Evidence
November 11, 2022CGM Technology and Digital Health Article / Publication
Lilly’s new Tempo personalized diabetes management platform features a reusable medical device that attaches to prefilled, disposable insulin pens and sends dose-related data to a compatible app. Patients attach the Tempo Smart Button to the Tempo Pen to send insulin-dose information to TempoSmart. Capturing the data facilitates medication reminders, personalized education resources, and feedback on blood glucose levels, realized through integration with compatible technologies, including real-time continuous glucose monitoring (RT-CGM) via the Dexcom G6. Labeled a “diabetes ecosystem” solution, the fully integrated combination of devices, drugs, and technology offers an opportunity to adapt to each patient’s unique needs in diabetes management while providing value to both physician and payer stakeholders at the same time.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
2022 Update of the ADA Standards of Medical Care Highlight the Strength of Evidence Supporting rtCGM
November 11, 2022Clinical Outcomes Guidelines / Policy
Real-time continuous glucose monitoring (RT-CGM) remains a key technologic advancement recommended for integration into the management of diabetes according to the American Diabetes Association (ADA) Standards of Care (SOC) 2022. ADA assigned Grade A evidence to the recommendation that RT-CGM be offered for diabetes management in adults with diabetes on multiple daily injections (MDI) of insulin or continuous subcutaneous insulin infusion (CSII). Similarly, the ADA assigned Grade A evidence to the recommendation that RT- CGM be used for diabetes management in adults with diabetes on basal insulin. ADA’s criteria for a Grade A designation is defined as clear evidence from well-conducted, generalizable randomized controlled trials that are adequately powered.
American Diabetes Association Professional Practice Committee, et al. 7. Diabetes Technology: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S97-S112.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
WISDM Trial: Hypoglycemia Avoidance Associated with rtCGM Sustained Out to 12 Months in Older Adults
November 11, 2022Clinical Outcomes Article / Publication
The Wireless Innovation for Seniors with Diabetes Mellitus (WISDM) randomized clinical trial (RCT) featured a 26-week phase comparing real-time continuous glucose monitoring (RT-CGM) with blood glucose monitoring (BGM) in 203 adults aged ≥60 years with type 1 diabetes (T1D). Of the 198 participants who completed the RCT, 98% of RT-CGM group participants continued (CGM-CGM cohort) and 98% of BGM group participants crossed over to CGM (BGM-CGM cohort) for an additional 26 weeks. In the BGM-CGM cohort, median time <70 mg/dL decreased from 3.9% to 1.9% (P<0.001), TIR increased from 56% to 60% (P=0.006) and HbA1c decreased from 7.5% to 7.3% (P=0.025). Severe hypoglycemic events were reported for 9 participants while using BGM during the RCT and for only 2 participants during the extension phase with RT-CGM (P=0.02), indicating a sustained benefit of hypoglycemia avoidance in older adults out to 12 months.
Miller KM, et al. Benefit of Continuous Glucose Monitoring in Reducing Hypoglycemia Is Sustained Through 12 Months of Use Among Older Adults with Type 1 Diabetes. Diabetes Technol Ther. 2022;24(6):424-434.
Learn MoreNovember 11, 2022Clinical Outcomes Guidelines / Policy
According to the 2022 American Association of Clinical Endocrinology (AACE) Clinical Practice Guideline, CGM is recommended for all persons with T1D, regardless of insulin delivery system, to improve A1C levels and to reduce the risk for hypoglycemia and DKA. The updated guideline likewise recommends CGM for those with T2D who are treated with insulin therapy, or who have high risk for hypoglycemia and/or who have hypoglycemia unawareness. These recommendations are Grade A—indicating the highest strength made by the AACE—and are supported by the best evidence level available, based on data from randomized controlled trials. Managed care and payer professionals should take note of this latest guideline as part of the growing body of consensus recommendations supporting the coverage of CGM in a broader population of members with diabetes.
Blonde L, et al. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract. 2022;28(10):923-1049.
