CGM Category Update:
Clinical Outcomes, New Technologies, and Therapeutic Dosing
with Andrew J. Ahmann, MD; Viral Shah, MD and Lori M. Laffel, MD, MPH

INTENDED AUDIENCE

Diabetologists, Endocrinologists, Primary Care Physicians, Nurse Practitioners, Pharmacists, Certified Diabetes Educators and other Health Care Professionals interested in the management of diabetes attending the American Diabetes Association's 78th Scientific Sessions.

STATEMENT OF NEED

Self-monitoring of blood glucose (SMBG) is a core component of a diabetic patient's management but only provides a measurement of blood glucose levels at a specific point in time, often missing trends, hyperglycemic or hypoglycemic excursions. HbA1c is even more limited and reports an average reading over 90 days; therefore incapable of alerting the patient of fluctuations in blood glucose at any point in time.

Selection of an appropriate Continuous Glucose Monitoring (CGM) device is important because improvements in accuracy and reliability are ongoing. RT-CGM is one cornerstone of optimal glycemic control. Each varies; relying on different sensing technology and requiring the traditional finger-stick for confirmation of alerts. The Mean Absolute Relative Difference (MARD) between sensor readings and reference glucose levels can vary by as much as 20% with worrisome discrepancies in the hypoglycemic range. But new generation devices have significantly improved MARD measurements. These devices have shorter lag times and improvements in accuracy. Many physicians are lacking the appropriate level of knowledge to employ CGM as part of their practices.

Significant improvements in accuracy of CGM sensors and device algorithms have made CGM-based treatment decisions a current reality. This program will evaluate the clinical application of CGM in diabetes management decisions and the importance of various aspects of CGM to guide optimal treatment, regardless of insulin mode of administration.

EDUCATIONAL OBJECTIVES

At the conclusion of this activity, participants should be better able to:

  1. Recognize the role of CGM and its clinical benefit for patients using multiple daily injections.
  2. Employ real-time insulin dosing methods using CGM information to make more informed diabetes management decisions.
  3. Identify therapeutic CGM as a unique category, defined by Medicare, as CGM that does not require fingersticks to confirm diabetes management decisions; review the clinical study that proves CGM dosing is safe and efficacious.

ACCREDITATION AND CERTIFICATION

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Evolve Medical Education LLC and CogniMed Inc. Evolve Medical Education LLC is accredited by the ACCME to provide continuing medical education for physicians.

Evolve Medical Education LLC designates this enduring material for a maximum of 2.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The University of South Carolina College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education (CPE). The Universal Activity Number (UAN) for this activity is 0062-9999-18-159-H01-P. The activity is accredited for 2.0 contact hours (0.2 CEUs). The initial release date for this activity is August 13, 2018, and the expiration date is August 13, 2019.

Upon completion of the requirements for this activity (completing the pretest, viewing the webcast and successfully passing the posttest), you will be provided instructions to complete a pharmacist-specific evaluation via the University of South Carolina College of Pharmacy's platform, providing your NABP e-Profile ID and month/day of birth. Upon completion of the evaluation, your continuing pharmacy education credit will be automatically submitted to the NABP CPE Monitor. From the NABP CPE Monitor, you may view your transcripts and print an official statement of ACPE credit. This process must be completed within 60 days of the date of program completion for credit to be submitted to the NABP CPE Monitor.

CONTENT REVIEW STATEMENT

To resolve identified/potential conflicts of interest, the educational content was fully reviewed by a physician member of the Evolve Medical Education LLC Clinical Content Review Committee who have no financial relationships with commercial interests. The resulting certified activity was found to provide educational content that is current, evidence based, and commercially balanced.

DISCLOSURE STATEMENTS

It is the policy of Evolve Medical Education, LLC to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All faculty participating in sponsored programs are expected to identify and reference off-label product use and disclose any significant relationships with those supporting the activity or any others whose products or services are discussed. The faculty for this activity have disclosed that there will not be discussion about the use of products for non-FDA-approved indications. In accordance with the Accreditation Council for Continuing Medical Education standards, parallel documents from other accrediting bodies, and Evolve Medical Education LLC policy, the following disclosures have been made:

It is the policy of the University of South Carolina College of Pharmacy that faculty and other individuals who are in the position to control the content of this activity disclose any real or apparent conflict of interests relating to the topics of this educational activity. The University of South Carolina College of Pharmacy has full policies in place that will identify and resolve all conflicts of interest prior to this educational activity.

Evolve Medical Education LLC Staff
Erin Fletcher has nothing to disclose.

University of South Carolina College of Pharmacy Staff
Caitlin Mardis, PharmD, has nothing to disclose.

CogniMed Inc. Staff
Jeffrey Rosenberg has nothing to disclose.

Chair
Andrew J. Ahmann, MD, received Grant/Research support from Dexcom, and Medtronic. He is a Dexcom, Lilly, Mannkind, NovoNordisk, and Sanofi US Advisory Board/Speaker's Bureau/Consultant.

Faculty
Viral Shah, MD, received Grant/Research support for Dexcom, the Jaeb Center for Health Research, EyeNuk, and Sanofi US. He is an Advisory Board/Speaker's Bureau/Consultant for Dexcom and Sanofi US.

Lori M. Laffel, MD, MPH, is an Advisory Board/Speaker's Bureau/Consultant for AstraZeneca, Boehringer Ingelheim, Dexcom, Eli Lilly, Johnson & Johnson, MannKind, Menarini, Novo Nordisk, Roche, and Sanofi.

Jointly provided by CogniMed Inc. and Evolve Medical Education LLC.

This activity is supported by an independent educational grant provided by Dexcom.

© 2018 CogniMed Inc. All rights reserved.

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