Expanding Your DSMES Program using Person-Centered CGM Technology” – A Guide for Healthcare Professionals
Expanding Your DSMES Program using Person-Centered CGM Technology” – A Guide for Healthcare Professionals

Healthcare professionals are constantly seeking innovative ways to enhance their Diabetes Self-Management Education and Support (DSMES) programs. With the emergence of Person-Centered Continuous Glucose Monitoring (CGM) technology, they now have a powerful tool at their disposal to improve patient care. This guide aims to provide healthcare professionals with practical insights and tips for integrating CGM technology into their DSMES programs, creating a more personalized experience for patients. By leveraging Person-Centered CGM technology, healthcare professionals can enhance their patients’ knowledge, engagement, and self-efficacy, ultimately leading to better health outcomes.

Hello my name is Gina patno from the Diabetes self-management education and Support interest group leadership team I serve as the early career Representative I'm joined by Mandy Reese who serves as The advisor on our team We're fortunate to be joined as well by Two members of the technology interest Group leadership team who will be Sharing their expertise Today we're presenting the first of a Three series webinar The topic of today's webinar is how to Grow your dsmes program with Person-centered CGM technology And we thank you in advance for Providing feedback at the end of the Webinar So here are today's learning objectives First identify current FDA approved Personal and professional CGM systems Second describe opportunities for Personal and professional CGM billing Within a dsmes program And last summarize the process for Building a CGM service within a dsmes Program And I'm pleased to introduce our Presenters Dr act Turk assistant professor of Medicine and pediatrics at Barbara Davis Center for diabetes at the University of Colorado

Dr McKee assistant professor of medicine At Washington University in St Louis Again I'm Gina at the international Diabetes center in Minneapolis in Melrose Center And Sarah Mandy Reese associate Professor and vice chair at the pharmacy Practice and director of ipe at the School of Pharmacy Philadelphia College Of Osteopathic Medicine in Georgia Foreign And now I'll turn it over to Dr Actor to Share an overview of the current CGM Systems on the market Thank you very much Gina so I will start With the professional personal and Professional CGM system so we can Classify the cgms in many different ways And now I will just start with the Real-time cgms And so we can categorize the cgms with Again real time in time returns can run The professional cgms the real-time cgms That have FDA probable in United States Are the XCOM G6 Dexcom G7 And ever since E3 and Liberty Tree Intermittently scan cgms are the Libre 14 day and Libra 2. and professional Cgms are the blinded CGM salibre Pro Dexcom Pro and ipro 2 and as you all Know that Dexcom G7 has recently got FDA Approval and it's currently in the Launching phase and Libre 14 days has Been discontinued by the uh

Manufacturers so we will not be Reviewing Libre 14 day So we will start with the real-time cgms And as we started the Dexcom G6 so Dexcom G6 is a real-time CGM it's a 10-day sensor life In 90 days transmitter you are just Placing on top of the 10-day sensor and You are just using with them together And sensor measures the interstitial Glucose every five minutes and sends This old data with the transmitter to Either your smartphone or the receiver And there's a 2R To our warm-up it means that in the First two hours there is no results are Available And there are plenty of alerts and Alarms in this CGM and there is a ryzen Full alerts and there is an urgent love Alarm which means that if your Sensibilicals at or below 55 milligram Decilitator that your CGM is going to be Uh Notifying you and then so you can just Make necessary changes and this alarm Cannot be turned off And there is an urgent law soon alarm in Dexcom systems which is unique to this System so it means that it predicts the Urgent low volatility cause within 20 Minutes so if your blood sugar is you Know going to be Um below or

Um at 55 and 20 minutes and you will be Getting you will be getting a Notification before 20 minutes so then It will give you some time to uh Decrease the risk of uh hyperglycemia And also it decreases the risk of Rebound hyperglycemi that you may be Over correcting So this system is as of today compatible With tandem T slim pumps which is the Baseline control IQ and omnipot 5 Insulin pumps and the tandem control Icon on pad 5 are the aid systems that Are working with the Dexcom G6 The XCOM G6 also has an Icgm I mean the category as well as the Dexcom G7 liberate 2 and Laboratory So the Dexcom G7 is currently launching At the end of February and then is that Recently FDA approach and it has been in Use for some time in Europe And the difference is basically between The XCOM G6 and G7 to highlight the Sensor and transmitter is completely Combined so you see that there is a one Piece only and it is 60 smaller volume Bias and 30 minutes warm up instead of Two hours compared to G6 and there's a 12 hour Grace periods so what does it Mean so it means that actually you can Increase the sensor life about 12 hours Or so when combining and transitioning To the next sensor so it gives you some Time that it's not going to die in the