![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring in Critically Ill COVID-19 Patients
November 9, 2022Clinical Outcomes Article / Publication
This feasibility study of critically ill patients with COVID19 in a single medical ICU (MICU) wearing Dexcom G6 concluded real-time continuous glucose monitoring (RT-CGM) systems can be successfully implemented in the MICU using a hybrid protocol implementation approach. Nurses indicated RT-CGM provided an overall time savings and decreased the time spent in COVID19 rooms
Faulds ER, et al. Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring (CGM) in Critically Ill Patients With COVID-19. Endocr Pract. 2021;27(4):354-361.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients With Diabetes: A Randomized Clinical Trial
November 9, 2022Clinical Outcomes Article / Publication
This randomized control trial (RCT) of 185 general medicine and surgery patients with Type 1 and Type 2 diabetes found real-time continuous glucose monitoring (RT-CGM) safe and effective for guiding insulin therapy in hospitalized patients treated with a basal-bolus insulin regimen compared with a point-of-care (POC) group with blinded CGM and POC-guided insulin adjustments. RT- CGM resulted in a similar improvement in glycemic control and a significant reduction of recurrent hypoglycemia among patients with one or more hypoglycemic events compared with POC group.
Spanakis, EK et al. Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients with Diabetes: A Randomized Clinical Trial. Diabetes Care. Diabetes Care. 2022;45(10):2369-2375.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes
November 9, 2022Clinical Outcomes Article / Publication
This publication describes a retrospective analysis of an inpatient real-time continuous glucose monitoring (RT-CGM) program at a community hospital and the accuracy of the system. Authors concluded RT-CGM for inpatient diabetes monitoring is feasible, is a reliable comparator to POC (point-of-care) testing, prevents adverse patient outcomes through safe and timely treatment decisions, and poses minimal risk when used for management decisions. A corresponding podcast is available below.
Baker M, et al. Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes. Am J Health Syst Pharm. 2022;79(6):452-458.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline
November 9, 2022Clinical Outcomes Article / Publication
A clinical practice guideline for inpatient hyperglycemia management from the Endocrine Society was published in The Journal of Clinical Endocrinology & Metabolism. The guideline focuses on hyperglycemia management in non-critically ill hospitalized patients and highlights the use of emerging diabetes technology, including real-time continuous glucose monitoring (RT-CGM), for glycemic management in the hospital. Based on available evidence, the guideline recommends use of RT-CGM with confirmatory point-of-care (POC) testing for insulin dosing decisions in adults with insulin-treated diabetes hospitalized for noncritical illness who are at high risk of hypoglycemia.
Korytkowski M, et al. Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022;107(8):2101-2128.
Learn MoreNovember 7, 2022Clinical Outcomes Coverage and Benefit Design Article / PublicationLearn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
Lilly’s new Tempo personalized diabetes management platform features a reusable medical device that attaches to prefilled, disposable insulin pens and sends dose-related data to a compatible app. Patients attach the Tempo Smart Button to the Tempo Pen to send insulin-dose information to TempoSmart. Capturing the data facilitates medication reminders, personalized education resources, and feedback on blood glucose levels, realized through integration with compatible technologies, including real-time continuous glucose monitoring (RT-CGM) via the Dexcom G6. Labeled a “diabetes ecosystem” solution, the fully integrated combination of devices, drugs, and technology offers an opportunity to adapt to each patient’s unique needs in diabetes management while providing value to both physician and payer stakeholders at the same time.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
2022 Update of the ADA Standards of Medical Care Highlight the Strength of Evidence Supporting rtCGM
November 11, 2022Clinical Outcomes Guidelines / Policy
Real-time continuous glucose monitoring (RT-CGM) remains a key technologic advancement recommended for integration into the management of diabetes according to the American Diabetes Association (ADA) Standards of Care (SOC) 2022. ADA assigned Grade A evidence to the recommendation that RT-CGM be offered for diabetes management in adults with diabetes on multiple daily injections (MDI) of insulin or continuous subcutaneous insulin infusion (CSII). Similarly, the ADA assigned Grade A evidence to the recommendation that RT- CGM be used for diabetes management in adults with diabetes on basal insulin. ADA’s criteria for a Grade A designation is defined as clear evidence from well-conducted, generalizable randomized controlled trials that are adequately powered.
