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Diabetes Technology

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106 Commerce Street, Suite 105 Lake Mary, FL 32746 TEL: 407.878.7606 • FAX: 407.878.7611 For additional copies, order at GuidelineCentral.com Copyright © 2016 All rights reserved ESDMTECH16123a Disclaimer is Guideline attempts to define principles of practice that should produce high-quality patient care. It is applicable to specialists, primary care, and providers at all levels. is Guideline should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. e ultimate judgment concerning the propriety of any course of conduct must be made by the clinician aer consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors endorse any product or service associated with the distributor of this clinical reference tool. Abbreviations CGM, continuous glucose monitoring ; CSII, continuous subcutaneous insulin infusion; DKA, diabetic ketoacidosis; HCP, health care professional; MDI, multiple daily injections; RT-CGM, real-time CGM; SMBG, self-monitoring blood glucose; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus Source Peters AL, Ahmann AJ, Battelino T, Evert A, Hirsch IB, Murad MH, Winter WE, Wolpert H. Diabetes Technolog y-Continuous Subcutaneous Insulin Infusion erapy and Continuous Glucose Monitoring in Adults: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016 Nov;101(11):3922-3937. Table 3. Suggested Health Care Provider Resources to Support the Safe and Effective Use of CSII and RT-CGM Clinicians should implement a formalized educational plan for the initiation and long-term support of CSII and RT-CGM that is established by the practice setting. Clinicians should communicate education plans to potential candidates and individuals new to the practice setting. Clinics should have a designated multidisciplinary diabetes team to evaluate potential candidates, initiate therapy and education, and to support long-term CSII and RT-CGM use that is part of the practice setting. Alternatively, a sole practitioner may also provide medical care and CSII education supported by other healthcare professionals or industry consultants as indicated. CSII and RT-CGM diabetes care team members could include the following health care providers: endocrinologist, advanced practice registered nurse, physician's assistant, primary care provider, certified diabetes educator, registered dietitian with expertise in diabetes medical nutrition therapy, and mental health/behavioral therapists. e clinical support staff or patient should know how to download data from glucose meters, insulin pumps, and RT-CGMs, and they should download data before an appointment in order to review data via print format, online secure patient pump portal, or the patient's electronic health record. Designated staff members (diabetes educators, medical assistants, or patient service representatives) should be available to help clinics obtain prior authorizations, schedule peer- to-peer reviews, submit supporting documents for determining coverage, answer insurance and distributor/third party vendor queries for additional documentation, and issue letters of support and/or appeal if therapy is declined.

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