Pharmacy U Toronto presenter Susie Jin: ‘Glucose monitoring technology is evolving . . . so should we.’

Susie Jin will be presenting at Pharmacy U Toronto on April 13, 2024.Glucose monitoring, through capillary blood glucose (CBG) checks (formerly known as self-monitoring of blood glucose), has traditionally been primarily available through the community pharmacy. However, in 2016, a Canadian Agency for Drugs and Technology in Health (CADTH) review (1) found that for people not using insulin, CGB reduced A1C levels by just 0.25%, which is not a clinically significant result and does not translate into improved quality of life, nor improved health outcomes (1). As a result of this CADTH report, it was concluded that CBG monitoring was not cost-effective and across Canada, all provinces and territories imposed over-arching restrictions in access to CBG for non-insulin users.Today, glucose monitoring, in the form of continuous glucose monitoring (CGM), continues to evolve. As CGM technology advances, so does the evidence demonstrating the utility of CGM. We now have conclusive studies that show that CGM technology offers more that glucose monitoring, but rather, CGM can be used as an intervention to improve glycemic metrics including increasing Time In Range, decreasing hypoglycemia, improving quality of life, amongst many other identified benefits (2).CGM sensors are more and more primarily being available through community pharmacies. It behooves our profession to support people with diabetes, and our communities at large, to ensure that the RIGHT glucose monitoring technology is available for the RIGHT person. When CGM is indicated, and provided the person is willing to use the data from CGM, CGM SHOULD be used to support the person to improve their clinical outcomes. With pharmacists being the primary providers of this glucose sensing technology, we MUST endeavour to avoid the same mistakes of the past. We must be actively involved in supporting people to whom we are dispensing glucose monitoring technologies to ensure appropriate, individualized, needs-based glucose monitoring. This involves:Identifying who would benefit from CGMStarting appropriate, individualized, needs-based CGM in the RIGHT personTimely (individualized) follow up with communication with and/or referral to diabetes team members when neededWhen a person is using existing CGM technology, engage the person in conversations to ensure the CGM technology is optimized for that person, i.e. Is the person at their individualized A1C target and meeting glycemic metrics? Is the person experiencing hypoglycemia?REFERENCES:https://www.cadth.ca/sites/default/files/pdf/CADTH_Infographicv_eng_final.pdfCheng AYY, Feig DS, Ho J, Siemens R, et al. Special Article: Blood Glucose Monitoring in Adults and Children with Diabetes: Update 2021. Can J Diabetes 2021;45:580-587.Susie Jin will be presenting at Pharmacy U Toronto on April 13, 2024.

Pharmacy U Toronto presenter Susie Jin: ‘Glucose monitoring technology is evolving . . . so should we.’

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