American Diabetes Association Professional Practice Committee, et al. 7. Diabetes Technology: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S97-S112.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
WISDM Trial: Hypoglycemia Avoidance Associated with rtCGM Sustained Out to 12 Months in Older Adults
November 11, 2022Clinical Outcomes Article / Publication
The Wireless Innovation for Seniors with Diabetes Mellitus (WISDM) randomized clinical trial (RCT) featured a 26-week phase comparing real-time continuous glucose monitoring (RT-CGM) with blood glucose monitoring (BGM) in 203 adults aged ≥60 years with type 1 diabetes (T1D). Of the 198 participants who completed the RCT, 98% of RT-CGM group participants continued (CGM-CGM cohort) and 98% of BGM group participants crossed over to CGM (BGM-CGM cohort) for an additional 26 weeks. In the BGM-CGM cohort, median time <70 mg/dL decreased from 3.9% to 1.9% (P<0.001), TIR increased from 56% to 60% (P=0.006) and HbA1c decreased from 7.5% to 7.3% (P=0.025). Severe hypoglycemic events were reported for 9 participants while using BGM during the RCT and for only 2 participants during the extension phase with RT-CGM (P=0.02), indicating a sustained benefit of hypoglycemia avoidance in older adults out to 12 months.
Miller KM, et al. Benefit of Continuous Glucose Monitoring in Reducing Hypoglycemia Is Sustained Through 12 Months of Use Among Older Adults with Type 1 Diabetes. Diabetes Technol Ther. 2022;24(6):424-434.
Learn MoreNovember 11, 2022Clinical Outcomes Guidelines / Policy
According to the 2022 American Association of Clinical Endocrinology (AACE) Clinical Practice Guideline, CGM is recommended for all persons with T1D, regardless of insulin delivery system, to improve A1C levels and to reduce the risk for hypoglycemia and DKA. The updated guideline likewise recommends CGM for those with T2D who are treated with insulin therapy, or who have high risk for hypoglycemia and/or who have hypoglycemia unawareness. These recommendations are Grade A—indicating the highest strength made by the AACE—and are supported by the best evidence level available, based on data from randomized controlled trials. Managed care and payer professionals should take note of this latest guideline as part of the growing body of consensus recommendations supporting the coverage of CGM in a broader population of members with diabetes.
Blonde L, et al. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract. 2022;28(10):923-1049.
![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring in Critically Ill COVID-19 Patients
November 9, 2022Clinical Outcomes Article / Publication
This feasibility study of critically ill patients with COVID19 in a single medical ICU (MICU) wearing Dexcom G6 concluded real-time continuous glucose monitoring (RT-CGM) systems can be successfully implemented in the MICU using a hybrid protocol implementation approach. Nurses indicated RT-CGM provided an overall time savings and decreased the time spent in COVID19 rooms
Faulds ER, et al. Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring (CGM) in Critically Ill Patients With COVID-19. Endocr Pract. 2021;27(4):354-361.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients With Diabetes: A Randomized Clinical Trial
November 9, 2022Clinical Outcomes Article / Publication
This randomized control trial (RCT) of 185 general medicine and surgery patients with Type 1 and Type 2 diabetes found real-time continuous glucose monitoring (RT-CGM) safe and effective for guiding insulin therapy in hospitalized patients treated with a basal-bolus insulin regimen compared with a point-of-care (POC) group with blinded CGM and POC-guided insulin adjustments. RT- CGM resulted in a similar improvement in glycemic control and a significant reduction of recurrent hypoglycemia among patients with one or more hypoglycemic events compared with POC group.
Spanakis, EK et al. Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients with Diabetes: A Randomized Clinical Trial. Diabetes Care. Diabetes Care. 2022;45(10):2369-2375.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes
November 9, 2022Clinical Outcomes Article / Publication
This publication describes a retrospective analysis of an inpatient real-time continuous glucose monitoring (RT-CGM) program at a community hospital and the accuracy of the system. Authors concluded RT-CGM for inpatient diabetes monitoring is feasible, is a reliable comparator to POC (point-of-care) testing, prevents adverse patient outcomes through safe and timely treatment decisions, and poses minimal risk when used for management decisions. A corresponding podcast is available below.
Baker M, et al. Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes. Am J Health Syst Pharm. 2022;79(6):452-458.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline
November 9, 2022Clinical Outcomes Article / Publication
A clinical practice guideline for inpatient hyperglycemia management from the Endocrine Society was published in The Journal of Clinical Endocrinology & Metabolism. The guideline focuses on hyperglycemia management in non-critically ill hospitalized patients and highlights the use of emerging diabetes technology, including real-time continuous glucose monitoring (RT-CGM), for glycemic management in the hospital. Based on available evidence, the guideline recommends use of RT-CGM with confirmatory point-of-care (POC) testing for insulin dosing decisions in adults with insulin-treated diabetes hospitalized for noncritical illness who are at high risk of hypoglycemia.
