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A Basic CGM Training Needs Checklist 

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Training patients to use their CGMs has many facets. Use this simple checklist to be sure all bases are covered.

From the Personal Continuous Glucose Monitoring Implementation Playbook from ADCES and AphA. Contributors include: Patricia L. Scalzo, MSN, NP, RN, CDCES, Kelly A. Brock, PharmD, RPh and Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, FADCES. This effort was supported by Dexcom & Abbott.

Training New CGM device users? This checklist walks you through the basics.

Basic Training Needs Checklist:

  1. Sensor site selection, rotation and sensor insertion: See the manufacturer's website for the most recent approved site selection locations. Note, be sure you select the US site as some countries have differing approved locations for device placement.
  2. Attachment of the transmitter to the sensor, if applicable
  3. Taping/securing of the sensor/transmitter, if applicable
  4. Connection of the transmitter to the receiver, if applicable
  5. Difference between interstitial glucose readings and blood glucose readings
  6. Understanding CGM data and trends
  7. Possible interference of products such as acetaminophen, salicylic acid, hydroxyurea, and high dose vitamin C
  8. Calibration including timing, frequency and importance of accurate meter/fingerstick technique, if applicable
  9. Education to prevent overcorrection of high glucose
  10. Removal and disposal of the device
  11. Basic troubleshooting tips
  12. How to calibrate, if applicable
  13. Using a traditional blood glucose monitor to double-check readings, if applicable

Treatment of Hypoglycemia Advanced Training Needs Checklist:

  1. Setting and managing alerts/alarms
  2. How to use trend arrows to adjust treatment decisions
  3. Problem solving for site adhesiveness and skin reactions
  4. Support with coping and problem solving
  5. Sharing of data with caregivers and healthcare providers

For comprehensive information on CGMs, check out our FREE certificate program, Putting Continuous Glucose Monitoring (CGM) into Practice:

References: 1 Chehregosha, H, Khamseh, ME, Malek, M, et al. A View Beyond HbA1c: Role of Continuous Glucose Monitoring. Diabetes Therapy. 2019;10, 853–863 2 Sagar R, Abbas A, Ajjan R. Glucose monitoring in diabetes: from clinical studies to real-world practice. Practical Diabetes. 2019;36. 57-62. 10.1002/pdi.2215. 3 Ajjan R, Slattery D, Wright E. Continuous Glucose Monitoring: A Brief Review for Primary Care Practitioners. Advances in Therapy. 2019;36:579-596 4 Aleppo G, Laffel LM, Ahmann AJ, et al. A Practical Approach to Using Trend Arrows on the Dexcom G5 CGM System for the Management of Adults With Diabetes, Journal of the Endocrine Society, Volume 1, Issue 12, 1 December 2017, Pages 1445–1460, https://doi.org/10.1210/js.2017-00388 5 Kudva YC, Ahmann AJ, Bergenstal RM, et al. Approach to Using Trend Arrows in the FreeStyle Libre Flash Glucose Monitoring Systems in Adults, Journal of the Endocrine Society, Volume 2, Issue 12, December 2018, Pages 1320–1337, https://doi. org/10.1210/js.2018-00294 6 Šoupal J, Petruželková L, Grunberger G, et al. Glycemic Outcomes in Adults With T1D Are Impacted More by Continuous Glucose Monitoring Than by Insulin Delivery Method: 3 Years of Follow-Up From the COMISAIR Study. Diabetes Care. 2020 Jan;43(1):37-43. doi: 10.2337/dc19-0888. Epub 2019 Sep 17. 7 Mulinacci G, Alonso T, Snell-Bergeon JK, Shah VN. Glycemic Outcomes with Early Initiation of Continuous Glucose Monitoring System in Recently Diagnosed Patients with Type 1 Diabetes. Diabetes Technology & Therapeutics. 2018;21. 10.1089/ dia.2018.0257. 8 Peters, AL. The Evidence Base for Continuous Glucose Monitoring. Role of Continuous Glucose Monitoring in Diabetes Treatment. American Diabetes Association. 2018 Aug: 3-7. doi: 10.2337/db20181-3 9 American Association of Diabetes Educators Practice Paper. The Diabetes Educator Role in Continuous Glucose Monitoring. 2018. Updated Dec2019; https://www.danatech.org/media/ntgjf2di/diabetescareeducationspecialistrolecgm_aug20.pdf 10 American Diabetes Association. Standards of Medical Care in Diabetes – 2020. Diabetes Care 2020;43(Suppl 1):S77-S88 11 Peters AL, Ahmann AJ, Battelino T, et al.: Diabetes Technology—Continuous Subcutaneous Insulin Infusion Therapy and Continuous Glucose Monitoring in Adults: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101:3922–3937 12 Garber AJ, Handelsman Y, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm - 2020 executive summary. Endocrine Practice 2020, 26 (1): 107-139 13 Danne T, Nimri R, Battelino T, et al. International Consensus on Use of Continuous Glucose Monitoring. Diabetes Care. 2017;40:1631–40 14 Aleppo G, Webb K. Continuous Glucose Monitoring Integration in Clinical Practice: A Stepped Guide to Data Review and Interpretation. Journal of Diabetes Science & Technology. 2018; https://doi.org/10.1177%2F1932296818813581 15 Petrie JR, Peters AL, Bergenstal RM, et al. Improving the clinical value and utility of CGM systems: Issues and Recommendations: A joint statement of the European Association for the Study of Diabetes and the American Diabetes Association Diabetes Technology Working Group. Diabetes Care. Oct 2017, dci170043; DOI: 10.2337/dci17-0043 16 American Diabetes Association. Standards of Medical Care in Diabetes – 2020. Diabetes Care 2020;43(Suppl 1):S77-S88 17 U.S. Centers for Medicare & Medicaid Services. Medicares Coverage of Diabetes Supplies, Services & Prevention Programs. Publication # 11022. Revised 12/01/2019 18 Kompala T, Neinstein A. A New Era: Increasing Continuous Glucose Monitoring Use in Type 2 Diabetes. American Journal Managed Care. 2019 Mar;25(4 Spec No.):SP123-SP126. 19 Welsh JB. Role of Continuous Glucose Monitoring in Insulin-Requiring Patients with Diabetes. Diabetes Technology & Therapeutics. Jun 2018.S2-42-S2-49.http://doi.org/10.1089/dia.2018.0100 20 Heinemann, L, Klonoff, D. C. An Opportunity to Increase the Benefit of CGM Usage: The Need to Train the Patients Adequately. Journal of Diabetes Science and Technology. 2019 https://doi.org/10.1177/1932296819895083 21 Longo, R, Sperling, S. Personal Versus Professional Continuous Glucose Monitoring: When to Use Which on Whom. Diabetes Spectrum. 2019;32. 183-193. 10.2337/ds18-0093 PART SIX: References Personal Continuous Glucose Monitoring Implementation Playbook 61 22 Tanenbaum ML, Adams RN, Lanning MS, et al. Using Cluster Analysis to Understand Clinician Readiness to Promote Continuous Glucose Monitoring Adoption. Journal of Diabetes Science & Technology. 2018;12(6):1108–1115 23 American Diabetes Association. Overcoming Therapeutic Inertia: Accelerating Diabetes Care for Life. American Diabetes Association Summit. Summary of Proceedings. 2019 24 Kazemian P, Shebl FM, McCann N, Walensky RP, Wexler DJ. Evaluation of the Cascade of Diabetes Care in the United States, 2005-2016. JAMA Intern Med. 2019;179(10):1376–1385. doi:10.1001/jamainternmed.2019.2396 25 Rodbard D. Continuous Glucose Monitoring: A Review of Successes, Challenges, and Opportunities. Diabetes Technol Ther. 2016 Feb 1; 18(Suppl 2): S2-3–S2-13. doi: 10.1089/dia.2015.0417 26 Smith MB, Albanese-O’Neill A, Macieira TGR, Yao Y, et al. Human Factors Associated with Continuous Glucose Monitor Use in Patients with Diabetes: A Systematic Review. Diabetes Technology & Therapeutics. Oct 2019.589-601.http://doi.org/10.1089/ dia.2019.0136 27 Johnson ML, Martens TW, Criego AB, Carlson AL, et al. Utilizing the Ambulatory Glucose Profile to Standardize and Implement Continuous Glucose Monitoring in Clinical Practice. Diabetes Technology & Therapeutics. Jun 2019.S2-17-S2-25.http://doi. org/10.1089/dia.2019.0034 28 Danne T, Nimri R, Battelino T, et al. International Consensus on Use of Continuous Glucose Monitoring. Diabetes Care. 2017;40:1631–40 29 Battelino T, Danne T, Bergenstal RM, et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations from the International Consensus on Time in Range. Diabetes Care 2019;42:1593-1603. doi10.2337/dci19-0028. 30 Bergenstal, RM. Continuous Glucose Monitoring Data as an Adjunct to A1C. Role of Continuous Glucose Monitoring in Diabetes Treatment. American Diabetes Association. 2018 Aug: 19-20. doi: 10.2337/db20181-3 31 Kruger DF, Edelman SV, Hinnen DA, Parkin CG. Reference Guide for Integrating Continuous Glucose Monitoring into Clinical Practice. The Diabetes Educator. 2019 Feb;45(1_suppl):3S-20S 32 Isaacs D, Cox C, Schwab K, et al. Technology Integration - The Role of the Diabetes Care and Education Specialist in Practice. The Diabetes Educator. 2020 Aug. 323-334. doi: 10.1177/0145721720935123 33 Greenwood DA, Howell F, Scher L, et al. A Framework for Optimizing Technology-Enabled Diabetes and Cardiometabolic Care and Education - The Role of the Diabetes Care and Education Specialist. The Diabetes Educator. 2020 Aug. 315-322. doi:10.1177/0145721720935125 34 Carlson AL, Mullen DM, Bergenstal RM. Clinical Use of Continuous Glucose Monitoring in Adults with Type 2 Diabetes. Diabetes Technology & Therapeutics. 2017;19:S4–11 35 Adolfsson P, Parkin CG, Thomas A, Krinelke LG. Selecting the Appropriate Continuous Glucose Monitoring System – a Practical Approach. European Endocrinology. 2018;14:24–29. 10.17925/EE.2018.14.1.24 36 Barnard-Kelly, KD, Polonsky, WH. Development of a Novel Tool to Support Engagement With Continuous Glucose Monitoring Systems and Optimize Outcomes. Journal of Diabetes Science and Technology, 2020;14(1), 151–154. https://doi. org/10.1177/1932296819848686

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This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your diabetes care and education specialist or healthcare provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. To find a diabetes care and education specialist near you, visit diabeteseducator.org.

ADCES and danatech curate product specifics and periodically review them for accuracy and relevance. As a result, the information may or may not be the most recent. We recommend visiting the manufacturer's website for the latest details if you have any questions.

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