Middle of the night or you know if you Are at work or if you are at school or Somewhere else It's also great advantage that actually With this decreased warm-up time and With this grace period if you are using In connected with an aid system you can Just use it a little bit longer the Sensor life is the same 10 days even Though some longer sensors are in in Development And sensor measures the same way the Entire social glucose every five minutes And sends to the results to the app or To the receiver Rice fall alerts are the same with the G6 and Urgent low and Urgent low soon Alarm are the same with the Dexcom G6 The main difference there in the alerts Are there is a delay First Alert System Only for hyperglycemia so which means That in traditionally in all cgms that Half the alarm system is working as soon As you hit your in your interstitial Glucose hits that number let's say that You put in a 200 your C gem is going to Be notifying you but in this system is Unique that you can actually delay that You can say that delay the first Highlight between 15 minutes to 4 hours Which means that it needs to be a little Bit longer in the duration it's not like If it's going to 595 205 so it's not going to be

Notifying here immediately So it can decrease the alarm fatigue and If you know that already will be high After a big meal so you can just ignore That alarm a little bit and when you Think that it needs to be uh necessary Changes needs to be made then you can Get notified So it's a little bit more customizable So if we go with the freestyle Liberty And this is the only real-time CGM from The ebit free style Libre and no Scanning required unlike the other Libre Which Libre one and Liberty 2 is you Know that these are the Intermittent scan cgms so this is the Smallest CGM and this is the size of a Two stick pennies and it's used with Only a smartphone apps so there is no Readers available and you have to use Your smartphone and your smartphone Should be compatible with the system and This sensor reads every one minute it's Different than the other systems and Then there's a 14-day sensor life Any decrease in carbon footprint is Significantly smaller packaging and Everything like the Dexcom G7 so Everything is getting smaller and There's a one piece inserters in uh Comparing to Libra 2 that has actually Two pieces you just assemble but in Deliberate three is just come with only One piece which is everything is loaded

And this is also the largest Bluetooth Integration of the 33 feet it gives a Great Um range for the connection So metronic card in sensor 3 is the FDA Approach latest sensors in the United States and it's a seven day wear and There's a two hours warm-up and two Calibration per day and three to four Calibration can optimize the accuracy There are high and low alarms and Follow-up systems like the other ones And also it can be used with an Artificial intelligence based diabetes Coaching system which is sugar IQ and Sugar IQ is another app that you can use For and uh coaching and it can give you Based on your input that it gives you Some feedback for the food that certain Food when you eat your blood sugar is Going high or when you do this exercise Or during that time you are getting low So you can customize things and as of Today it can work with metering 670g and 770g Insulin pumps So the last one I will review is the Sansgenics ever since E3 system so as You may know that this system had Already a 90-day sensor and uh last year It got FDA probably 180 day uh sensor This is the only implantable real-time CGM in the US there is a 24 hour warm-up And readings comes every five minutes And one calibration per day is the

Current FDA problem although you need to Do two collaborations uh first 21 days And sensor powered wirelessly by Variable transmitter and you need to Charge the transmitter every 10 to 50 Minutes so you basically take that Transmitter on you and with the silicone Taping which is a hypoallergenic and This is the only CGM with the vibrating Alarm which means that you can turn off The alarms and you can get notified for Highs and lows based on the different Tones of the vibration so it can be an Advantage if you know you don't want to Be notified in a crowded environment in A class or somewhere else and you can Get the notification by your smartphone In your watch or with this variable Transmitter And it's the sensor is itself is MRI Safe in most of the MRI so it it doesn't Need to be removed because it's Underneath the skin on the other hand You still need to remove the transmitter Which is that uh Taping that material And no interference with vitamin C and Acetaminophen in some of them can Interfere So and I will be closing my part here And I will be passing to Dr McKee thank You Thank you so much I'm going to be Discussing intermittently scanned or Also referred to as flash CGM

