2. Agenda
Sensors - wearable pieces of technology that detect
sugar levels
Insulin pumps +sensors = “artificial pancreas” or closed
loop systems
Technology on the horizon
3. Glucose Monitoring
1. Continuous Glucose Monitoring System:
Continual display of blood glucose, alerts user of high/low blood sugars.
Rapid ascent/descent
Pros: Use when patient has severe hypoglycemia, integrates with pumps
Con: Can’t turn off completely alarms
2. Flash Glucose Monitoring System
Requires scanner to be moved over the sensor for information to be
downloaded
Pros: Easier insertion, flatter, no alarms
Cons: Can’t integrate with pumps, no alarms
4.
5.
6. Dexcom G6
•No calibration
•10 days with a hard stop
•new “Urgent low soon” alert that can be set (on
the mobile app and/or receiver) to warn that
blood sugar is dropping 20 minutes in advance of
a 55 mg/dL.
7. Freestyle Libre 14-day sensor is $35.99, and each reader device
(one time purchase) is $69.99
8.
9.
10.
11.
12.
13.
14. Prior Authorization requirements for Medicare
is Variable
In general checking sugars (BG logs, attestation)
4 times a day X 4 weeks
19. Medtronic 670 closed loop pump
1. Auto mode: sensor works with pump to modulate basal.
Patient only enters in carbohydrates he/she plans to eat
The pump calculates bolus amount and modules basal
Cons: calibrates twice daily sensor, can require more calibrations
2. Safety mode: pump shuts off basal only if sugars are low
3. Manual mode: patient needs to fully operate the pump
Never remove the sensor if possible
25. Take away points
Sensors are allowed in the hospital but do not replace hospital
BG readings – clinical decision making by hospital BGs only
Sensors are increasingly common; try not to take them off
during the hospitalization
MRIs; infusion set is plastic and usually stays in.
However CGMS sensor and transmitters need to be removed
For pump and sensor malfunctions, patients usually call the toll
free number to be walked through a diagnostic
