Getting Started with CGM: A Walkthrough

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CGMs (continuous glucose monitors) can reduce the stress and uncertainty related to glucose monitoring. Healthy Living is here to help lessen the challenges of acquiring and maintaining a CGM. And it’s easy to get started! Our team will guide you through the whole process.

Here is a preview of what your first conversation with us might include, plus some other details of the progression of obtaining a CGM system.

Intro: Is this your first CGM system? If not, when was the last time you received supplies?

Basic Information: We ask questions to gather patient demographic info, insurance info, and doctor information.

CGM Options: What system are you looking for? We offer Dexcom G5, Dexcom G6, Guardian Connect, or FreeStyle Libre CGM.

Medicare CGM Requirements: Medicare patients must use the Dexcom G5 or FreeStyle Libre system, because Medicare doesn’t cover Medtronic supplies. Must be testing 4x/day and injecting insulin 3x/day.

Authorization & Documentation: If your insurance requires an authorization, the Healthy Living team will gather the appropriate docs, including prescription, chart notes, and 30 days of continuous logs. Once authorization is submitted, you can expect a response time of 7-14 days for most insurance companies, and 30-45 days for straight Medicaid.

Planning for Payment: We will ask for a credit card to place on file to charge once the order is ready to ship. We will never charge you without your permission.

Follow-Up with the Doctor: We will ask you to follow up with your doctor’s office to request required documents for authorization, and we will also reach out to your doctor every 3-4 days until the necessary documents are obtained.

Updates: We will text or call with updates about your account. You will also receive an email with a summary of our conversation and will be given access to our online portal to track the status of the initial CGM order.

Ready for your CGM?

Contact us using your preferred contact method. We have three different ways of helping you - choose whichever is best for you!

1. Call 866.779.8512.

2. Text “CGM” to 248.577.9903.

3. Fill out the form below.

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In the News: Eversense® CGM Real-World Data from First U.S. Users

The Eversense implantable CGM device has been making waves with its innovative functionality. Last week, Senseonics published Eversense CGM real-world data from the first U.S. users. The following information comes straight from the Business Wire press release for accuracy and clarity:

The real-world data demonstrated that the Eversense CGM System showed strong performance and safety over a 90-day sensor wear period, especially in the low glucose ranges. This data provides real-world evidence desired by patients, healthcare providers and payers on the clinical value and benefit of Eversense.

OVERALL PERFORMANCE

  • Wear-time – 83.6% (American Diabetes Association recommends 70% wear-time)

  • Time in Range – 62.3% between the ranges of 70 to 180 mg/dL

  • Time in Hypoglycemia – 1.2% at <54 mg/dL and only 4% at <70 mg/dL. Users spent only 1.7% of the nighttime in hypoglycemia (<54mg/dL)

  • Safety – No device or procedure related serious adverse events over the 90 days

  • Conclusion – The Eversense real-world data showed excellent glycemic results, sensor accuracy, and safety. This data demonstrates that the Eversense CGM System is a valuable tool for diabetes management.

The Eversense CGM System consists of a fluorescence-based sensor, a smart transmitter worn over the sensor to facilitate data communication, and a mobile app for displaying glucose values, trends and alerts. In addition to featuring the first long-term and first implantable CGM sensor, the system is also first to feature a smart transmitter that provides wearers with discreet on-body vibratory alerts for high and low glucose and can be removed, recharged and re-adhered without discarding the sensor. The sensor is inserted subcutaneously in the upper arm by a health care provider via a brief in-office procedure.

Learn more about the Eversense CGM System.

In the News: For Many Diabetes Patients, Skin Patches and Phones Are Replacing Finger Pricks

The Wall Street Journal recently featured a story that explains why and how more U.S. diabetes patients are using continuous glucose monitors (CGM) to track their blood sugar. Almost 840,000 patients in the U.S. used the devices as of March 31, more than double the 389,000 using them at the end of 2017, according to Seagrove Partners LLC, a health-care research and consulting firm. The Journal's article has a great diagram showing how CGM works and talks about the importance of this technology to improve quality of life for many people with diabetes.

CGM WSG article



Friends for Life - An Unforgettable Conference

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"One of the most magical times for people with diabetes happens every year in July, with the annual Friends For Life Conference hosted at Walt Disney World in Orlando, Florida."

Hosted at Disney's Coronado Springs Resort, the Friends for Life conference just wrapped up in July. This is the 20th anniversary of the conference! Friends for Life brings together an international group of world-renowned clinicians, researchers, physicians, adults, children, and families with diabetes, including siblings and children of adults with type 1 diabetes, to learn the most current information in diabetes care. At Friends for Life, participants have the opportunity to gather cutting edge ideas in diabetes management and share their stories to help motivate and inspire others who walk in the same shoes.