So we have one such CGM on the market Currently as Dr Actor said Abbott Library 14 days being phased out or is Phased out so Libre 2 just like his Predecessor Has a sensor life of 14 days and a one Hour warm-up after it's applied to the Back of the upper arm and it actually The sensor reads glucose every one Minute it does still have interference With high doses of Vitamin C greater Than 500 milligrams which could cause Fight false High readings Um but to put that into perspective a Multivitamin has about 60 milligrams of Vitamin C so you'd have to be on pretty High doses not to say that we never see That but to try to put it into context Um its accuracy is much to improved from The 14-day version where Um it had less accuracy in the Hypoglycemic ranges and it does have Optional alerts for high and low low Blood glucose levels Um so we teach our patients to scan with Either their phone or the device reader About every eight hours and that's so When you see the tracing on the download It's continuous Um if the patient gets a low alarm alert They'll have to scan in order to see That value but it's important to say That even if the patient forgets to scan About every eight hours

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Um and their glucose level Falls below The low threshold or as High they'll Still get that alarm If they have the app on their smartphone Um the mandatory urgent low glucose Alarm for blood sugars of below 55 is on There and cannot be turned off So now I'm going to summarize what Dr Actor and I spoke about with regards to Personal cgms so this is kind of a nice Summary table of all of the available Cgms on the market currently in the US And comparing you know days of sensor Wear being the longest of course is ever Since E3 and the shortest the guardian Three they all have various warm-up Times that we talked about Dexcom G7 Being the quickest 30 minutes and ever Since E3 taking a full 24 hours They all have various alerts you know That we discuss for high blood sugars Low blood sugar signal loss alerts Um and some of them do integrate with Pumps so as we discussed the guardian Three talks to the Medtronic pump 670g And 770g in its own hybrid closed loop System whereas Dexcom G6 talks to Tandem In the control IQ and basal IQ functions And also omnipot 5. they all have uh Smartphone integration Um it's pretty you know vast between the Android models the iOS and the Apple Um you know products that are available Right now some communicate even with the

Apple watches and it's great because They all really allow for data sharing With family and friends Um some of them do have available Separate receivers and that's important If for instance a patient doesn't have A compatible smartphone so they would Want to be able to have a device read in Order to get the data and then I listed Here interfering substances and Radiation so we now are utilizing a lot Of personal cgms so we have to think About our patients when they go for Instance for tests or surgeries and how That might interact with their sensor so For instance electrocautery has really Been shown to interfere with the sensor Readings and sometimes even post Procedure the sensor doesn't really go Back to its original state and isn't Reliable because there aren't redundancy In the prescriptions meaning if you take Off a sensor before it's a full wear Time the patient often has to call the Company for a replacement so on so forth So we want to be cautious and taking Them off but also know when they're not Going to be accurate And that can also include with various Medications which I listed there and for Those of you who are looking forward to Summer as much as I am we put in the Water resistance so that especially Everyone can go enjoy swimming and so on

And so forth And now I will move on to talk about Professional cgms So when to use a professional CGM there Are a lot of great instances where this Is very very helpful so in the setting Of patients with newly diagnosed Diabetes and whom you're trying to Capture some patterns right off the bat And and and you know get going with Improving their care this is very Helpful for individuals not using CGM It's also very beneficial to put a CGM On a few times a year in order to really Get you know a great overview of what's Going on the thing about Finger stick or capillary glucose is There's just a point in time but CGM Tells a much more elaborate story and so You'll be able to get a lot more Information on your patients and be able To help them or certainly if patients Are having hypoglycemia and don't have Their own personal CGM this is really Really important for capturing nocturnal Hypoglycemia for instance and for Patients not on insulin and have type 2 Diabetes who may not be able to Have their own personal CGM this is Beneficial and then we also have Patients and we see them frequently who Just aren't really sure they want to Wear something all the time they're not Sure if it's going to be comfortable or