Korytkowski M, et al. Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022;107(8):2101-2128.
Learn MoreNovember 7, 2022Clinical Outcomes Coverage and Benefit Design Article / PublicationLearn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
2022 Update of the ADA Standards of Medical Care Highlight the Strength of Evidence Supporting rtCGM
Real-time continuous glucose monitoring (RT-CGM) remains a key technologic advancement recommended for integration into the management of diabetes according to the American Diabetes Association (ADA) Standards of Care (SOC) 2022. ADA assigned Grade A evidence to the recommendation that RT-CGM be offered for diabetes management in adults with diabetes on multiple daily injections (MDI) of insulin or continuous subcutaneous insulin infusion (CSII). Similarly, the ADA assigned Grade A evidence to the recommendation that RT- CGM be used for diabetes management in adults with diabetes on basal insulin. ADA’s criteria for a Grade A designation is defined as clear evidence from well-conducted, generalizable randomized controlled trials that are adequately powered.
American Diabetes Association Professional Practice Committee, et al. 7. Diabetes Technology: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S97-S112.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
WISDM Trial: Hypoglycemia Avoidance Associated with rtCGM Sustained Out to 12 Months in Older Adults
November 11, 2022Clinical Outcomes Article / Publication
The Wireless Innovation for Seniors with Diabetes Mellitus (WISDM) randomized clinical trial (RCT) featured a 26-week phase comparing real-time continuous glucose monitoring (RT-CGM) with blood glucose monitoring (BGM) in 203 adults aged ≥60 years with type 1 diabetes (T1D). Of the 198 participants who completed the RCT, 98% of RT-CGM group participants continued (CGM-CGM cohort) and 98% of BGM group participants crossed over to CGM (BGM-CGM cohort) for an additional 26 weeks. In the BGM-CGM cohort, median time <70 mg/dL decreased from 3.9% to 1.9% (P<0.001), TIR increased from 56% to 60% (P=0.006) and HbA1c decreased from 7.5% to 7.3% (P=0.025). Severe hypoglycemic events were reported for 9 participants while using BGM during the RCT and for only 2 participants during the extension phase with RT-CGM (P=0.02), indicating a sustained benefit of hypoglycemia avoidance in older adults out to 12 months.
Miller KM, et al. Benefit of Continuous Glucose Monitoring in Reducing Hypoglycemia Is Sustained Through 12 Months of Use Among Older Adults with Type 1 Diabetes. Diabetes Technol Ther. 2022;24(6):424-434.
Learn MoreNovember 11, 2022Clinical Outcomes Guidelines / Policy
According to the 2022 American Association of Clinical Endocrinology (AACE) Clinical Practice Guideline, CGM is recommended for all persons with T1D, regardless of insulin delivery system, to improve A1C levels and to reduce the risk for hypoglycemia and DKA. The updated guideline likewise recommends CGM for those with T2D who are treated with insulin therapy, or who have high risk for hypoglycemia and/or who have hypoglycemia unawareness. These recommendations are Grade A—indicating the highest strength made by the AACE—and are supported by the best evidence level available, based on data from randomized controlled trials. Managed care and payer professionals should take note of this latest guideline as part of the growing body of consensus recommendations supporting the coverage of CGM in a broader population of members with diabetes.
Blonde L, et al. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract. 2022;28(10):923-1049.
![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring in Critically Ill COVID-19 Patients
November 9, 2022Clinical Outcomes Article / Publication
This feasibility study of critically ill patients with COVID19 in a single medical ICU (MICU) wearing Dexcom G6 concluded real-time continuous glucose monitoring (RT-CGM) systems can be successfully implemented in the MICU using a hybrid protocol implementation approach. Nurses indicated RT-CGM provided an overall time savings and decreased the time spent in COVID19 rooms
Faulds ER, et al. Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring (CGM) in Critically Ill Patients With COVID-19. Endocr Pract. 2021;27(4):354-361.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients With Diabetes: A Randomized Clinical Trial
November 9, 2022Clinical Outcomes Article / Publication
This randomized control trial (RCT) of 185 general medicine and surgery patients with Type 1 and Type 2 diabetes found real-time continuous glucose monitoring (RT-CGM) safe and effective for guiding insulin therapy in hospitalized patients treated with a basal-bolus insulin regimen compared with a point-of-care (POC) group with blinded CGM and POC-guided insulin adjustments. RT- CGM resulted in a similar improvement in glycemic control and a significant reduction of recurrent hypoglycemia among patients with one or more hypoglycemic events compared with POC group.