Learn more and maybe join the fun next year!

Medtronic’s Next-Gen Hybrid Closed Loop System

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Medtronic's next-gen hybrid closed loop system will be the Minimed 780G, designed to help patients enjoy greater freedom and less burdens. Currently, the 780G is being studied in an in-home trial with 350 adult and pediatric patients with type 1 diabetes participating, using the device over a three-month period. The in-home study is estimated to be completed in January of 2020, with the results presented in July, 2020.

What should you expect from the new Medtronic system?

  • New vertical "modern" look

  • Automatic correction bolusing

  • A new algorithm, that according to Medtronic is more accurate and reliable

  • A function to automatically adjust for missed meals

  • Adjustable target range, down to 100 mg/dL

  • Option for remote software updates

  • Bluetooth connectivity

Stay tuned for a launch date and other news on the Minimed 780G!

Managing Diabetes in the Heat

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Summer is finally heating up! The CDC (Centers for Disease Control and Prevention) has some great guidance for understanding the effects of the heat and best practices for managing diabetes during the summer.

Feeling the Heat

People living with diabetes (type 1 and type 2) feel the heat more than others. Certain diabetes complications can affect sweat glands so that your body can't cool as effectively, and people with diabetes get dehydrated more quickly. Also, high temperatures can affect how your body uses insulin. The humidity also plays a part. It's harder to stay cool because sweat does not evaporate as well in high humidity. The CDC recommends checking the heat index and taking intentional steps to stay cool when it reaches 80°F in the shade with 40% humidity or above.

Summer Checklist

  • Drink plenty of water.

  • Test your blood sugar often.

  • Keep medicines, supplies, and equipment out of the heat.

  • Stay inside in air-conditioning when it’s hottest.

  • Wear loose, light clothing.

  • Get medical attention for heat-related illness.

  • Make a plan in case you lose power.

  • Have a go-bag ready for emergencies.

Read more details for managing summer heat here.

Summer at the Farm Market & Diabetes-Friendly Recipes

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Summertime is the best time for fresh food and enjoying the local harvest. Have you checked out your neighborhood farm market yet this year? A few favorites in the SE Michigan area are Eastern Market, the Oakland County Farmer's Market, and the Royal Oak Farmer's Market - but big or small, most communities have a local market. Last weekend, I happened upon strawberries, garlic scapes, cremini and shiitake mushrooms, lettuces, herbs and veggies ready to be planted, swiss chard, kale, early tomatoes, microgreens, rhubarb, sunflowers, and the list goes on! The market is full of colors and textures and hustle and bustle and the freshest food you can find (short of picking out of your own backyard).

Summer cooking is great on the grill, and simple creations let the flavors shine! When you're cooking at home this summer, get creative! You may find inspiration from these sources for diabetes-friendly recipes and new flavor ideas:

Some of these sites state that their recipes have been medically reviewed while a couple others don't. Be sure to use your best judgment for your own health needs when choosing recipes. Eat well and enjoy!!

Developing Best Care Practices for Patients with Diabetes Undergoing Surgery

Tamra Dukatz, Certified Registered Nurse Anesthetist

Tamra Dukatz, Certified Registered Nurse Anesthetist

People with diabetes need special care in the surgical setting to control blood sugar. Tammy Dukatz, a certified registered nurse anesthetist at Beaumont Health, has spent a lot of time, with exceptional success, doing research to develop best care practices for patients with diabetes who are undergoing surgery. Tammy has been a nurse anesthetist for more than 25 years and a nurse for 40 years. For the last 15 years, she has taken a great interest in diabetes since two of her three children developed type 1 diabetes. Her research has been aimed at strategies for the best possible glycemic control during surgery. She credits her colleagues and the anesthesia department leadership with phenomenal interest and support for these projects.

Conducting research with endocrinologist Dr. Solomon Rosenblatt and other Beaumont Health staff members, Tammy brought the Hospital guidelines up to date to provide the most appropriate strategies for blood sugar control for people with diabetes having surgery. This is important because high glucose levels during surgery may cause electrolyte imbalances and dehydration, and lows are especially dangerous under anesthesia because signs and symptoms largely can't be observed. The clinical research study on insulin glargine dosing took place from 2005-2008, was published in 2012, and was centered at Beaumont Hospital in Royal Oak, Michigan.