Bothersome and so a trial of a Professional CGM sometimes really really Helpful So here's a comparison of the various Professional cgms so we have Medtronic Ipro 2 so this is a six day disposable Sensor but the transmitters reusable so They actually have to bring the Transmitter back so that you can Download this transmitter and obtain the Report the results are blinded so that The patient when they go home wearing it They won't see any data and they need to Calibrate the sensor twice a day Um in comparison Abbott has their Freestyle Libre Pro which is looks just Like their Um Libre 2 sensor it's worn for 14 days Um and it's the sense it's just like the Libre too so it's the sensor and Transmitter combined and it's also Blinded no calibrations and then the Patient just returns uh the sensor and Download it and can generate the report Um Dexcom G6 Pro is kind of interesting So it's still a 10-day uh sensor with Um a disposable transmitter which is Which is good so you don't have to keep Track of that in your office but you can Set it as being blinded or unblinded for The patient and if you set it in an Unblinded mode so the patient can look At their G6 app on their phone they can Actually receive low and high blood

Glucose alerts or alarms and that may be That may be good I I think Um You kind of need to think about that in Your office setting two uh you know in Terms of how you're going to triage Potential phone calls or messages about It but it is really nice for patients to Also Um utilize that future if you think that Would be very helpful no calibrations Um on the G6 Pro and then the patient Returns the device and downloads it or Can share it on their smartphone via Clarity And so now I'm going to turn it over to Gina to talk about billing for CGM Services All right thank you so much Dr McKee Um so yes I'm going to share about the Different opportunities to bill for both Professional and personal CGM to be able To expand Revenue through your dsmes Program So there are three CPT codes I will Review 95249-95250 and 95251 None of these are time based and they Can be billed in addition to G Codes if Your clinic is providing dsmt So first CPT code 95249 This is used for personal cgms so it's For setup and training for a patient Provided CGM specifically

Training must include instruction on Sensor placement and application Calibration with the monitor training on How to use removal of sensor in review Of that recorded data This cannot be billed at the time of Training because 72 hours of data must First be obtained so you could bill 95249 when your patient returns with Their device at a follow-up appointment Some considerations This code can be used once in the Lifetime of each new device So for example even if you charge 95249 When providing training with a Libre 2. Say your patient came back a month later And decided they want to try the Dexcom G6 you could build this code again or Even if they came back now with a Libre 3 because it's a new generation you Could use this code again as long as It's documented clearly in your note That that device or generation has Changed So from my experience with this code and In the other codes I'll talk about it's Really important to just have a general Understanding of the code and when you Would use it and then work with your own Coding team internally for specifics Within your system and as well just to Confirm a frequency of billing with Different insurance plans You'll note that this says that the

Initial visit must be face to face I Will say within our department our Coding team does allow a video visit for The initial visit we just can't do a Phone visit you really need that visual Piece for for appropriate training So who who can bill 95249 This could be the cdces RN Rd or M A if It's within their scope a pharmacist and So these people can do the billing and Then this code does specify that the Service must be done quote under direct Supervision of an mdpa or NP so while The cdces for example can provide the Training and service our department Bills this under an on-site health care Provider we refer to this as the doc of The day You can see on the right the minimum Documentation that's required Patient name date of birth and MRN Indication for device placement so this Could just be type 1 type 2 or Gestational diabetes Name and type of device placed The time period the CGM was worn and That signature of the healthcare Provider The national average reimbursement for This code is 59.87 So a lot going on here but this is a Sample of the template that we use at The international diabetes center when We're planning to build 95249

So as you can see we have templates for Both the initial visit or that training Is provided and then also at the Follow-up visit when the data is Actually reviewed and again you can Charge that that 95249 code You'll notice in our template that we do Include time spent on dsmt verse and the CGM training so again the CPT codes are Not time based but our coding team does Like us to specify how much time was Spent on each part so that we can Justify that double charge being billed In the follow-up visit my team also Includes the AGP and other relevant data From the CGM report So next we have CPT code 95250 This is very similar to 95249 those Those specific to clinic or health care Provided equipment so the professional CGM in this case The training should also include Instruction on sensor placement and Application calibration with the monitor Training on how to use removal of sensor And review of that recorded data And again this also could not be billed Until the return visit when 72 hours at Least of data has been collected For this code since the clinician of Course has to apply that CGM Pro the Initial visit must be face to face And this can be billed one time per Month though I find it's not always

