Home

Continuous Glucose Monitoring (CGM)

CGM is the latest tool used to measure blood glucose levels. Many people are having great success managing diabetes with the addition of this tool in their kit. However, many people who have tried CGM from the various manufacturers have not.

Based on the experiences of the mygluco community , Diabetech is in the process of developing two CGM Education & Intensive Management Programs. The first one is in response to many people who are curious about CGM but aren't yet ready to commit to the extra work associated with an unknown. It's nearly impossible to know until you've tried CGM personally.

  • Will I like CGM? 
  • Will my child or elder parent like / use CGM?
  • Which CGM is right for me?

CGM  Boot Camp (One-Time)

The first program under development will allow people to 'try before you buy'. This program will cover 30 days of education, blood glucose pattern management training and use of a loaner CGM program kit. The kit includes the CGM reader, CGM transmitter and a single-use disposable CGM sensor. Your kit will also include GlucoMON-ADMS, a supported meter, 30 days of test strips and detailed instructions for you to follow at home. The kit is drop shipped to your home so you never have to leave your house, except to return the kit at the end of your program.

CGM Driver's School (Recurring)

If you want to get the most out of your new sports car, you take it to a driving school where man meets machine and the driver really has a chance to open it up and learn about his new tool. Likewise, even after you've committed to CGM, there is presently no established method of analyzing the data created by the CGM sensor. Clinical research is currently in the process of developing these algorithms and will someday put them to the test with real patients. Until that day comes, CGM users are left wondering about the best way to get the most out of their new tool. Enrollment in this program will help you to get the most out of your CGM. After all, it's just a tool that needs a driver. Further, you wouldn't just take this course once. You would return from time to time to hone & refresh your skills.

CGM as an integrated tool within Diabetech's ADMS.

While this is not yet a reality, teh technical integration of CGM data into your profile is a relatively trivial exercise. The more important questions deal directly with what you do with that data once you have it. Currently, CGM data is locked up inside the CGM handheld and is therefore very limited as to what you can do with it. A future technical project may unlock this data and make itself relevant to better care. In the meantime, our participants receive the benefit of managing their diabetes with CGM as part of a program. 

One such project which is similar to the research and development pioneered by Diabetech for analysis of spot blood sugar data is just now launching at the Joslin Diabetes Center but for CGM data:

"A team led by Howard A. Wolpert, M.D., will develop software to analyze continuous glucose monitoring (CGM) data that incorporates pattern recognition algorithms; identifies problem areas, such as recurrent hypoglycemia, hyperglycemic burden and high rate of change post-meal that point to a need for therapy adjustments; and determines if the alarms of CGM devices are set optimally to detect frequent out-of-target glucose measurements.  Dr. Wolpert is an acknowledged world leader in the introduction of new technologies into diabetes care and improving patient adherence to treatment. "

And when that software is ready, it will have an opportunity to go through ADMS Certification as a proven process which ensures that R&D is ready for use by patients and providers in the real world.

GlucoMON-ADMS compared to Continuous Glucose Monitoring

The New England Journal of Medicine recently published mid-point outcomes from the first ever randomized, conrolled trial of CGM. The bottom line for blood sugar control is that adults can lower their A1c (a measure of average blood sugar) by a half-point by using CGM on a daily basis. Teens and Children in this study did not fare so well. Both of these groups showed no benefit from CGM with regard to lowering A1c. We discuss the possible reasons for this here.

In contrast, GlucoMON-ADMS preliminary trial results from its first randomized, controlled clinical trial were published at the 2008 Conference of Pediatric Endocrinology Society of Texas, Oklahoma, Lousiana and Arkansas. This study includes children under age 11 who are issued a GlucoMON and trained on how to review their ADMS generated report. These patients in the treatment group have reduced their A1c by a half-point when compared to the control group. The reason for this is that report review and spotting blood sugar trends is easy with GlucoMON-ADMS. A typical review takes only a minute or two once a week essentially translating what seems like no extra work into concrete benefit and all without direct provider intervention, additional visits to the clinic, or the pain and time required to use current generation CGM sensors.

Conclusion

People with diabetes should be enrolled in a program that utilizes GlucoMON-ADMS before they start using CGM. Also, CGM needs to be incorporated into ADMS for it to realize its full potential.

CGM Reimbursement Resources

CGMSCentral.com is a free site with lots of information about the various health plans and their policies on CGM as a covered benefit. There are also tips, tricks and strategies available as well as connections to others going through the same process of trying to secure reimbursement for CGM equipment and sensors.