As a registered nurse, identifying the discoveries that have brought opportunities for fuller, healthier lives to so many could be a full-time job. During my career the synergy of medical science and computer science has created amazing advances in management of chronic illness that goes beyond treatment to alleviating much of the burden many diseases present to daily life. One such advancement is in diabetes technologies, offering tremendous improvements in the management of the disease.
Continuous Glucose Monitors, CGMs, offer a real-time, accurate look at blood sugar levels as they are happening. The obvious benefits to accurate monitoring over best-guess are clear, as are the lifestyle and medical maintenance improvements. Unmanaged diabetes outcomes include kidney and heart disease, blindness, and amputations, meaning the
management of blood glucose is also a cost-savings in overall health care. The American Diabetes Association estimates $106 billion to be the total estimated national cost of diabetes that can be attributed to lost productivity at work, unemployment from chronic disability, and premature mortality. Those outcomes illustrate why CGMs have become the standard of care for people with diabetes on insulin. For children, CGMs can be tied to a parent’s phone through an app or monitored by the school nurse, allowing them to see in real time how the child is doing and take corrective action to prevent dangerous situations.
Before CGMs, individuals with diabetes were required to have multiple finger sticks to extract blood droplets in order to test their blood sugar levels. The physical downside was the discomfort of the finger sticks, with multiple sticks a day eventually the fingertips get sore, and sites are hard to find. This was especially hard on children.
Children with diabetes had to leave their classroom multiple times a day, every day, for finger sticks to measure their blood glucose levels. Not to mention live with the risk of dangerously unstable insulin levels for something as minor as an overly active recess following a lighter than usual lunch. Parents were tasked with the lifestyle necessity of keeping supplies on hand, at all times, while at school, home, or other activities.
A finger stick only provides a quick snapshot of the blood sugar levels at that point. Unfortunately, that isn’t how the body works. Blood sugar can spike or fall without much notice, leaving folks to use their best guess as to their actual levels. Many may recall the iconic scene from the movie “Steel Magnolias,” when Julia Roberts, while getting her hair done for her wedding, suddenly goes from happily discussing the celebration to slumping over in the chair, unable to talk or control her body. Now imagine a 7-year-old with diabetes coming in from a hot day on the playground and having that type of reaction.
However, there remain obstacles to providing this proven technology to those who need it most. Studies have shown that poorer and older Americans, as well as Black, Native American and those on Medicaid (AHCCCS in Arizona) have the hardest time accessing these devices. The needed changes are as simple as accessing CGMs through the closest most accessible health care provider, the local pharmacist, instead of the need to rely on shipments from medical equipment providers which can cause delays and disruption in care. Also, recognizing that the choice of the right CGM for a patient should be determined by the patient’s physician, based on what best meets the patient’s needs and their life circumstances.
Twenty-five years into the use and development of diabetes maintenance with CGMs, proven to decrease overall costs and increase standard of living, it is time for these barriers to be removed. Implementing AHCCCS rules that allow individuals, adults and children alike, to receive actual 21
st century heath care through the provision of CGMs would increase the health of Arizonans and be fiscally responsible.
Lisa Alexander is president of School Nurses Association of Arizona. Copyright © 2024 BridgeTower Media. All Rights Reserved.
Most Popular
Comments / 0