Reimbursed that frequently And the who for this code is the same as 95249 so again could be that cdces RN RDMA or pharmacist and again consider Billing it under that on-site position You'll see the minimum documentation Here is also the same as 95249 The national average for reimbursement For this code is a bit higher it's 151.58 And here again is our team's sample Template just to give you an idea if You're building this in your clinic Um you'll see we do have the added step Of patient consent and I know this is Really common among several other Diabetes education programs across the Country so this is just to ensure the Patient understands how to proceed with The professional CGM what expectations Are so you see that documented here You'll also see again the indication and An explanation of the training that was Provided The follow-up visit template is pretty Simple just gives the dates that that Sensor was worn and again we do include That AGP or other pertinent info from The CGM report The final code to consider to expand Revenue for your dsmes program is 95251 And this code is a bit different this is Used for analysis and interpretation of At least 72 hours of CGM data so this

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Could be interpreting data from either a Personal or professional CGM And depending on collaborative practice Agreements at your clinic it is possible That this code could be billed at the Same time as 95249 or 95250 This can be billed one time per month And a face-to-face visit is not required The Who so this code can generally only Be billed by an MD do and P or PA However other clinicians such as fmd or Cdces may be able to provide Interpretation if you have a Collaborative practice agreement again This is dependent on state-specific laws So for example a cdces could potentially Interpret the data in their note and Then forward it on to their referring Provider then that provider could sign And note that they agree with the Interpretation and actually charge that Billing code Here on the right again you see that Minimum required documentation Note that in addition to what was needed For the previous codes this code Requires a written analysis and Interpretation of the data In the national average reimbursement For this code is 35.30 And here is a sample template that our Endocrinology group uses So you can see here the analysis is just A listing of some key metrics from the

AGP and the interpretation is a written Description of some of the patterns that Provider notes so you can see this Example reads post meal blood glucose Elevations consistently elevated later Evening through early morning occasional Hypoglycemia after morning meal so it Doesn't have to be complicated a simple Few sentences is is just fine for that Interpretation And now I will pass it over to Dr Reese Excellent thank you so much Gina and I Am just thrilled and to finish off our Presentation as my colleagues have um Presented wonderful information that you All can use and I'm going to finish it Up kind of talking about a couple of Folks um in different parts of the Country who have successfully built a CGM service line within their dsmes Program Meet Rhonda she's from Georgia she is a Diabetes Care and education specialist She's actually not in management but She's on the team of Diabetes Care and Education specialist she's been working Um in this role for more than 20 years And she actually began Um Having access to cgms probably 12 years Ago within her dsmes Department And she had been doing lots of Education With various providers as well as care Managers about continuous glucose

Monitors and the value of these monitors And she um basically when they began Using the cgms it was to align with Their insulin prop services that they Provided downloading insulin pumps Talking about the findings with the Patient sending the reports of the data To The Physician or the provider and so When they started using cgms they really Began with the insulin pump for folks That were using the insulin pumps and so Rhonda had a real passion for cgn she Saw the value of it and so she reached Out to her manager for the diabetes and Education department at the time and Just really shared her vision and her Excitement and her manager was very Supportive of her vision and Rhonda Figured out quickly who to collaborate With in terms of you know building this Program and one of the key players was The care managers who were actually Embedded in the primary care practices They were continually communicating with Providers about closing gaps and Providing services for their patients With diabetes or their persons with Diabetes and also another partner that Rhonda collaborated with or with the CGM Companies one in particular had really Marketed their professional CGM version And they were Really marketing it to Rhonda and her Team as well as the care managers Gina

Did an excellent job in terms of talking About The specifics of the billing and the Opportunities there for professional and Personal CGM one thing I want to point Out here is that when I was talking to Rhonda she shared that how with the Professional CGM at her practice they Really offer blinded and unblinded and They really give the provider in the Person with diabetes the option of Whether to choose blinded or unblinded Data or ability to see the data more Often than not as you would probably Guess folks tend to choose the unblinded Version So how did Rhonda Market the services Um currently and they actually get their Referrals by going straight to the Providers within the Primary Care Network Um and oftentimes when that provider is Sending in that referral for Daddy Beatty self-management education and Support such a great opportunity whether It's at the time of diagnosis a person That's coming in for their annual Diabetes self-management education and Support or maybe they're struggling with Managing their diabetes and they're Coming to see The Diabetes Care and Education Specialists Um in terms of marketing early on Rhonda Again had worked with the care managers