Spanakis, EK et al. Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients with Diabetes: A Randomized Clinical Trial. Diabetes Care. Diabetes Care. 2022;45(10):2369-2375.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes
November 9, 2022Clinical Outcomes Article / Publication
This publication describes a retrospective analysis of an inpatient real-time continuous glucose monitoring (RT-CGM) program at a community hospital and the accuracy of the system. Authors concluded RT-CGM for inpatient diabetes monitoring is feasible, is a reliable comparator to POC (point-of-care) testing, prevents adverse patient outcomes through safe and timely treatment decisions, and poses minimal risk when used for management decisions. A corresponding podcast is available below.
Baker M, et al. Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes. Am J Health Syst Pharm. 2022;79(6):452-458.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline
November 9, 2022Clinical Outcomes Article / Publication
A clinical practice guideline for inpatient hyperglycemia management from the Endocrine Society was published in The Journal of Clinical Endocrinology & Metabolism. The guideline focuses on hyperglycemia management in non-critically ill hospitalized patients and highlights the use of emerging diabetes technology, including real-time continuous glucose monitoring (RT-CGM), for glycemic management in the hospital. Based on available evidence, the guideline recommends use of RT-CGM with confirmatory point-of-care (POC) testing for insulin dosing decisions in adults with insulin-treated diabetes hospitalized for noncritical illness who are at high risk of hypoglycemia.
Korytkowski M, et al. Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022;107(8):2101-2128.
Learn MoreNovember 7, 2022Clinical Outcomes Coverage and Benefit Design Article / PublicationLearn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
WISDM Trial: Hypoglycemia Avoidance Associated with rtCGM Sustained Out to 12 Months in Older Adults
The Wireless Innovation for Seniors with Diabetes Mellitus (WISDM) randomized clinical trial (RCT) featured a 26-week phase comparing real-time continuous glucose monitoring (RT-CGM) with blood glucose monitoring (BGM) in 203 adults aged ≥60 years with type 1 diabetes (T1D). Of the 198 participants who completed the RCT, 98% of RT-CGM group participants continued (CGM-CGM cohort) and 98% of BGM group participants crossed over to CGM (BGM-CGM cohort) for an additional 26 weeks. In the BGM-CGM cohort, median time <70 mg/dL decreased from 3.9% to 1.9% (P<0.001), TIR increased from 56% to 60% (P=0.006) and HbA1c decreased from 7.5% to 7.3% (P=0.025). Severe hypoglycemic events were reported for 9 participants while using BGM during the RCT and for only 2 participants during the extension phase with RT-CGM (P=0.02), indicating a sustained benefit of hypoglycemia avoidance in older adults out to 12 months.
Miller KM, et al. Benefit of Continuous Glucose Monitoring in Reducing Hypoglycemia Is Sustained Through 12 Months of Use Among Older Adults with Type 1 Diabetes. Diabetes Technol Ther. 2022;24(6):424-434.
Learn MoreNovember 11, 2022Clinical Outcomes Guidelines / Policy
According to the 2022 American Association of Clinical Endocrinology (AACE) Clinical Practice Guideline, CGM is recommended for all persons with T1D, regardless of insulin delivery system, to improve A1C levels and to reduce the risk for hypoglycemia and DKA. The updated guideline likewise recommends CGM for those with T2D who are treated with insulin therapy, or who have high risk for hypoglycemia and/or who have hypoglycemia unawareness. These recommendations are Grade A—indicating the highest strength made by the AACE—and are supported by the best evidence level available, based on data from randomized controlled trials. Managed care and payer professionals should take note of this latest guideline as part of the growing body of consensus recommendations supporting the coverage of CGM in a broader population of members with diabetes.
Blonde L, et al. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract. 2022;28(10):923-1049.
