DIABETES TECHNOLOGY
Diabetes Technology is an all-encompassing term to describe the tools (ie. hardware, devices, and software) that patients with diabetes use to manage their blood glucose levels. These tools help patients to prevent long term complications from diabetes and improve their quality of life.
Below we will discuss the most relevant tools that we use here at Capitol Endocrinology including methods for insulin delivery (insulin syringes, pens and insulin pumps) and continuous glucose monitors (CGMs)
INSULIN DELIVERY
INSULIN SYRINGES AND PENS
For our patients who require insulin the most common method for insulin delivery is with an insulin syringe or an insulin pen. The decision is made on patient preference, cost of medications, insulin type, dosing regimen, and patient competency.
When using an insulin syringe the insulin has to be drawn out of a vial.
When using an insulin pen the pen has a mechanism to allow you to adjust to the prescribed dose. Each time you use the insulin a new pen needle is placed onto the end of the pen.
Now there is a newer pen available which can offer a lot more than just a vehicle for injecting Insulin in the body. Its called InPen. It offers advanced tracking inside the pen and an intuitive app. You can dose with the smart pen and rely on the app to track your data, get personalized recommendations, and keep an eye on your active insulin throughout the day. (
INSULIN PUMPS & OTHER DELIVERY DEVICES
Insulin pumps provide another method for insulin delivery and are appropriate for all our patients with Type 1 Diabetes and our patients with Type 2 Diabetes who are currently using multiple daily injections of insulin. Most insulin pumps use tubing to deliver insulin from the pump to a cannula that is inserted underneath the skin (Medtronic: Minimed and Tandem: t:slimX2) Another insulin pump adheres directly to the skin without tubing (Insulet Corporation: Omnipod)
https://www.tandemdiabetes.com/
https://www.medtronicdiabetes.com/home
https://www.myomnipod.com/home
https://www.medtronicdiabetes.com/products/i-port-advance
CONTINUOUS GLUCOSE MONITOR (CGM)
What is a CGM?
CGM stands for Continuous Glucose Monitor. A CGM is a device that tracks your blood glucose throughout the day.
What are the components of a CGM?
1) Sensor: A small sensor that measures glucose levels underneath the skin (flexible wire), lays flat on the skin surface with adhesive
2) Transmitter: Connects to the sensor and sends data wirelessly to your display device
3)Receiver: A receiver or compatible smart device or an insulin pump that displays your glucose reading in real time.
What are the benefits?
CGM has been shown to help lower A1c, reduction in hypoglycemia (low blood glucose), and allows patients to make decisions for appropriately giving insulin
Who should use a CGM?
The American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE) published guidelines that recommend:
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Patients with Type 1 Diabetes Mellitus
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Patients with Type 2 diabetes on multiple insulin injections, basal insulin, or Sulfonylureas.
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Patients that are at high risk for hypoglycemia and/or have hypoglycemia unawareness may benefit from using a CGM
The most common CGM we work with are Freestyle Libre and DEXCOM. Please find the links to educate yourself more. We will be happy to help you with the right choice that meets your needs.
Please call to schedule a visit at 530-677-0700
How do I start using my new Dexcom or Freestyle libre CGM?
Both the Dexcom CGM and Freestyle libre CGM are approved for patient self-start. We advise that you follow the manual that was provided with your CGM for more comprehensive instructions. For your convenience we have compiled a few quick resources below to help guide you in starting your CGM at home. Please review the resources under the appropriate TYPE of CGM that you have (i.e.. Dexcom vs. Freestyle libre)
What if I have reviewed the resources below and still need further assistance with my CGM?
Please call our office at 530-677-0700 and we will be happy to set up an appointment to help you start your CGM. Please be sure to bring all your CGM supplies with you to your scheduled appointment.
