Continuous glucose monitoring system upgrade at VMH


Glucose monitoring at VMH ... Pictured above at right is Emmet Jones of rural Lansing and at left Angie Mettille, RN/CDE, Diabetes Educator at Veterans Memorial Hospital. Jones has successfully managed his diabetes since he was diagnosed in 1949, until now. Thanks to the new continuous glucose monitoring system, his insulin dosing has been adjusted and he again has the confidence that he is safe at home in managing his diabetes. Submitted photo.

The Veterans Memorial Hospital Diabetes Management Program recently upgraded its continuous glucose monitoring system.  The Freestyle Libre Pro System offers the option of continuous glucose monitoring for up to 14 days, rather than the three-day maximum duration of the prior system.  This new system helps health care providers fine-tune their patients’ diabetes treatment plan, giving patients optimal control of their diabetes and their life.

What is Continuous Glucose Monitoring?
Continuous glucose monitoring is used to determine what a patient’s blood glucose levels are continuously, 24 hours a day, even while they sleep. When the data is downloaded at the end of the study, there are a total of 288 blood sugar readings available over a 24-hour time span. The information is able to be transferred into graphs which can show the healthcare providers how a patient’s blood sugar trends throughout each day.

How does Continuous Glucose Monitoring Work?
Once a physician has ordered a Continuous Glucose Monitoring Study, the diabetes educator is able to insert a tiny glucose sensor on the back of the patient’s arm.  This procedure is quick and painless. The sensor is about the size of a quarter and lies relatively flat to the patient’s skin. The sensor is worn for whatever duration of time that has been decided by the patient and the healthcare providers, which is usually seven to 14 days. At the end of this set timeframe, the information in the sensor is downloaded by the diabetes educator using a handheld reader, which generates a graphical report that can be shared with the patient’s provider.

This information is a useful tool in modifying the patient’s medications, meal planning and activity routine to improve blood sugar control. One improvement with this new monitoring system is the patient can have their blood sugar information downloaded at any time throughout the duration of wearing the sensor, by simply stopping in to the VMH Diabetes Education office.  The sensor can be quickly scanned without actually removing it. The patient can then continue to wear the device until the study duration time has been met. The prior system only allowed the download to take place at the time of sensor removal.

What lifestyle changes need to be made while this monitor is in place?
Persons utilizing the continuous glucose monitor are asked not to change their daily routine in any way while the sensor is in place. They can shower or bathe, and participate in their usual daily activities. The patient will be asked to keep a daily log of the times they eat their meals or snacks, record their exercise and activity times, as well as diabetes medication doses and times. They will also need to check their finger stick blood sugars according to their usual routine.

Will insurance cover the Freestyle Libre Continuous Glucose Study?
Most private insurance companies, as well as Medicare and Medicaid, will help cover Continuous Glucose Monitoring studies for both Type 1 and Type 2 diabetes when they are medically necessary and ordered by a physician. A patient may check with their individual plan benefits for their specific coverage, if desired.

“The Freestyle Libre Continuous Monitoring System has been an extremely useful tool in helping our diabetes patients gain better control of their blood sugars,” states Angie Mettille, RN, CDE, Diabetes Educator at Veterans Memorial Hospital. “If you have been struggling to meet your hemoglobin A1c and blood sugar goals, the Continuous Glucose Monitor can help you and your healthcare provider figure out what changes are needed with your diabetes treatment. It can also be useful to anyone that has frequent, unexplained low blood sugars which can be extremely dangerous and frightening for you and your loved ones. I would encourage anyone who is having difficulty managing their diabetes to ask their doctor about this simple, painless procedure.”

Emmet Jones of rural Lansing was diagnosed with diabetes in 1949. He has lived through many changes in diabetes treatment from medications used to advancements in the equipment available to care for his diabetes, such as glucose meters and insulin delivery devices. Throughout the last few years, he has been having more frequent low blood sugars.

“This glucose sensor helped a lot with my low blood sugars,” explains Emmet. “Nearly every morning, around 2 a.m., I would have a low blood sugar of 50. Luckily, I would wake up when this happened. I used to always be able to feel it when my blood sugar was less than 100, but now as I’ve gotten older, I don’t feel them all of the time.”

“These very low blood sugars that Emmet was experiencing are called hypoglycemia, which can be extremely dangerous and cause a person to become confused or weak. In extreme cases, if left untreated, one can fall, become unconscious or even die,” explains Mettille.

“We were able to use this Continuous Glucose Monitor on Emmet and found that nearly every night at midnight, his blood sugars would dramatically decrease, causing him to be dangerously low while sleeping. By adjusting his insulin dosing, we have nearly eliminated this issue for him, and have much more confidence that Emmet is safe at home.”

“I hope more people will be able to use this,” adds Jones. “It was very easy, I hardly knew the sensor was there and even forgot about it!”

For more information on the new continuous glucose monitoring system offered by the Diabetes Education Department at Veterans Memorial Hospital, call Angie Mettille RN, CDE at 563-568-3411, ext. 172.