Wearing a CGM – Try to live as your patients as a CDE



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When I was studying to become a CDE, students in our class who did not have diabetes were given the task of living as if we had diabetes that requires insulin for a period of time. It was very useful. At that time, we did not have continuous glucose monitors (CGMs), but we had insulin, vials and syringes (not sure about pens, but I do not remember them), glucose monitors and other supplies. We gave ourselves normal saline as if it were insulin, we checked our glucose at least four times a day, we counted carbohydrate and all the rest needed to administer our "diabetes" daily. One incident that stands out to me was a friend pretending to have a hypoglycemic event while waiting for his food at a restaurant. It was a period of great openness for all of us.

From that, I learned to try to get the patient's experience as much as possible. With the new technology, this was quite enlightening and helped me avoid disasters for specific patients. Another thing that helped was not having to spend extra time to learn while I was in the office, causing the office to be late because I was late for other patients, etc.

One of the many examples of the need to put yourself in the patient's seat is years ago, before we knew how annoying all alarms could be, especially when we could not turn off some of them, I set alarms for myself. CGM warned me several times a night to warn me of impending hypoglycaemia. As my glucose levels were in the 70s and 80s, they were firing. He kept waking my husband up. With this experience, I have learned to set targets / alarms so they do not go out as often. For my patients who are not hypoglycemic unfamiliar or about whom I'm not worried about having hypoglycemia, I usually choose a system that does not alarm.

When I wanted to personally experience CGM that did not alarm, the Abbott Freestyle Flash, the first thing my husband said to me was, "I hope this thing will not wake me up all night." no and it did not happen It was not a problem. He still used one to check it out. So not only did I learn how my patients would react, but I also learned how family members and other household members can respond.

I learned a lot from using a CGM. Watch Lessons Learned find out more. If you have tried to live as your patients and have learned lessons, please inform us.

  • Buying or trying to buy a system or sensor has given me a better understanding of what a patient needs to go through just to get one.
  • Having taken my reader with me when I had the labs drawn, I learned that my glucose was the same as in the laboratory. That gave me more confidence in that. Also teach patients about latency time so they understand it may not be as close as expected, and hopefully they will have more confidence in their CGM.
  • It helps me tell my patients how it feels and even warns them about the high click on insertion.
  • It has helped me learn to warn patients about things that can start the sensor, like knocking on door openings, rubbing it gently with a towel after showering or showering, and putting on and taking off shirts or bras that run over head.
  • Having forgotten to pick up my reader and take him with me to bed one night and having skipped the readings helped me warn them about the possibility of this. The next time I use it, I will learn how to set it up on my phone and teach my patients how to do it. Most people take the phone to bed.
  • Having had what appears to be hypoglycemia within the first 24 hours of using a new sensor, I learned that unless there is a risk of hypoglycemia, they need not worry about hypoglycemia. Yes, they should still check with a fingertip so that when they have an event, they will be able to see the difference in times like these.
  • Like putting a sensor in and taking one from me, which helped me teach patients to do it alone.
  • How does it feel when a sensor is turned off.
  • There is nothing like experiencing what we ask our patients.

Looking forward to hearing from you!

Joy Pape, FNP-CDE
Medical Editor, DiabetesInControl

If you have a history of "Diabetes Averted Disaster", please let us know! If we file your Avoided Disaster in our Diabetes Clinical Mastery Series e-newsletter, you will receive a $ 25 gift card. Click here to submit a brief summary of the incident, what you think you learned in dealing with the incident, and your name and title. If you prefer to remain anonymous, please let us know, but still provide us with your name and address (so we can send you the gift card).

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