But also she had her manager for the Diabetes education program go to the Physicians offices in the primary Care Network and Market what the services That they could provide and in more Recent years in terms of marketing They've used the Ambulatory Care Pharmacists who are working hand in hand With a person with diabetes as well as The providers and using them to increase Awareness about the CGM service line as Well as assisting with the Implementation really growing that Within the Primary Care Network of Course like with all good things in life That are worth doing in Endeavors we Have challenges along the way and Awareness Rhonda shared had been a Challenge because within her health System there's been a huge explosion in Growth in terms of the number of Providers within the Primary Care Network as the health system has Numerous different graduate medical Education programs in terms of Specialties and internal medicine and Family Medicine in particular a large Increase in numbers so just the Challenge of keeping up with all of the New providers and making sure that they Get education about the continuous Glucose monitors and then also provider Education about the ctm interpretation And as Sheena talked about in her

Presentation really there's that Opportunity for interpretation of the Data and so ronda's been working to Figure out you know how do you educate The provider so they understand How to take that data what it means and How to explain it to the person with Diabetes and certainly cost I know Um you know working with folks with Diabetes and my colleagues here today we Want all persons with diabetes to have Access to cgn and we're continuing to Work through cost barriers that are Actually present Um at this point in time and I had and I Asked Rhonda for a couple of success Stories and she shared Um a couple Um with me and one is particular and a Person who recently was hospitalized for A diet Um diabetes ketoacidosis And they were sent home on multiple Daily injections of insulin they were a Person with type 2 diabetes and once They were on that basal bolus regimen They were having significant low blood Sugars dangerously low blood sugars that Were discovered by that continuous Glucose monitor fortunately the dose of The basil insulin was able to be Significantly reduced in the bolus Insulin was removed altogether and now That person is actually doing really

Well And Rhonda also shared and I feel this Is very profound is for that person with Diabetes who's able to wear that Continuous glucose monitor they're Accountable to themselves not to a Provider that they feel May judge them Or fuss at them but fear getting Information for themselves to empower Them to manage their diabetes Next let's meet Lucille from New York She is the manager of a diabetes Self-management education program as Part of a health system she recently Moved to a new to a different Health System but I'm sure her story of what Happened in the previous health system That she worked in now she began the Program about three years ago Implementing a CGM service line as part Of their department and they've launched It within the primary care practices in Their health system they had certified Diabetes Care and education Specialists Embedded within the primary care offices And so it was a golden opportunity to Expand that and incorporate diabetes Technology into the services that they Were already doing now it was so very Passionate about diabetes technology and As a director she shared this with me That for her she wanted to make sure That her Department was maximizing all The opportunities for outreach and

Access to persons with diabetes Improvements and contributing to the Um improving the quality of care that The person with diabetes has in the Knowing that her department is also Responsible for the financial side and Opportunities for revenue streams and Growth of that Revenue stream is Absolutely important and so Lucille when She had this Vision spoke to the vice President that she answered to for her Department and they bought into her Vision and her passion and what she Wanted to do and the next step was to Really find a lead position within the Primary Care Group the primary care service line that Would get behind this Vision that would Buy into to this vision and there was One he was well respected he was a Visionary and she scheduled a one-on-one Meeting and with him and said hey this Is my vision this is what I see and this Is how we can help you and it ended up Turning into a real win-win situation Because he actually needed some some Help with mentoring of one of his Advanced practice practitioners and Lucille was able to assist with that and So it started small it started with this Physician leader in his practice and Started providing the cgn service in his Office as other offices saw the benefit And the value added which I'll talk more

About in a bit they bought into it and Said we want this service as well As I shared earlier Fortunately in Lucille's case the Certified Diabetes Care and education Specialist was already built into the Primary Care Network now for her Beginning this service line is also Making sure these certified Diabetes Care and education Specialists were Thoroughly trained in the devices Themselves the cgms making sure that They were comfortable with them also Making sure that they understood the Data interpretation for the cgms because We all know it's not enough just to give A person a CGM whether it's Professional you've got to be able to Interpret that data same thing with Personal we can educate but we also need To know how to interpret that data so That was a big component of her Implementation of the program See and for the initial visit they would Use G Codes MNT codes and then what was A little bit different about Lucille and Her team's approach is they would bring Folks back about halfway through wearing The professional seats yet so for Dexcom They would bring them back after about Five days for a Libre they would bring Them back after seven days and they Would talk with the person about their Data what they're seeing then they would