DEXCOM
1) Quick Start Videos
Choose your appropriate Dexcom G6 or Dexcom G5
Dexcom G6 - Inserting the Sensor and Attaching the Transmitter
2) Online tutorials
Dexcom https://www.dexcom.com/tutorials (once on the tutorial page click on the correct Dexcom version you are using)
3) Still have questions about how to start your Dexcom CGM?
Dexcom customer service phone#: (888) 738-3646
FREESTYLE LIBRE
1) Quick Start Video
Freestyle Libre | Getting Started
2) Online tutorials
3) Still have questions about how to start your Freestyle libre CGM?
Please call Freestyle libre customer service at 1-(855)-632-8658
Libre Patient Assistance
Website: https://www.freestylelibre.us/support/overview.html
Get Started: https://youtu.be/1BtkD7okMB0
Apply: https://youtu.be/qjCWXePWxJY
Get First Reading: https://youtu.be/GompAQx_NqQ
Settings: https://youtu.be/2kc7qCBs-JQ
Replace Sensor: https://youtu.be/RL1mV59r7gc
CGM Readings: https://youtu.be/I3tQ80NXvGk
Manage Better: https://youtu.be/-q8ixdYZCco
STARTING A NEW CGM
PLEASE USE THIS REFERENCE IF YOU ARE STARTING A CGM FOR THE FIRST TIME OR SWITHING TO A DIFFERENT CGM TO HELP YOU WITH SETUP
Upload My Continuous Glucose Monitor (CGM)
PLEASE UPLOAD YOUR CGM BEFORE YOUR VISIT TO REVIEW AT THE TIME OF YOUR VISIT
Why do I need to upload my CGM?
Uploading your CGM at home allows our providers to view your current blood glucose data and make informed decisions about how to adjust your diabetic medications and/or insulin dosage. This is especially important for our scheduled telemedicine (video) visits which we recommend to provide more frequent monitoring in order to improve blood glucose control.
How often do I upload my CGM?
It is important to upload your insulin pump the day prior to your scheduled telemedicine (video) visit.
How do I upload my CGM?
Please follow the instructions below that correlate with your TYPE of continuous glucose monitor (CGM)
DEXCOM
1) Create an account
First time users must create a Dexcom Clarity account
Click on the link below and choose "Dexcom Clarity for Home Users" and then scroll down and click on "Create a Dexcom Account"
2) Share with our Clinic
***First you will need to request a sharing code from our office and once we are notified we will email you a sharing code
Once you receive your sharing code by email there are TWO ways you can share:
On your smart phone:
Login to your Dexcom clarity app, tap SHARE and follow the on screen instructions
On your computer:
Login to Dexcom Clarity Share Data
3) Upload Data
--> For patients using your smart phone to view your Dexcom glucose data:
After you have shared with are clinic as per the instructions above your data uploads automatically
--> For patient using the Dexcom receiver to view your glucose data:
You will need to login to your Dexcom clarity account (Dexcom Clarity Login) Follow the instructions to install the Uploader software
Then connect your Dexcom receiver to your computer to upload automatically
***For all future uploads just connect your receiver to your computer
4) Quick Reference Guides
Dexcom Clarity Reference Guide
5) Still have questions about your Dexcom CGM?
Please call Dexcom Support: 1-888-738-3646 or visit Dexcom Support
FREESTYLE LIBRE
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Create an account:
First time users must create a Libre View account (Sign up Here)
If any problems with creating account please call patient line @ 855-786-4263
If you already have a libre view account go to step 2
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Share your data with our clinic (Link Your Account)
Option 1: Email invitation
Check your email inbox: "Request to Share Data"
Click Accept Invitation >enter country/language
If you have a libre view account "Log in"
If you don’t have a libre view account "Create an account"
Option 2: Using our Clinic Practice ID
Didn't get an email?
Login into Libre View account
Go to Account settings> my practices > enter practice id: Capitolendo
Now you are sharing your data with our clinic!
