Utilizing CGMs for Diabetes Management in COVID-19

Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES: CGMs [continuous glucose monitors] have been instrumental during the COVID-19 pandemic. We’ve all had to pivot to virtual care. We were fortunate. At Cleveland Clinic, we were doing virtual visits long before the pandemic, but we do it much more frequently now than we ever did before. What’s nice about a CGM is that the data with most of these devices are Bluetooth connected, so it’s going into a portal that can be viewed basically instantly to see how someone is doing. Even the data that aren’t automatically going into a portal have the capability to be plugged in and downloaded. In terms of virtual care, we’re able to view those data. It’s a lot more informative than if we only had an A1C [glycated hemoglobin] value.

One of the unique things about a CGM is that we have all these different CGM key metrics. In addition to time in range, we have the glucose management indicator [GMI]. That’s essentially an estimated A1C. I’m able to use that to track how someone is doing and see if they’re meeting their treatment targets. During COVID-19, that’s been very helpful, because a lot of people don’t want to come in. They don’t want to go to the laboratory. I have people who haven’t been to the laboratory in a long time, but I still have a very good objective assessment of how they’re doing. In fact, there’s a lot of movement to see if GMI and time in range could overtake A1C or at least be supplemented with A1C so we’re not relying on this 1 metric every 3 months for evaluating diabetes care.

Transcript Edited for Clarity