Spectrum

Gehr, Bernhard; Holder, Martin; Kulzer, Bernhard; Lange, Karin; Liebl, Andreas; Sahm, Claudia; Sengbusch, Simone von; Schlüter, Sandra; Siegmund, Thorsten; Thurm, Ulrike; Ziegler, Ralph; Freckmann, Guido; Heinemann, Lutz

doi:10.1177/1932296816661735

Cited by 35 publications

(15 citation statements)

References 3 publications

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“…For centers with limited experience or resources, there are commercially available patient education curricula and easy-to-use trend arrow recommendations in form of scorecards, which give a detailed guide on educational essentials for CGM users. 40–42…”

Section: Prerequisites For Cgm Initiationmentioning

confidence: 99%

Clinical Practice Recommendations on the Routine Use of Eversense, the First Long-Term Implantable Continuous Glucose Monitoring System

Deiss

Szadkowska

Gordon

et al. 2019

Diabetes Technology & Therapeutics

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Background: The use of real-time continuous glucose monitoring (rtCGM) systems has proved to positively impact the management of type 1 diabetes with the potential to lower HbA1c, reduce frequency and time spent in hypoglycemia, and lower glycemic variability. Nevertheless, the acceptance of rtCGM remains below expectations and the dropout rate within the first year has been reported to be 27%. Besides financial reasons due to limited reimbursement, reasons include the need for frequent sensor replacement, the discomfort of wearing a sensor, the presence of adverse skin reactions, or privacy. Thus, novel approaches to rtCGM are desired to overcome these barriers. The first long-term implantable rtCGM system diversifies the field of glucose monitoring further. However, due to its novelty, there are no published clinical practice guidelines available. Aims: The aim of this article is to set the foundation for a best clinical practice for the everyday clinical care using a long-term implantable CGM system. Methods: An international expert panel for the long-term implantable CGM system developed this best practice guidance. All participants were certified and experienced in the use of the Eversense ® long-term implantable CGM system. The workflows from the respective clinics were presented, discussed and are summarized in an ideal care workflow outlined in these practice recommendations. Results: The participants agreed on the following aspects: definition of the patient population that will benefit from a long-term implantable CGM device; real-world experience on safety and accuracy of a long-term CGM; definition of the ideal sensor position; description of the optimal process for sensor insertion, removal, and replacement.

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Section: Prerequisites For Cgm Initiationmentioning

confidence: 99%

Clinical Practice Recommendations on the Routine Use of Eversense, the First Long-Term Implantable Continuous Glucose Monitoring System

Deiss

Szadkowska

Gordon

et al. 2019

Diabetes Technology & Therapeutics

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“…Glycemic variability (<36% = stable, >36% = unstable) materials and comprehensive training, which is offered by the manufacturers, for example FLASH (for iscCGM systems), independent training programs, for example Spectrum (for rtCGM systems), are also available [43,44]. The training program Spectrum is offered either for parents of children with diabetes, adolescents or adults.…”

Section: Education and Trainingmentioning

confidence: 99%

“…Its aim is to mediate basic information to users of rtCGM systems and to accompany the start of the usage. During this training program, the participants are trained on the readout, analysis and course of glucose data, as well as on the setup and usage of alarms, respectively [43]. In the evaluations study of the iscCGM training program FLASH, it could be shown that clinical parameters, such as HbA 1c and TiR (see also section "Evaluation and visualization of CGM data"), were significantly improved by participating in this training program and moreover, that the communication between patients and their caregivers was also improved [45].…”

Section: Education and Trainingmentioning

confidence: 99%

Basics and use of continuous glucose monitoring (CGM) in diabetes therapy

Freckmann

2020

Journal of Laboratory Medicine

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BackgroundFor a long time, self-monitoring of blood glucose (SMBG) was widely viewed as the essential glucose measurement procedure in the therapy of insulin-treated people with diabetes. With increasing accuracy and simplified handling of continuous glucose monitoring (CGM) systems, this evolving technology challenges and at least partly replaces SMBG systems.ContentSensors of all currently available CGM systems measure glucose levels in the subcutaneous interstitial fluid for 6–14 days. The only available implantable sensor facilitates a measurement span of up to 6 months. Depending on the used system, glucose levels are either shown in real time (rtCGM systems) or after scanning (iscCGM systems). Functions such as alerts, alarms and trend arrows and data presentation encourage independent self-management of diabetes therapy. The high frequency of glucose data and the multitude of existing functions require an extensive training of people with diabetes and their caregivers.SummaryCGM systems provide a much more detailed picture of glycemia in people with diabetes. Educated patients can use these data to react adequately to their glucose levels and therefore avoid hypoglycemic and hyperglycemic events. Studies showed that glycated hemoglobin (HbA1c) levels and hypoglycemic events can be significantly reduced by frequent use of CGM systems.

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“…Ein geschulter Patient kann durch geeignete therapeutische Reaktionen auf den aktuellen Glukoseverlauf und seine Dynamik akute Komplikationen wirksam vermeiden und gleichzeitig eine gute Glukosekontrolle erreichen [5].…”

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Diabetes-Technologie: Stand der Dinge

Heinemann¹

2018

Diabetologie und Stoffwechsel

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In the last decades diabetes technology has developed into an integer part of diabetes therapy. A number of different technologies, most of them are also related to digitalization, are summarized under this heading: techniques that enable a more accurate and reliable diagnostic approach, i.?e. glucose measurement for both, follow-up and diabetes diagnosis. Self-monitoring of capillary blood glucose samples is still a cornerstone of diabetes therapy of most patients with diabetes. It is impressive to see which level of measurement accuracy is possible with modern devices. With a smarter handling of the glucose information collected, i.?e. better translation into therapeutic action, improvements in patient?s overall glucose control and well-being can be achieved. Technological advancements also helped to improve insulin pens and insulin pumps in the last years considerably, especially the development of thin and short needles. Bringing the glucose information with the therapeutic options available in a smart way enables construction of systems that automatically adjust insulin dosing to the individual needs and situation. Artificial pancreas systems will be used most probably by a considerable part of patients with diabetes, depending mainly on the costs involved. Digitalization will massively change the way patients are treated in the future, many decisions will not be made by the diabetologist and his team, but by smart algorithms. Such developments are associated with a number of aspects like data privacy that require careful handling and attention by diabetes medical associations. In summary, diabetes technology represents already an important pillar of diabetes therapy that most probably will gain an even bigger role in the future.

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Spectrum

Cited by 35 publications

References 3 publications

Clinical Practice Recommendations on the Routine Use of Eversense, the First Long-Term Implantable Continuous Glucose Monitoring System

Clinical Practice Recommendations on the Routine Use of Eversense, the First Long-Term Implantable Continuous Glucose Monitoring System

Basics and use of continuous glucose monitoring (CGM) in diabetes therapy

Diabetes-Technologie: Stand der Dinge

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