Continuous Glucose Monitoring Systems by Katy McGaughy https://padlet.com/mcgaughy_katy/4dfkbb3cusog The future of glucose monitoring in patients with diabetes and beyond en-us 2019-02-04 22:36:49 UTC 2026-03-15 03:23:21 UTC hello@padlet.com https://padlet-assets.s3.amazonaws.com/icons/Apple.png Summary of Current Innovation: A brief history of continuous glucose monitors (CGMs): mcgaughy_katy https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327577847
  • In 2016, Dexcom's G5 Mobile Continuous Monitoring System was the first CGM to gain FDA approval.  Since then, several other CGMs have gained FDA approval and become available to patients.  
  • The latest CGM models differ from older models, in that they eliminate many of the finger sticks required for monitoring of blood glucose levels.  Finger sticks are generally only done for calibration purposes, sometimes only once per day (Wolinsky, 2018). 
  • To obtain continuous glucose readings, sensors are placed on the arms or abdomen.  These sensors have very small needles which enter the subcutaneous layer, analyzing the glucose level every five minutes (Wolinsky, 2018).
  • The majority of this new generation of CGMs have Bluetooth capabilities, allowing for automated syncing with mobile devices.  In the event of hypoglycemia or device errors, the CGM can send an alert to the patient via the connected mobile device (Wolinsky, 2018).
  • In late 2018, a French company called PKVitality announced the pending release of a smartwatch called "K'Watch Glucose," which will have continuous glucose monitoring capabilities.  A patch beneath the watch face contains micro-needles, which measure glucose levels nearly continuously ("Continuous glucose measuring smartwatch, K'Watch glucose, expected soon", 2018).
    • ]]>     2019-02-04 23:15:10 UTC https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327577847     mcgaughy_katy https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327585913 Dexcom. (2018, 1 June).  Continuous glucose monitoring: The basics.  Retrieved from https://www.youtube.com/watch?v=6XrjnXlZ5WY]]> 2019-02-04 23:57:38 UTC https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327585913 Pros mcgaughy_katy https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327592435
  • Studies have shown that CGMs are generally very reliable sources of data (Zhou et al., 2017).
  • CGMs can be used in critically-ill hospitalized patients, and have been shown to reduce major swings in glucose levels, thereby improving the safety of insulin administration (Preiser et al., 2018).
  • High levels of glycemic variability put patients at risk for complications related to diabetes.  Use of CGMs has been shown to decrease glycemic variability in patients, thereby reducing their risk of complications (Peyser, Balo, Buckingham,  Hirsch, & Garcia, 2018).
  • More inconspicuous design for monitoring glucose levels for self-conscious adolescents living with diabetes.
  • Allows for multi-device communication, which can be helpful for parents of children and adolescents living with diabetes.
    • ]]>     2019-02-05 00:38:41 UTC https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327592435     Cons mcgaughy_katy https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327592469
  • As with all technology, technical "glitches" are possible.  These errors could result in life-threatening hypoglycemia or undetected hyperglycemia in patients.
  • These technologies often come at a high price. Though prices vary, depending on insurance coverage and other factors, the Dexcom G5 costs an estimated $4800 annually (Wolinsky, 2018).
    • Furthermore, a study in Spain compared the cost effectiveness of CGMs compared to self monitoring of glucose levels, considering HbA1C levels and glucose control-related complications. The researchers determined that CGMs were not a cost-effective mechanism for glucose control in diabetic patients (Garcia et al., 2018).
  • Because these technologies are new, clear protocols have yet to be established for hospitalized, critically-ill patients.
    • ]]>     2019-02-05 00:38:58 UTC https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327592469     Opinion mcgaughy_katy https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327592638 These evolving technologies have the potential to cause a significant positive impact on many patients with diabetes or other diseases causing inappropriate regulation of insulin and glucose levels.  Diabetes is a very challenging disease to control medically, but it also has such a devastating psychological impact, particularly in children and adolescents with type 1 diabetes.  These young patients are given a permanently life-altering diagnosis at such a vulnerable age.  These new technologies will give them the tools to manage their diabetes, with the help of their families.  Many of the devices allow data to be shared between devices, helping children and their parents to stay on the same page. ]]> 2019-02-05 00:40:11 UTC https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327592638 References mcgaughy_katy https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327593912 Continuous glucose measuring smartwatch, K'Watch glucose, expected soon.  (2018, November 28).  Retrieved from https://www.medgadget.com/2018/11/continuous-glucose-measuring-smartwatch-kwatch-glucose-expected-soon.html