Now Tammy and her team keep up the guidelines up-to-date. It's a constant – reviewing the anesthesia and diabetes literature for current diabetes tech and best practices. Recent updates in diabetes technology have brought up new questions and decisions to be made. For example, a patient’s home continuous glucose monitoring (CGM) is based off interstitial glucose readings. CGM can be used in the hospital to follow the glucose trends, but patients are treated based on lab values using venous blood draws. Expert opinion is being sought to determine if hybrid closed loop insulin pumps should be kept in auto mode or put in manual mode during surgery.

Tammy has been working on her newest project with a team including her daughter, Gwen, who is a student nurse anesthetist at Oakland University. To make it easier for nurses to ensure accuracy, Dr. Rosenblatt and Gwen created an algorithm to guide insulin use after heart surgery. The whole team worked with Beaumont’s IT department to place the algorithm into an electronic calculator. A pilot was performed in one Beaumont department in September of 2018. For further refinement of this algorithm and help with back-end programming, they are soon to be working with the Oakland University College of Computer Science and Engineering. Tammy's son, Carl, has also been involved in the tech end of this project.

If you have diabetes and you're going into a surgery soon, here are some tips to keep in mind:

  1. It does matter how well you are controlling your diabetes before surgery - it can lead to better outcomes.

  2. If you are scheduled for elective surgery and you are not meeting your blood sugar goals, check with your diabetes care physician. Your physician may recommend medication changes to help prepare for the surgery.

  3. Anesthesia prescreening nurses will give you individualized instructions for the day of surgery. These should include what medications to take and how to handle high and low blood sugars before hospital arrival.

  4. Communicate well with your anesthesia team. Your blood sugar will be checked frequently throughout your surgery and recovery time. Because of the stress of surgery, treatment with insulin is common - even if you do not usually take insulin. Be sure to speak up if you feel that your blood sugar may be low.

Lifting Up Healthy Living's Core Values

Healthy Living developed guiding Core Values a few years ago, and I thought today would be the perfect day to highlight them. These values affect our movements on a day-to-day basis, influencing our passion for customer care, our relationships with patients, providers, and manufacturers, and our positive internal culture.

Healthy Living's Core Values

  • Earn Trust: Delight customers, simplify their experience, and surprise them in unanticipated ways.

  • Get Better Every Day: Practice continuous improvement, determined to surpass yesterday over and over again.

  • Own and Learn from Mistakes: Seek to understand your mistakes, make things right, share what you learned, and move on.

  • Pursue Ongoing Learning: Strive for personal and professional growth through curiosity, exploration, and education.

  • Build a Positive Team: Work collaboratively to create a loyal customer following, and have fun along the way!

  • Embrace Change: Be agile and prepared to adjust to the quickly and inevitably changing healthcare environment.

  • Be Humble: Appreciate your teammates, be yourself, and focus on the goal instead of the spotlight.

As a growing company shaped by integrity and our purposeful commitment to customers and employees, we use these values to guide our way and focus our daily vision.

Dexcom Highlights Next-Gen G7 Updates

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This month has been full of diabetes tech news as many manufacturers revealed product updates and research at the ADA 2019 Conference in San Francisco. For a great summary article from Diabetes Mine, check this out.

At the conference, Dexcom highlighted their upcoming next-gen G7 updates. Being developed with Verily, the next-gen G7 product will:

  • Have a faster warm-up time than the current G6 startup window

  • Include extended wear time of 14-15 days

  • Offer a fully-disposable, all-in-one sensor-transmitter with a smaller on-body footprint

  • Provide a dramatic cost reduction and more accuracy and reliability

  • Allow direct Bluetooth-to-smartphone communication

Dexcom's slating this for later 2020 with a limited launch at first, and then rolling it out more broadly across the U.S. and internationally in 2021.

FreeStyle's LibreLink App Now Compatible with Android

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Starting last week, FreeStyle LibreLink is now available for Android phones, as well as compatible iPhones. FreeStyle LibreLink is a mobile app that enables compatible Android and Apple phones to scan a sensor and display glucose data and trends, including:

  • Current glucose reading

  • Trend arrow

  • Up to eight hours of glucose history

With a quick scan over the sensor, you will have glucose readings anytime and anywhere. You can download the new Android app here.

