How to Increase Continuous Glucose Monitoring Utilization in Patients With Type 1 Diabetes

February 11, 2020
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Learn how a QI project took utilization from less than 9% to 50% in a pediatric Endocrinology Clinic.

Type 1 diabetes accounts for approximately 10% of the more than 420 million global cases of diabetes. With type 1 diabetes (T1D), the pancreas produces little to no insulin, and people with T1D must administer insulin via injection or an insulin pump every day for their entire life. How much insulin they need is determined by their blood glucose.

Now, an increasing number of children with diabetes are avoiding the dreaded finger pricks that come with traditional glucose monitoring, thanks to the latest in diabetes management technology, which uses a sensor that can be worn on the abdomen. The technology works with a mobile app that stores the blood glucose levels. The app can also transmit results to providers and other app users, such as parents.

While the quality of life benefits of continuous glucose monitoring (CGM) seem obvious – no finger pricks, no stopping your day to test your glucose, alerts to parents and family members if insulin levels reach an unsafe range – recently, physicians and researchers have been investigating whether using the technology makes a difference in disease-related outcomes of the patients. For example, does CGM increase the amount of time a patient’s blood sugar is in the ideal range? Does it result in better HbA1c levels? (HbA1C is a type of hemoglobin chemically linked to sugar. The test tells you the average level of blood sugar over the past 2 to 3 months.) The majority of studies and reviews show that the answer is “yes.”

But studies about CGM have uncovered some challenges to ensuring that as many patients as possible benefit. Clinicians and quality improvement experts in the Section of Endocrinology at Nationwide Children’s Hospital recently used quality improvement methodology to increase the number of children using CGM to manage their diabetes.

The team increased the number of eligible patients on CGM from less than 9% to more than 30% in two years, by addressing key barriers in awareness of CGM and access to the devices. Interventions included increasing patient and family education and starting the CGM conversation at diagnosis. The team also worked with device and insurance companies to streamline the process of sending the needed documentation for coverage – thus increasing patient access and shortening the waiting period.

To learn how they achieved this goal, download Increasing Continuous Glucose Monitor Utilization Among Children With T1D: A How-To Guide.