Primary care digital innovations in type 1 diabetes


Sally Humphrey, DNP, APRN, CPNP-PC, discusses current technology to treat youth with diabetes. Humphrey highlights continuous glucose monitoring systems (CGMs) and how they have evolved and improved.


Sally Humphrey, DNP, APRN, CPNP-PC:

Hi, I'm Sally Humphrey, I am an assistant professor at the University of Tennessee Health Sciences Center. I am the coordinator for the Primary Care Pediatric Nurse Practitioner program. My clinical background is in pediatric endocrinology, and specifically diabetes.

Contemporary Pediatrics:

Can you tell us about your session, "Digital Innovations in Type 1 Diabetes Treatment: Empowering Primary Care Providers," presented at NAPNAP 2024?


Over the last decade or so, the treatment modality has really changed a lot, for type 1 diabetes, specifically in technology. There have been great leaps in the technology that we use for treating type 1 diabetes and sometimes it's moving at such a rapid pace that primary care providers are a little confused on what technology is out there. So this presentation was specifically meant to address primary care providers and give them an update on where we are with technology, I focused on the most commonly used continuous glucose monitoring systems or CGMs systems. Those are sensors that are used to read blood sugar every 5 minutes. There are 2 or 3 that are most commonly seen that with our type 1 diabetic population here in the United States. I also focused on some of the insulin pump systems that are most commonly seen as well. Right now, we even in the last 3 or 4 years have seen some big strides. We have pumps that I like to call smart pumps, that connect with the sensors to automate some of the insulin delivery. We're focusing on that technology and the basics of how it works, not really getting into the weeds of all the specifics on how, but but the basics of how it works. Then also looking at some of the reports that those technologies generate, that can give a little insight into how the patients are controlling their diabetes and what issues might be there.

Contemporary Pediatrics:

What are some of the benefits of a CGM system?


Benefits for the patients are ease of use and also these technologies do improve their glycemic control, so we're seeing more and more patients with type 1 diabetes wearing these. Specifically, the sensors, really do improve quality of life for these patients, because it cuts down on the finger sticks that they have to do it also. They also alert for high blood sugars and low blood sugars and there are lots of safety features that are just very beneficial for the patients.

Contemporary Pediatrics:

What can the primary care provider tell parents who are curious about CGMs?


Parents overwhelmingly love these systems. The sensors provide a safety net, so they will alarm for low blood sugars, and high blood sugars but it's usually the low blood sugars that our parents are most concerned about, especially overnight so those alarm features are very beneficial. A lot of these smart pump systems will actually cut the insulin delivery off as they are going low, and then turn it back on automatically as the blood sugar is correcting. So again, that's another level of a safety net there that parents really, really have a sense of relief about. Overall it does improve glycemic control, we see that patients that are on these systems have higher percentage of what we call in target range, where they're spending more of their time in a in a more acceptable blood sugar range as opposed to having a lot of lows or a lot of highs. So there's a big learning curve and some parents and families are a little hesitant about that at first, but generally when patients are transitioned to a pump or a sensor, there's lots of education that goes along with it and support from the specialists from the endocrinologist side. Once they once they get past that big learning curve, it really does improve their quality of life and make day to day living easier. They will have a sensor and a pump on but all patients can play sports, be in the classroom setting. They may have Some beeping going on they usually can, mute that or put it on a vibrate setting, but school nurses are becoming more and more familiar with these and have a lot of experience dealing with it so they are really able to do anything they want to.

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