In this week’s review of telemedicine studies, you’ll discover the benefits of remote continuous glucose monitoring (CGM). CGM is considered the gold standard for monitoring glucose levels, and is improving diabetes management by offering real-time insights into blood glucose levels. This article provides data on diabetes, and will help you understand CGM, and summarize a recent study on its implementation in senior adults living with diabetes.
Understanding Diabetes and Continuous Glucose Monitoring
Diabetes is a chronic condition affecting 38 million Americans. According to the World Health Organization, approximately 422 million people are living with diabetes globally. A significant number of these individuals rely on insulin therapy. Proper management of blood glucose levels is crucial in preventing complications associated with diabetes, such as cardiovascular disease, neuropathy, and retinopathy.
What is Continuous Glucose Monitoring?
Continuous glucose monitoring is a technology that allows individuals with diabetes to track their blood glucose levels continuously throughout the day and night. Unlike traditional finger-prick tests, which provide a single glucose reading, CGM systems use a small sensor inserted under the skin to measure glucose levels in interstitial fluid every few minutes. This data is transmitted to a receiver or smartphone app, providing real-time glucose readings, trends, and alerts.
Benefits of Remote Glucose Monitoring
Remote glucose monitoring offers numerous benefits for patients, including:
- Improved Glucose Control: Continuous data enables better detection of glucose trends and patterns, enabling timely interventions to maintain optimal glucose levels.
- Reduced Hypoglycemia: Alerts for high and low glucose levels help prevent dangerous hypoglycemic events.
- Enhanced Quality of Life: Real-time monitoring reduces the need for frequent finger-prick tests, decreasing the burden of diabetes management.
- Convenience and Accessibility: Remote monitoring and virtual education platforms make CGM accessible to a broader range of patients, including those in remote areas or with mobility issues.
Study Summary in Continuous Glucose Monitoring
A recent study published in Diabetes explored the remote initiation of continuous glucose monitoring in senior adults with diabetes who use insulin. The study aimed to assess this population’s benefits and challenges of starting CGM remotely.
Study Details and Findings
The study involved 24 adults (mean age 72 years) with a long history of diabetes (average duration 30 years). Most participants were new to CGM and on multiple daily insulin injections.
Key findings of the study include:
- Positive Reception: All participants rated remote education and the overall value of CGM favorably. Remote education was praised for its convenience and ease of scheduling. Importantly, 100% of participants found the remote education effective.
- Successful Implementation: All participants successfully initiated and maintained CGM use with remote assistance. A significant data point is that 95% planned to continue using CGM after the study.
- Challenges Encountered: Some challenges included difficulties with mobile applications (33%), annoyance with alarms (50%), and concerns about Medicare coverage (42%).
Does Medicare Cover CGM?
The Centers for Medicare and Medicaid recognize the benefits of continuous glucose monitoring in managing diabetes. Under the Durable Medical Equipment (DME) benefit, Medicare provides coverage for both adjunctive and non-adjunctive CGMs. Non-adjunctive CGMs, like the Dexcom G7, can be used for treatment decisions without the need for confirmation from a traditional blood glucose monitor. For a CGM to be covered, it must be classified as DME, meaning it should have a stand-alone receiver or be integrated into an insulin infusion pump.
Medicare also covers the supply allowance for continuous glucose monitoring systems, which includes sensors and transmitters. However, CGMs that display results solely on non-DME devices, such as smartphones, are not covered. Additionally, to be eligible for Medicare reimbursement, CGM devices must undergo a coding verification review by the Pricing, Data Analysis, and Coding contractor and be listed on the Product Classification List (PCL) for their respective Healthcare Common Procedure Systems codes.
Understanding The Benefits of Continous Glucose Monitoring
The study demonstrates that remote initiation of CGM in older adults is feasible and well-received, despite some challenges. The positive outcomes highlight the potential of remote glucose monitoring to enhance diabetes management in older populations, offering improved glucose control and convenience.
The benefits of remote glucose monitoring are evident in both improved health outcomes and patient satisfaction. As telemedicine continues to evolve, technologies like CGM will be crucial in managing chronic conditions like diabetes, making healthcare more accessible and effective for all.