![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring in Critically Ill COVID-19 Patients
November 9, 2022Clinical Outcomes Article / Publication
This feasibility study of critically ill patients with COVID19 in a single medical ICU (MICU) wearing Dexcom G6 concluded real-time continuous glucose monitoring (RT-CGM) systems can be successfully implemented in the MICU using a hybrid protocol implementation approach. Nurses indicated RT-CGM provided an overall time savings and decreased the time spent in COVID19 rooms
Faulds ER, et al. Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring (CGM) in Critically Ill Patients With COVID-19. Endocr Pract. 2021;27(4):354-361.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients With Diabetes: A Randomized Clinical Trial
November 9, 2022Clinical Outcomes Article / Publication
This randomized control trial (RCT) of 185 general medicine and surgery patients with Type 1 and Type 2 diabetes found real-time continuous glucose monitoring (RT-CGM) safe and effective for guiding insulin therapy in hospitalized patients treated with a basal-bolus insulin regimen compared with a point-of-care (POC) group with blinded CGM and POC-guided insulin adjustments. RT- CGM resulted in a similar improvement in glycemic control and a significant reduction of recurrent hypoglycemia among patients with one or more hypoglycemic events compared with POC group.
Spanakis, EK et al. Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients with Diabetes: A Randomized Clinical Trial. Diabetes Care. Diabetes Care. 2022;45(10):2369-2375.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes
November 9, 2022Clinical Outcomes Article / Publication
This publication describes a retrospective analysis of an inpatient real-time continuous glucose monitoring (RT-CGM) program at a community hospital and the accuracy of the system. Authors concluded RT-CGM for inpatient diabetes monitoring is feasible, is a reliable comparator to POC (point-of-care) testing, prevents adverse patient outcomes through safe and timely treatment decisions, and poses minimal risk when used for management decisions. A corresponding podcast is available below.
Baker M, et al. Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes. Am J Health Syst Pharm. 2022;79(6):452-458.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline
November 9, 2022Clinical Outcomes Article / Publication
A clinical practice guideline for inpatient hyperglycemia management from the Endocrine Society was published in The Journal of Clinical Endocrinology & Metabolism. The guideline focuses on hyperglycemia management in non-critically ill hospitalized patients and highlights the use of emerging diabetes technology, including real-time continuous glucose monitoring (RT-CGM), for glycemic management in the hospital. Based on available evidence, the guideline recommends use of RT-CGM with confirmatory point-of-care (POC) testing for insulin dosing decisions in adults with insulin-treated diabetes hospitalized for noncritical illness who are at high risk of hypoglycemia.
Korytkowski M, et al. Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022;107(8):2101-2128.
Learn MoreNovember 7, 2022Clinical Outcomes Coverage and Benefit Design Article / PublicationLearn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
According to the 2022 American Association of Clinical Endocrinology (AACE) Clinical Practice Guideline, CGM is recommended for all persons with T1D, regardless of insulin delivery system, to improve A1C levels and to reduce the risk for hypoglycemia and DKA. The updated guideline likewise recommends CGM for those with T2D who are treated with insulin therapy, or who have high risk for hypoglycemia and/or who have hypoglycemia unawareness. These recommendations are Grade A—indicating the highest strength made by the AACE—and are supported by the best evidence level available, based on data from randomized controlled trials. Managed care and payer professionals should take note of this latest guideline as part of the growing body of consensus recommendations supporting the coverage of CGM in a broader population of members with diabetes.
Blonde L, et al. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract. 2022;28(10):923-1049.
![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring in Critically Ill COVID-19 Patients
November 9, 2022Clinical Outcomes Article / Publication
This feasibility study of critically ill patients with COVID19 in a single medical ICU (MICU) wearing Dexcom G6 concluded real-time continuous glucose monitoring (RT-CGM) systems can be successfully implemented in the MICU using a hybrid protocol implementation approach. Nurses indicated RT-CGM provided an overall time savings and decreased the time spent in COVID19 rooms
Faulds ER, et al. Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring (CGM) in Critically Ill Patients With COVID-19. Endocr Pract. 2021;27(4):354-361.
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Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients With Diabetes: A Randomized Clinical Trial
November 9, 2022Clinical Outcomes Article / Publication
This randomized control trial (RCT) of 185 general medicine and surgery patients with Type 1 and Type 2 diabetes found real-time continuous glucose monitoring (RT-CGM) safe and effective for guiding insulin therapy in hospitalized patients treated with a basal-bolus insulin regimen compared with a point-of-care (POC) group with blinded CGM and POC-guided insulin adjustments. RT- CGM resulted in a similar improvement in glycemic control and a significant reduction of recurrent hypoglycemia among patients with one or more hypoglycemic events compared with POC group.