Learn more about the FreeStyle Libre continuous glucose monitoring (CGM) system by checking out these previous blogs:

Getting to Know Libre CGM

A Review of the FreeStyle Libre Sheds More Light on the New Technology

Healthy Living Now Providing the Abbott Freestyle Libre to Medicare Members

Real-World Data from Medtronic's Guardian Connect & Sugar.IQ Shows Improved Outcomes

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This week at the American Diabetes Association (ADA) Annual Meeting, Medtronic announced real-world data on its Guardian Connect continuous glucose monitoring (CGM) system and Sugar.IQ diabetes assistant app. The Guardian Connect system and Sugar.IQ app empower people using multiple daily injections (MDI) to more proactively manage their diabetes with meaningful, personalized insights. The real-world data was recorded by users of the Guardian Connect CGM paired with the Sugar.IQ.

Sugar.IQ diabetes assistant is a separate app that continually analyzes how an individual's glucose levels respond to food intake, insulin dosages, daily routines, and other factors. The Sugar.IQ app combines data from the Guardian Connect CGM system with artificial intelligence technology from IBM Watson Health to detect important patterns and trends for people with diabetes and help them make more informed decisions on how to better manage glucose levels and stay within target range.

The data showed that people using the Guardian Connect system with the Sugar.IQ app experienced 4.1% more Time in Range (63.4%) compared to Guardian Connect alone (59.3%), which represents about one extra hour per day. And those who also used the optional Glycemic Assist feature to review their response to specific foods increased Time in Range by an additional 4% compared to those not using that feature.

Learn more from the official Medtronic press release.

Noteworthy Positive Trial Results for Tandem's Closed Loop System

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The diabetes community is excited about positive results from two Tandem studies that were announced earlier this week. Data from the studies has demonstrated that Tandem's advanced hybrid closed-loop system has achieved the primary outcome of increasing time in range (70-180 mg/dL) without any severe hypoglycemic events for both adult and pediatric age groups.

Tandem's t:slim X2 insulin pump with Control-IQ technology utilizes Dexcom G6 continuous glucose monitoring (CGM) sensor values to predict glucose levels and adjust insulin delivery to prevent highs and lows, while still allowing the user to manually bolus for meals. The system also automates correction boluses, a feature not commercially available today on automated insulin delivery devices.

Read the entire press release for many more details on the studies and outcomes. This news supports Tandem as the company moves toward a future FDA approval on their closed loop system, expected later this year.

In the News: Newly Discovered Hybrid Immune Cell Could Finally Explain The Cause of Type 1 Diabetes

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We have learned that type 1 diabetes is caused by the body's immune system turning against insulin-producing cells. New research has found a 'hybrid' white blood cell that displays features of two of our immune's system most important cells (T and B cells). Further research will work to confirm the white blood cell's actions and possibly provide insight into treatments for diabetes and other immune conditions.

Read the whole article for a lot more details at Science Alert.

Diabetes Myths Debunked from Beyond Type 2

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Have you heard about Beyond Type 2? We are big fans. This site is chock full of resources and guides for living with and understanding Type 2 diabetes. I want to point out the Diabetes Myths Debunked article. It covers a lot of territory and is definitely worth a read.

From Beyond Type 2... 11 Myths About Diabetes

Check out the entire article to find out the truth about these topics.

  1. Diabetes isn't that serious.

  2. You get Type 2 diabetes after you have been scared.

  3. Being overweight causes diabetes; thin people don't have diabetes.

  4. I can never eat sweets or my favorite foods again and have to follow a strict, bland diet.

  5. Diabetes doesn't run in my family, so I'm good to go.

  6. It's okay to stop taking my medication once my blood sugar is under control.

  7. Type 2 diabetes is a death sentence.

  8. Going on insulin means you "failed" at diabetes management.

  9. Type 2 diabetes can be cured.

  10. Insulin causes blindness.

  11. Eating too much sugar causes Type 2 diabetes.

Don't forget to check out the Beyond Type 2 website!

Encouraging Resources for May - Diabetes & Mental Health

We are nearing the end of Mental Health Awareness Month, but we couldn't have missed this important topic! From small, day-to-day stressors and burdens to larger scale, chronic mental health issues, everyone needs to create their own path to balance and stability. Type 1 and type 2 diabetes bring additional challenges to already complicated lives, but in the midst of this we can strive to find moments of peace, glimmers of light, and hope through connection.

At some point, you may find some encouragement in these resources:

ADA's Mental Health Provider Directory
(Mental health professionals who specialize in diabetes)

Beyond Type 1 Mental Health Resources Page
(Articles on Stress, Diabetes & Type 1, Diabetes Burnout, Diabulimia, Caregiver Burnout, Eating Disorders, Anxiety & Diabetes, Self-Care, and more)

NAMI: National Alliance on Mental Illness
(For a deeper dive on mental health issues and concerns)