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They would identify what Behavior Changes does that person want to make Then the person with diabetes would go Make that there's changes there's Lifestyle changes and then come back in For that visit and at that visit talk About the impact that that lifestyle Change actually had on their diabetes Management their glucose such a powerful Opportunity and talk about growing and Revenue streams across a health system Lucille and her team encouraged the Providers to build for to bill for the Interpretation that 95251 to for them to Bill and for their interpretation Because we all have a role in the CGM in The provision of the services in terms Of marketing for Lucille and her team it Was truly at the practice level so they Had Flyers put up within the practice And the flyer said things such as new Service in this practice ask your Provider about the Diabetes Care and Education specialist There were reminders that Lucille and Her team did early on when they were Providing this service she would meet With all the providers in the practice And remind them don't forget don't Forget about the diabetes Self-management education and support Don't forget about the professional and Personal CTF now once the provider saw The value they were ecstatic they it was

The seed planted in their mind so they Knew hey I remember the value of that Professional or personal ctm for the Person with diabetes and the care that They received Constant reinforcement I don't know About you but this hits home with me With with me is that reminder for that Diabetes Care and education specialist In that Primary Care office reminding The providers and the staff hey friendly Reminder I'm here don't forget refer Patients to me I'm here to help you in This provision of care this team-based Care now the Champions were certainly The Physicians as well as the Diabetes Care and education Specialists because They were boots on the ground ground Level and so they had to be champions For their service as well as starting With that one physician champion and Just growing that exponentially Challenges certainly awareness and Having the patience and understanding That it's not a free service in Educating both providers and persons With diabetes the value of the service But it's not a free service just like if You were to take your uh your your Favorite canine friend or your cat to The vet they're certainly not Um it's not free services and the values That we you know Services we receive in The Health Care System certainly are

Free and then the growing opposition Champions over time finding those Champions building and hard wiring in Them Um the CGM and really embedding that in Their practice success stories a couple Of great ones here from Lucille the First one is actually from that initial Physician Champion that she had had now This particular physician he took great Interest in caring for the people with Diabetes that were under his care and he Prided himself in really providing Excellent care and there was an elderly Um lady who had diabetes and her fasting Glucose had been elevating and just Slowly rising over time and and he was Titrating her basil insulin and Titrating it and titrating it up and up And felt okay we're addressing the Hyperglycemia well this um sweet older Lady wore a professional continuous Glucose monitor only to discover he and The patient discovered oh my goodness She is actually having severe Hypoglycemia nocturnally sir needless to Say backed off of the basal insulin and Actually significantly reduced the dose To where now she wear there's very Little for that provider that listed Left a lasting impact in his mind of the Value of that CGM as well as for the Older lady who was wearing the CGM the Second story is very warming and daring

As well And there was recently an Italian Gentleman who was diagnosed with type 2 Diabetes and he had been told early on By some well-meaning folks that he Couldn't have any of his favorite foods Anymore now I'm sure you can imagine Your favorite foods and somebody telling You you can't have that anymore And he basically felt like how can I Live like this I can't do this Well there was actually a Diabetes Care And education specialist in his primary Care provider's office and he actually Wore a professional cgn and he actually Learned that there were a lot of his Cultural foods that he could actually Still enjoy in different portion sizes And he said I didn't think I was going To be able to do this but you gave me my Life back The technology had taken down a barrier For this gentleman and now he can live a Full life with type 2 diabetes so from Lucille and Rhonda words of wisdom for You all out there Focus on CGM as a tool for patient Confidence just like the gentleman I Just shared about we want people with Diabetes to feel empowered to feel Really good about themselves and their Ability to manage their diabetes and cgn Is one of the tools that can help them Do this

Second from Lucille bring in that person Halfway through the time period that They're wearing that professional cgn to Look and see what impact lifestyle Factors medications are having on their Glucose set some goals around those Lifestyle Changes then bring them back At the end of wearing the professional CGM Let the person with diabetes know the Cost up front for professional cgn one Thing that Lucille and her team did is They actually included on the Flyers and Rhonda has as well most insurance plans Will cover the CGM just so that folks Know there is a cost involved Market the CGM at the primary care provider level Gain physician Champions once they see The value they will buy in find that one Physician Champion that folks trust work With them and then build it from there And lastly educate the primary care Provider on CGM value in terms of Patient satisfaction it's in fact it's Effectiveness and how to interpret the Data the sky is truly the limit and to Challenge you what is your action step Going to be after listening to this Webinar Don't Be Afraid take the plunge Into CGM for the patients you care for With diabetes thank you on behalf of my Colleagues I want to thank you for Joining us today we appreciate it and Please can complete the survey so we can

