Part A: A Closer Look into the Importance of the Role of the Diabetes Care and Education Specialist to Minimize Glucose Variability in Patients on Longer-acting Insulins
2) We are honored to have 2 pharmacists and 1 nutritionist guide us through the complex and vitally important topic, which was addressed from the physician perspective by @RpratleyMD (still available for CE/#CME credit at https://t.co/V7rpesToxp).
— cardio-met (@cardiomet_CE) December 5, 2022
4) Accreditation statement & author disclosures are at https://t.co/gvXca4GHMU. This 3-part program is supported by an educational grant from Sanofi and is intended for healthcare professionals. Follow this 3-day 🧵to earn up to 0.75h CE/#CME credit 🇺🇸🇨🇦🇬🇧🇪🇺
— cardio-met (@cardiomet_CE) December 5, 2022
5b) Her topic is "A Closer Look into the Importance of the Role of the Diabetes Care and Education Specialist to Minimize Glucose Variability in Patients on Longer-acting Insulins.”
— cardio-met (@cardiomet_CE) December 5, 2022
7) Let’s start by talking about the current state of #diabetes. Did you know that 11.3% of the US population live with diabetes, that’s 37.3 million and means 1 in every 9 people has diabetes! pic.twitter.com/qbBBiSTyKh
— cardio-met (@cardiomet_CE) December 5, 2022
9) Although #A1C has long been the gold standard, there are many limitations. It’s based on the half-life of red blood cells, so we can only check it every 3 months. It’s also just an average, meaning a person could have a lot of highs and lows, but still an A1C at target. pic.twitter.com/AyXs4TGSQ1
— cardio-met (@cardiomet_CE) December 5, 2022
11) #CGM provides a lot of data, which brings us to time in range. This is the percentage of time spent between 70-180mg/dL. The goal for most people is >70% which correlates well with an #A1C of 7%. There are also goals for time above range and time below range. pic.twitter.com/5k1OQvS7Sh
— cardio-met (@cardiomet_CE) December 5, 2022
13) The correct answer is C. The coefficient of variation is a measure of #glycemic variability. A CV<36% indicates stable #glucose levels. A high CV looks like a rollercoaster. 🎢 pic.twitter.com/B6uhqW6lhq
— cardio-met (@cardiomet_CE) December 5, 2022
15) Increased glucose variability is associated with increased risk of #hypoglycemia, microvascular and macrovascular complications and even mortality. See this review on GV and impact on #cardiovascular outcomes. 🔓https://t.co/S7YG3Rabsz pic.twitter.com/czQWRsLx5r
— cardio-met (@cardiomet_CE) December 5, 2022
17) Using #CGM and achieving the time in range targets can help to reduce glycemic variability. The target is >70% for most people with #T1D or #T2D. However, those with more comorbidities or higher risk of #hypoglycemia and alternate goal of >50% is acceptable. pic.twitter.com/wnP5y6mCR1
— cardio-met (@cardiomet_CE) December 5, 2022
19a) Time for another Poll Question: A coefficient of variation of 40% indicates what?
— cardio-met (@cardiomet_CE) December 5, 2022
A. Elevated estimated A1C
B. High glucose variability (correct answer)
C. Stable glucose variability
D. Clinically significant hypoglycemia
20) How can the diabetes care and education specialize utilize this data to help the person with #diabetes? Introducing the #DATAA model! pic.twitter.com/InwAsd7jzN
— cardio-met (@cardiomet_CE) December 5, 2022
22) Next focus on what’s working well and try to replicate. Look at a time of day or a day of the week where time in range is highest and discuss behaviors that contributed to it. pic.twitter.com/uVIAo8j7Qr
— cardio-met (@cardiomet_CE) December 5, 2022
23b) And remember this is just information, none is inherently good or bad. #languagematters pic.twitter.com/9kyIAo6YIk
— cardio-met (@cardiomet_CE) December 5, 2022
25) Let’s Recap: #CGM is a valuable tool to assess time in range and glycemic variability especially since there are 42 factors that affect glucose levels! The #DCES can play a pivotal role in introducing CGM to #PWD and helping to review the #DATAA. pic.twitter.com/SngEtszqgC
— cardio-met (@cardiomet_CE) December 5, 2022
26) Thank you for following along. To claim 0.25h CE/#CME credit, go to https://t.co/DzsKJQIg57. I am @dianamisaacs and COME BACK TOMORROW for Part 2 of this series, from @KOBPharmD!#MedTwitter #TwitteRx #primarycare #EndoTwitter #Diabetescare
— cardio-met (@cardiomet_CE) December 5, 2022