Spanakis, EK et al. Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients with Diabetes: A Randomized Clinical Trial. Diabetes Care. Diabetes Care. 2022;45(10):2369-2375.
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Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes
November 9, 2022Clinical Outcomes Article / Publication
This publication describes a retrospective analysis of an inpatient real-time continuous glucose monitoring (RT-CGM) program at a community hospital and the accuracy of the system. Authors concluded RT-CGM for inpatient diabetes monitoring is feasible, is a reliable comparator to POC (point-of-care) testing, prevents adverse patient outcomes through safe and timely treatment decisions, and poses minimal risk when used for management decisions. A corresponding podcast is available below.
Baker M, et al. Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes. Am J Health Syst Pharm. 2022;79(6):452-458.
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Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline
November 9, 2022Clinical Outcomes Article / Publication
A clinical practice guideline for inpatient hyperglycemia management from the Endocrine Society was published in The Journal of Clinical Endocrinology & Metabolism. The guideline focuses on hyperglycemia management in non-critically ill hospitalized patients and highlights the use of emerging diabetes technology, including real-time continuous glucose monitoring (RT-CGM), for glycemic management in the hospital. Based on available evidence, the guideline recommends use of RT-CGM with confirmatory point-of-care (POC) testing for insulin dosing decisions in adults with insulin-treated diabetes hospitalized for noncritical illness who are at high risk of hypoglycemia.
Korytkowski M, et al. Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022;107(8):2101-2128.
Learn MoreNovember 7, 2022Clinical Outcomes Coverage and Benefit Design Article / PublicationLearn More
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Updates, Recent News, And Resources
Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring in Critically Ill COVID-19 Patients
This feasibility study of critically ill patients with COVID19 in a single medical ICU (MICU) wearing Dexcom G6 concluded real-time continuous glucose monitoring (RT-CGM) systems can be successfully implemented in the MICU using a hybrid protocol implementation approach. Nurses indicated RT-CGM provided an overall time savings and decreased the time spent in COVID19 rooms
Faulds ER, et al. Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring (CGM) in Critically Ill Patients With COVID-19. Endocr Pract. 2021;27(4):354-361.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients With Diabetes: A Randomized Clinical Trial
November 9, 2022Clinical Outcomes Article / Publication
This randomized control trial (RCT) of 185 general medicine and surgery patients with Type 1 and Type 2 diabetes found real-time continuous glucose monitoring (RT-CGM) safe and effective for guiding insulin therapy in hospitalized patients treated with a basal-bolus insulin regimen compared with a point-of-care (POC) group with blinded CGM and POC-guided insulin adjustments. RT- CGM resulted in a similar improvement in glycemic control and a significant reduction of recurrent hypoglycemia among patients with one or more hypoglycemic events compared with POC group.
Spanakis, EK et al. Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients with Diabetes: A Randomized Clinical Trial. Diabetes Care. Diabetes Care. 2022;45(10):2369-2375.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes
November 9, 2022Clinical Outcomes Article / Publication
This publication describes a retrospective analysis of an inpatient real-time continuous glucose monitoring (RT-CGM) program at a community hospital and the accuracy of the system. Authors concluded RT-CGM for inpatient diabetes monitoring is feasible, is a reliable comparator to POC (point-of-care) testing, prevents adverse patient outcomes through safe and timely treatment decisions, and poses minimal risk when used for management decisions. A corresponding podcast is available below.
Baker M, et al. Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes. Am J Health Syst Pharm. 2022;79(6):452-458.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline
November 9, 2022Clinical Outcomes Article / Publication
A clinical practice guideline for inpatient hyperglycemia management from the Endocrine Society was published in The Journal of Clinical Endocrinology & Metabolism. The guideline focuses on hyperglycemia management in non-critically ill hospitalized patients and highlights the use of emerging diabetes technology, including real-time continuous glucose monitoring (RT-CGM), for glycemic management in the hospital. Based on available evidence, the guideline recommends use of RT-CGM with confirmatory point-of-care (POC) testing for insulin dosing decisions in adults with insulin-treated diabetes hospitalized for noncritical illness who are at high risk of hypoglycemia.
Korytkowski M, et al. Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022;107(8):2101-2128.