    Dexcom. (2018, 1 June).  Continuous glucose monitoring: The basics.  Retrieved from https://www.youtube.com/watch?v=6XrjnXlZ5WY

    García, L. B., Rivero, S. A., Vallejo, T. L., Castilla, R. I., García, P. S., García, P. L., & Perestelo, P. L. (2018). Cost‐effectiveness analysis of real‐time continuous monitoring glucose compared to self‐monitoring of blood glucose for diabetes mellitus in Spain. Journal of Evaluation in Clinical Practice, 24(4), 772–781. https://doi-org.ezproxy.uttyler.edu/10.1111/jep.12987

    Peyser, T. A., Balo, A. K., Buckingham, B. A., Hirsch, I. B., & Garcia, A. (2018). Glycemic Variability Percentage: A Novel Method for Assessing Glycemic Variability from Continuous Glucose Monitor Data. Diabetes Technology & Therapeutics, 20(1), 6–16. https://doi-org.ezproxy.uttyler.edu/10.1089/dia.2017.0187

    Preiser, J. C., Lheureux, O., Thooft, A., Brimioulle,  S., Goldstein, J., Vincent, J. L.  (2018).  Near-continuous glucose monitoring makes glycemic control safer in ICU patients. Critical Care Medicine, 46(8), 1224‐1229.

    Wolinsky, H. (2018).  The First Four Continuous Glucose Monitors. Retrieved February 4, 2019, from https://www.managedcaremag.com/archives/2018/7/first-four-continuous-glucose-monitors

    Zhou, J., Zhang, S., Li, L., Wang, Y, Lu, W., Sheng, C., Li, Y., Bao, Y., & Jia, W. (2017). Performance of a new real-time continuous glucose monitoring system: A multicenter pilot study. Journal of Diabetes Investigation.  doi: 10.1097/CCM.0000000000003157]]>     2019-02-05 00:48:35 UTC https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327593912     Team Members mcgaughy_katy https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327834294
  • Faith (futuristic)
    • Faith is a strategic thinker that I am excited to add to this team. She is inspired by the future and the possibilities it holds. Faith can hold us all accountable to the gravity of the potential benefits of adding this technology into daily practice at our hospital.
  • Carter (communication)
    • Carter will be a huge asset to our team. He will be skilled at relaying our findings to the upper level management at the conclusion of our research.
  • Carlos (context)
    • Carlos is another strategic thinker and he will add a lot to our team. He is skilled at learning lessons from the past. This will help us as we explore the idea of trying something new. He may have some ideas to share with us about how to improve implementation of CGMs, from things he has learned or heard of similar past situations.
  • Fernando (focus)
    • Fernando is skilled in execution of ideas. He will help to keep our team focused on the end goal and make sure that we stay on target throughout this journey.
  • Daisy (developer)
    • Daisy is adept at relationship building. She will play a huge role in cultivating our team and improving group cohesion. I know she will help keep us all on the same page as we delve into this project.

    • ]]>     2019-02-05 15:41:13 UTC https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327834294     My top 5 strengths and how they relate to this project: mcgaughy_katy https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327867003
  • Input: My love of collecting data will be beneficial as I prepare information to guide my team in its review of this product.
  • Achiever: Will push me towards productivity and accomplishment in this project.
  • Learner: Will help me gather information for the project.
  • Discipline: Will help me stay focused on this project.
  • Intellection: Will help me guide the team in discussions on the merits and disadvantages of adopting CGMs in our facility.
    • ]]>     2019-02-05 16:28:16 UTC https://padlet.com/mcgaughy_katy/4dfkbb3cusog/wish/327867003