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Upload Data
If you are using the LibreLinkApp on your smart device to view your blood glucose the data is uploaded automatically (be sure your shared with our clinic on step 2 above)
If you are using Freestyle libre reader device to view your blood glucose then you have to download by connecting the USB cord to your computer (follow the prompts on your libre view account to UPLOAD DEVICE)
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Quick Reference Guides
Freestyle Libre: Preparing for your appointment
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For Caregivers: Stay connected to the patients CGM by using LibreLinkUp (LibreLinkUp)
Upload My Insulin Pump
Why do I need to upload my insulin pump?
Uploading your pump at home allows our providers to view your insulin pump data and make informed decisions about how to change your insulin delivery.
This is especially important for our scheduled telemedicine (video) visits which we recommend to provide more frequent monitoring in order to improve blood glucose control.
How often do I upload my insulin pump?
It is important to upload your insulin pump the day prior to your scheduled telemedicine (video) visit.
How do I upload my insulin pump?
Please follows the instructions that correlate with your TYPE of insulin pump.
TANDEM
t:slim X2 insulin pump
1) Create an account
If you are new to using your t:slim X2 pump you will need to create what is called a t:connect account.
In order to create an account click on the link below and then click "GET STARTED" in the upper right hand corner.
t:connect Diabetes Management Software - Learn More Today!
Once you have created a t:connect account see the next step
2) Upload your t:slim X2 insulin pump
Follow the link below for instructions on how to install t:connect and upload your t:slim X2 insulin pump. Install/Upload for t:connect
(If you have uploaded your tandem before- t:connect should be available on your desktop for PC users. For Mac computers, type t:connect in your search feature and the application will appear, click on it to open)
3) Still have questions about your Tandem t:slim X2 insulin pump?
Please call Tandem 24 hour Technical support team at (877) 801-6901
MEDTRONIC
1) Create an account.
If you are new to using Medtronic insulin pump you will need to create what is called a CareLink Personal account.
In order to create an account click on the link below and then click "sign up now"
http://medtronicdiabetes.com/carelink
Once you have created an account then go to the next step
2) Upload your Medtronic pump
Now that you have created an account you can follow the link below and sign in and click "upload data from my device" and then Minimed insulin pump
http://medtronicdiabetes.com/carelink
3) Quick Reference Guides
These links summarize the process for creating a CareLink personal account and uploading your Medtronic insulin pump data
Medtronic 670G:
MINIMED® 670G SYSTEM | CARELINK® PERSONAL SOFTWARE QUICK REFERENCE GUIDE
Medtronic 630G or 500 series or older:
Medtronic CareLink-Personal 530G or older pumps.pdf
4) Still have questions about your Medtronic insulin pump?
Please call Medtronic 24 hour helpline at 1-800-646-4633
OMNIPOD
1) Create an account
If you are new to using your Omnipod insulin pump you will need to create a Glooko account. To create an account click on this link:
Underneath sign in you will see a prompt that says "Don’t have an account? Sign up for Glooko HERE" (click on HERE to create an account) You will be prompted to enter a "proconnect code" to share with our clinic
PROCONNECT CODE : CAPITOLENDO (this allows your data to be shared with our clinic)
Please note: If your provider has already uploaded your current Omnipod at least once before you already have an account (If you can't remember your login credentials call Glooko support at 1-800-206-6601)
2) Install Glooko uploader
Now that you have a Glooko account log in My Glooko Sign in
Under settings in top right, scroll down to Get Glooko Uploader
Choose MAC or PC, open the file, follow the prompts
Restart your computer to compete installation
3) Upload your insulin pump
Now that you have installed the Glooko uploader, open this on your desktop and sign in
Plug in your Omnipod PDM into your computer and begin upload
Of note: If you entered the proconnect code when you created a Glooko account, your data will automatically be shared with our clinic once you upload.
Omnipod Classic Glooko for Classic OmniPod (2).pdf
Omnipod DASH Glooko for DASH (1).pdf
5) Still have questions about your Omnipod insulin pump?
Please call Omnipod 24 hour customer care team at 1-800-591-3455