Learn MoreNovember 7, 2022Clinical Outcomes Coverage and Benefit Design Article / PublicationLearn More
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Updates, Recent News, And Resources
Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients With Diabetes: A Randomized Clinical Trial
This randomized control trial (RCT) of 185 general medicine and surgery patients with Type 1 and Type 2 diabetes found real-time continuous glucose monitoring (RT-CGM) safe and effective for guiding insulin therapy in hospitalized patients treated with a basal-bolus insulin regimen compared with a point-of-care (POC) group with blinded CGM and POC-guided insulin adjustments. RT- CGM resulted in a similar improvement in glycemic control and a significant reduction of recurrent hypoglycemia among patients with one or more hypoglycemic events compared with POC group.
Spanakis, EK et al. Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients with Diabetes: A Randomized Clinical Trial. Diabetes Care. Diabetes Care. 2022;45(10):2369-2375.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes
November 9, 2022Clinical Outcomes Article / Publication
This publication describes a retrospective analysis of an inpatient real-time continuous glucose monitoring (RT-CGM) program at a community hospital and the accuracy of the system. Authors concluded RT-CGM for inpatient diabetes monitoring is feasible, is a reliable comparator to POC (point-of-care) testing, prevents adverse patient outcomes through safe and timely treatment decisions, and poses minimal risk when used for management decisions. A corresponding podcast is available below.
Baker M, et al. Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes. Am J Health Syst Pharm. 2022;79(6):452-458.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline
November 9, 2022Clinical Outcomes Article / Publication
A clinical practice guideline for inpatient hyperglycemia management from the Endocrine Society was published in The Journal of Clinical Endocrinology & Metabolism. The guideline focuses on hyperglycemia management in non-critically ill hospitalized patients and highlights the use of emerging diabetes technology, including real-time continuous glucose monitoring (RT-CGM), for glycemic management in the hospital. Based on available evidence, the guideline recommends use of RT-CGM with confirmatory point-of-care (POC) testing for insulin dosing decisions in adults with insulin-treated diabetes hospitalized for noncritical illness who are at high risk of hypoglycemia.
Korytkowski M, et al. Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022;107(8):2101-2128.
Learn MoreNovember 7, 2022Clinical Outcomes Coverage and Benefit Design Article / PublicationLearn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes
This publication describes a retrospective analysis of an inpatient real-time continuous glucose monitoring (RT-CGM) program at a community hospital and the accuracy of the system. Authors concluded RT-CGM for inpatient diabetes monitoring is feasible, is a reliable comparator to POC (point-of-care) testing, prevents adverse patient outcomes through safe and timely treatment decisions, and poses minimal risk when used for management decisions. A corresponding podcast is available below.
Baker M, et al. Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes. Am J Health Syst Pharm. 2022;79(6):452-458.
Learn More![Open Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_down.svg)
![Close Post](/wp-content/themes/managedcarecgm/assets/images/theme/earrow_up.svg)
Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline
November 9, 2022Clinical Outcomes Article / Publication
A clinical practice guideline for inpatient hyperglycemia management from the Endocrine Society was published in The Journal of Clinical Endocrinology & Metabolism. The guideline focuses on hyperglycemia management in non-critically ill hospitalized patients and highlights the use of emerging diabetes technology, including real-time continuous glucose monitoring (RT-CGM), for glycemic management in the hospital. Based on available evidence, the guideline recommends use of RT-CGM with confirmatory point-of-care (POC) testing for insulin dosing decisions in adults with insulin-treated diabetes hospitalized for noncritical illness who are at high risk of hypoglycemia.
Korytkowski M, et al. Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022;107(8):2101-2128.
Learn MoreNovember 7, 2022Clinical Outcomes Coverage and Benefit Design Article / PublicationLearn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline
A clinical practice guideline for inpatient hyperglycemia management from the Endocrine Society was published in The Journal of Clinical Endocrinology & Metabolism. The guideline focuses on hyperglycemia management in non-critically ill hospitalized patients and highlights the use of emerging diabetes technology, including real-time continuous glucose monitoring (RT-CGM), for glycemic management in the hospital. Based on available evidence, the guideline recommends use of RT-CGM with confirmatory point-of-care (POC) testing for insulin dosing decisions in adults with insulin-treated diabetes hospitalized for noncritical illness who are at high risk of hypoglycemia.
Korytkowski M, et al. Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022;107(8):2101-2128.
Learn More