December - 20219CGMs play a movie of blood glucoses as compared to snapshot picture of finger stick glucosereadings were lesser than 54mg/dL with a clinical target of less than 1 percent. A busy provider can quickly assess the need to further investigate hypoglycemia and hyperglycemia events with the TIR report. The provider can then review the AGP graph to identify the time of day that low and high glucose levels, trends and excursions are occurring. The AGP report can also give an estimate of the A1C level based on glucose measured for a given time period. This is called the glucose management indicator (GMI). The glucose variability (%CV) indicates glucose variability with a clinical guideline target of less than 36 percent. AGP report can help providers assess glucose management, make treatment decisions, guide discussions with PWD and help them set individualized goals. The PWD can then watch over time as they move closer to their goals not only during provider visits but between visits and even daily. PWD are sometimes resistant to trying a CGM because they do not want a device attached to them and may not understand how the CGM can assist with ongoing diabetes self-management. They are often encouraged to wear the sensors for a short time and if they do not like it, they can always go back to monitoring with glucose meter. Needless to say, patients' try it and fall in love wanting their own CGM. They report lifestyle changes they have already made by seeing the glucose responses to variables such as food choices, activity, insulin doses or timing of doses just to mention a few. CGMs play a movie of blood glucoses as compared to snapshot picture of finger stick glucose. A common saying of one of the diabetes educator on our team who wears a sensor is "without my sensor, I feel like I am stranded in the middle of the ocean without a life jacket"With all the assistance CGMs can provide with diabetes management, I wonder why every PWD does not have their own CGM. Patient resistance and clinician inertia may be reasons, but mostly it is due to insurance coverage or lack thereof. Insurance plans have different requirements for coverage with out- of -pocket tiers that can make CGMs cost prohibitive. This is truly unfortunate as the CGM has elevated glucose monitoring and added additional layer of meaning. CGM companies can do their part by ensuring that marketing does not only focus on its convenience to reduce finger sticks but most importantly highlight the benefit of getting more glucose data to direct therapeutic and lifestyle decision. JoEllen Condon
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