Long gone are boiling urine samples and glass syringes full of insulin – new technologies have elevated diabetes management into the realm of continuous glucose monitoring (CGM), automated insulin pumps and smartphones.
In just the past year, the FDA approved a mobile app, an artificial intelligence-based treatment decision tool and the first interoperable insulin pump, among other technologies.
“Diabetes tech is an evolving area that is expanding rapidly,” said Shichun Bao, M.D., Diabetes Technology Program Leader at Vanderbilt University Medical Center. “As providers, we have to stay on top of it to help our patients. We’ve created a structured program to help keep everyone up to date.”
Training Providers
Bao helped launch the Vanderbilt Diabetes Technology Program (VDTP) in 2017. The dedicated clinic hosts in-services, webinars and on-site seminars that introduce new tech to providers and clinical staff. It also offers a three-month rotation for fellows.
“We train physicians, nurse practitioners, diabetes educators—everyone involved—to make sure they understand these new technologies and can guide patients.”
“The main component is education. We train physicians, nurse practitioners, diabetes educators—everyone involved—to make sure they understand these new technologies and can guide patients,” Bao said.
A VDTP newsletter helps granular details reach providers—how the Guardian link 3 CGM and transmitter now work with Medtronic’s 630G pump, for example—and how to bill for data interpretation. Bao also tucks in app screenshots, links to patient discount coupons and summaries of the latest research and FDA approvals in each edition.
Diabetes providers and educators can also field test devices through the VDTP. Bao wears CGMs and insulin pumps (filled with saline) and reports back to the team. “I always try to wear the new devices, to have a real sense of how they feel and work, and to understand the patient perspective.”
Connecting Patients and Technology
The primary goal of the VDTP is to connect patients with the right product. This includes not only helping patients choose devices (like CGMs and pumps), but setting up data management and device connectivity (sharing data remotely). Many devices are tailored to meet individual patient needs—such as sending results to practice parents’ smartphones, or to telemedicine providers.
VDTP providers monitor patients’ glucose and pump data remotely between clinic visits when needed, and communicate with patients promptly about insulin adjustments.
Patient education occurs through Diabetes Self-Management Education (DSME) services, recognized by the American Diabetes Association. “We offer one-on-one sessions and group classes for patients. The offerings meet national standards, and have a 94 percent satisfaction rate,” said Elaine Boswell King, M.S.N., quality coordinator of DSME services at Vanderbilt.
The classes provide an opportunity for patients to explore the full range of tech options, said Brenda Weedman, R.N., lead certified diabetes educator in the VDTP. “In the classes patients get to see the actual products, not just pictures. We help them select a product that matches their lifestyle, and get familiar with how to use it.” Diabetes educators also follow up with patients to troubleshoot device use and help navigate the ordering process.
Supporting Continued Growth
Bao anticipates continued growth for the VDTP to help patients navigate their options. “Diabetes tech is booming. It’s going to continue. Companies constantly emerge with new devices that are easier to use, smaller and more comfortable to wear.”
New technologies could translate into improved diabetes management, but only with proper education for both providers and patients.
“I’ve seen the frustration patients have, and how the technology can help them,” Bao said. “We are doing our part to help everyone get trained and comfortable with these new products.”