Rapid Recap for Advanced Diabetes Technology – Conversations and Collaborations Webinars
Advanced Diabetes Technology Rapid Recap
September 2022

Benefits of Continuous Glucose Monitoring 

  • Insights into effects of food, exercise, illness and medication on real-time diabetes management 
  • Improved Time in Range (TIR) 
  • Directional arrows 
  • Audible alarms for highs and lows 
  • Approved for children and adults with diabetes 
  • Connectivity to insulin pumps 
    • Predictive alerts for highs and lows can automatically adjust insulin delivery rates 
  • Connectivity with clinicians and family members 
  • Data can be easily downloaded to the clinician's office and reviewed during a face to face or virtual visit 
  • Improved A1C 
  • Reduced absenteeism from work 
  • Reduced ED Visits 
  • Reduction in Hypoglycemia 
  • Reduction in long and short-term DM related complications  

 

Tricks to Successful Initiation of CGM in Primary Care

Role of the Clinician 

  • Make it simple! 
  • Consider putting the first sensor on in the office for the patient. Subsequent sensors can be placed by the patient with guidance from MA 
  • Explain how the CGM may benefit patients' diabetes control 
    • More time in prescribed range 
    • Reduced incidence of hypoglycemia 
    • Improved glycemic variability 
    • Access to data while sleeping 
    • Improve A1C 
    • Reduce risk of hospitalizations 
    • Improved rates of work absenteeism 

Role of the Patient 

  • Confidence in applying the sensor appropriately 
  • Scan frequently 
  • Minimize gaps in sensor wear 
  • Contact Customer Service if sensors fail or fall off 
  • Bring data to each visit 
  • Understand glycemic patterns related to food, sleep, exercise, travel, etc. 

 

CGM Comparison

  Dexcom G6​ Guardian 3 Libre 14-day Libre 2 Libre 3 Eversense
Type of CGM rtCGM rtCGM isCGM isCGM rtCGM rtCGM
Days of Sensor Wear 10 7 14 14 14 Up to 180
Warmup Time 2 hours 2 hours 1 hour 1 hour 1 hour 24 hours
Fingerstick calibration required? No Yes – minimum of twice daily No No No Yes – 24 hours after insertion 4 calibrations 2-12 hours apart, then twice daily 10-14 hours apart
Alarms Yes Yes No Yes Yes Yes
Integrations with Pump Yes – Tandem t:slim X2 and OmniPod5 Yes and No; The Guardian 3 is part of the Medtronic 670G/770G hybrid closed-loop insulin pump system. The Guardian Connect is a standalone CGM that does not connect to any pump. No​ No, but is​ compatible with Bigfoot smart pen cap No No
Smartphone Integration Android, iOs, Apple Watch Android, iOs Android, iOs Android, iOs iOs (Android pending at time of writing) Android, iOs, Apple Watch
Data sharing (only available if using app) Up to 10 people with Dexcom Follow app (Apple, Google) Up to 4 people with CareLinkTM Connect web app (Apple, Google) Up to 20 people with LibreLinkup app (Apple, Google) Up to 20 people with LibreLinkup app (Apple, Google) Up to 20 people with LibreLinkup app (Apple, Google) Up to 5 people with Eversense Now app
Separate Receiver Available Yes No Yes Yes Not at time of writing No
Water Resistance​ (SENSOR ONLY) 8 feet for up to 24 hours 7.5 feet for 10 minutes 3 feet for 30 minutes 3 feet for 30 minutes 3 feet for 30 minutes 1 meter (~3 feet) for 30 minutes
Interferences Hydroxyurea – may falsely elevate sensor readings) Tylenol – may falsely elevate sensor readings) Vitamin C – may falsely elevate sensor readings​
Aspirin – may falsely lower sensor readings
Vitamin C >500mg/day – may falsely elevate sensor readings Vitamin C >500mg/day – may falsely elevate sensor readings Tetracyclines – may falsely lower sensor readings

 

 

Reference: 

Grunberger G, Sherr J, Allende M, et al. American Association of Clinical Endocrinology Clinical Practice Guideline: The Use of Advanced Technology in the Management of Persons With Diabetes Mellitus. Endocr Pract. 2021 Jun;27(6):505-537.