthcare providers how a patient’s blood sugar trends throughout each day the sensor is worn.
Once a physician has ordered a Continuous Glucose Monitoring Study, the diabetes educator is able to insert a small glucose sensor on the back of the patient’s arm. This procedure is quick and painless. The sensor is about the size of a quarter and lies relatively flat to the patient’s skin. The sensor is worn for whatever duration of time that has been decided by the patient and the healthcare providers, which is usually 7-14 days. At the end of this set time frame, the information in the sensor is downloaded by the diabetes educator using a hand held reader, which generates a graphical report that can be shared with the patient’s provider. (pictured below)
This information is a useful tool in modifying the patient’s medications, meal planning, and activity routine to improve blood sugar control. One advantage with the Freestyle Libre monitoring system, is the patient can have their blood sugar information downloaded at any time throughout the duration of wearing the sensor, by simply stopping in to the VMH Diabetes Education office. The sensor can be quickly scanned without actually removing it. Insulin dosing can be adjusted and then re-evaluated within a few days to monitor progress. The patient can continue to wear the device until the study duration time of 14 days has been met.
Persons utilizing the continuous glucose monitor are asked not to change their daily routine in any way while the sensor is in place. They can shower or bathe, and participate in their usual daily activities. The patient will be asked to keep a daily log of the times they eat their meals or snacks, record their exercise and activity times, as well as diabetes medication doses and times. They will also need to check their finger stick blood sugars according to their usual routine.
Most private insurance companies as well as Medicare and Medicaid will help cover Continuous Glucose Monitoring studies for both Type 1 and Type 2 diabetes when they are medically necessary and ordered by a physician. A patient may check with their individual plan benefits for their specific coverage, if desired.
“The Freestyle Libre Continuous Monitoring System has been an extremely useful tool in helping our diabetes patients gain better control of their blood sugars,” states Angie Mettille, RN, BSN, Certified Diabetes Educator at Veterans Memorial Hospital. “If you have been struggling to meet your hemoglobin A1c and blood sugar goals, the Continuous Glucose Monitor can help you and your healthcare provider figure out what changes are needed with your diabetes treatment. It can also be useful to anyone that has frequent, unexplained low blood sugars which can be extremely dangerous and frightening for you and your loved ones. I would encourage anyone who is having difficulty managing their diabetes to ask their doctor about this simple, painless procedure.”
Rural Waukon resident, Pat Curtin, has utilized CGM a few times over the past 6 months. Having diabetes for a number of years and needing insulin therapy, he had found himself struggling to keep his A1c within goal. His provider referred him to VMH Diabetes Education, and he completed the 14 day CGM study.
“Pat doesn’t check his blood sugar like he should, which made it difficult to know what insulin adjustments were needed. We were introduced to CGM, and Pat found it to be painless,” explains Pat’s wife, Kate Curting. “Angie was able to get information to help regulate Pat’s amount of insulin. He was able to bring his A1c down two points within a few months. We have Medicare with a supplement, and coverage was 100%. We will continue to use this tool in the future to make sure Pat feels the best he can with good blood sugars.”
There are also continuous glucose monitoring systems that can be ordered by a physician for patients to use at home daily to check their blood sugars. These do not completely eliminate the finger stick approach, but can decrease the frequency of poking for many. At this time, insurance coverage is variable, but some patients view any extra out-of-pocket expense as minor when considering the advantages of easier, painless, and more frequent blood sugar checks.
For more information on continuous glucose monitoring, please call the Diabetes Education Department at Veterans Memorial Hospital at 563-568-3411 ext 172.