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The American Diabetes Association has released a new video called “Expanding Your DSMES Program using Person-Centered CGM Technology” that educates healthcare professionals on the benefits of using person-centered continuous glucose monitoring (CGM) technology. The video follows the journey of a patient with diabetes and shows how the technology can provide personalized care. Let’s dive deeper into the details of the video and learn how healthcare professionals can use this technology to improve patient outcomes.

What is the Person-Centered CGM Technology?

Person-centered CGM technology is designed to provide patients with individualized care based on their unique glucose patterns. This technology is designed to monitor the patient’s glucose levels in real-time using a small sensor inserted under the skin. The sensor continuously records the patient’s glucose data and transmits it to a receiver or smartphone app. The data is then analyzed and presented to healthcare providers in an easy-to-understand format, allowing them to make personalized treatment decisions for each patient.

Benefits of Person-Centered CGM Technology

The video highlights several benefits of using person-centered CGM technology in a DSMES program:

  • Individualized care – This technology provides patients with customized care based on their glucose patterns, allowing healthcare providers to tailor their treatment plans to each patient’s unique needs.
  • Improved clinical outcomes – Using CGM technology can lead to better glycemic control, reduced hypoglycemic events, and improved patient outcomes. In fact, a recent study showed that using CGM technology can lead to a 1.0% reduction in A1C levels.
  • Better patient engagement – CGM technology allows patients to be more involved in their care by monitoring their glucose levels and understanding how their diet, exercise, and medication choices affect their glucose levels.
  • Time-saving – Using CGM technology can help healthcare providers save time by reducing the need for frequent in-person visits and phone calls to check glucose levels, allowing them to focus on other aspects of patient care.

How to Implement Person-Centered CGM in a DSMES Program?

The video also provides advice on how healthcare providers can successfully implement person-centered CGM in their DSMES program. Here are the key takeaways:

  1. Choose the right patients – Not all patients will benefit from CGM technology. Healthcare providers should select patients who are motivated to use the technology, have the cognitive ability to understand its use, have adequate insurance coverage, and have a high-risk for hypoglycemic events.

  2. Provide adequate training – Healthcare providers should provide thorough training to patients on how to use the CGM technology, including how to insert and remove the sensor, how to calibrate the device, and how to interpret glucose data.

  3. Integrate CGM technology into care plans – Healthcare providers should integrate CGM technology into their care plans by regularly reviewing glucose data, adjusting treatment plans based on the data, and educating patients on how to make lifestyle changes to improve their glycemic control.


The American Diabetes Association’s video on “Expanding Your DSMES Program using Person-Centered CGM Technology” is a valuable resource for healthcare professionals looking to implement CGM technology into their practice. The video highlights the benefits of using this technology and provides practical advice on how to successfully implement it in a DSMES program. By using person-centered CGM technology, healthcare providers can provide patients with individualized care, improve clinical outcomes, engage patients in their care, and save time.


  1. What is DSMES?
    DSMES stands for Diabetes Self-Management Education and Support. It is a program designed to help patients with diabetes manage their condition by providing education, training, and support.

  2. What is continuous glucose monitoring (CGM)?
    Continuous glucose monitoring (CGM) is a technology that allows patients to monitor their glucose levels in real-time using a small sensor inserted under the skin.

  3. How can person-centered CGM technology benefit patients?
    Person-centered CGM technology provides patients with individualized care based on their unique glucose patterns, resulting in better clinical outcomes, improved patient engagement, and time-saving.

  4. What are the challenges of implementing person-centered CGM technology?
    Implementing person-centered CGM technology can be challenging due to the need for adequate patient training, selecting the right patients, and integrating the technology into care plans.

  5. Is person-centered CGM technology covered by insurance?
    Many insurance companies cover the cost of CGM technology, but patients should check with their insurer to determine their coverage.