On this episode of Danatech Talks–a special series from The Huddle–Katrina Flaskerud, MS, RDN, LD, CDCES outlines some of the fundamentals of diabetes technology. Katrina provides a foundational overview of all of the devices out there today and how they differ from each other, how to have conversations with clients about what diabetes technology options may be best for them, and how diabetes care and education specialists and other health care professionals who are less familiar with diabetes technology can get started and learn more. This episode was supported by educational grant funding from Abbott. Explore the latest in diabetes technology as well as trainings and resources on danatech: danatech l Diabetes Technology Education for Healthcare Professionals
On this episode of Danatech Talks–a special series from The Huddle–Katrina Flaskerud, MS, RDN, LD, CDCES outlines some of the fundamentals of diabetes technology. Katrina provides a foundational overview of all of the devices out there today and how they differ from each other, how to have conversations with clients about what diabetes technology options may be best for them, and how diabetes care and education specialists and other health care professionals who are less familiar with diabetes technology can get started and learn more.
This episode was supported by educational grant funding from Abbott.
Explore the latest in diabetes technology as well as trainings and resources on danatech: danatech l Diabetes Technology Education for Healthcare Professionals
Dana Moreau
Welcome to Danatech Talks, a special series from ADCES's The Huddle, Conversations with the diabetes care team. I'm Dana Moreau of Danatech, and in this series, we're going to dive into the latest in diabetes technology, bringing you expert insights, clinical strategies, and the innovations that are shaping patient care. So whether you're new to diabetes tech or looking for the next level of expertise, Danatech Talks is your source for real-world knowledge. Today's episode is made possible thanks to an educational grant from Abbott. Thanks, Abbott.
Today we're going back to the basics and we're joined by Katrina Flaskerud, MS, RDN, LD, CDCES. Katrina is going to give us a high level but foundational overview of diabetes technology and what kinds of devices are out there today.
Katrina, welcome to the Huddle!
Katrina Flaskerud
Thank you for having me today.
Dana
We're going to start where we almost always start, and we'd love for you to give us a little bit of background on who you are, what you do, and really anything else you think would be interesting or valuable to the audience.
Katrina’
I am a registered dietitian and diabetes care and education specialist. I work with diabetes technology on a daily basis and because of that technology is really important to me. I think it's a great tool for helping empower patients in their diabetes self-management and that's why I'm so excited to discuss this topic today based on my own personal perspective and experience.
Dana
We haven't talked to you before and we're always very excited to have a new guest with a fresh perspective. So again, today we're talking about the basics, so we're going to take a few steps back. When we say the basics of diabetes technology, where do you think that a health care professional who is new to this space should begin? What is their starting point?
Katrina
Ooh, such a good question. There are so many varieties of types of diabetes technology available on the market at this point. I think a good place to start when we think about the basics of diabetes technology is just to learn about the different categories of the different devices that are available to persons with diabetes and just in general how each of those different types of devices work.
Dana
Yeah, clearly there's a lot of options out there and sometimes they can be overwhelming. So when you start to look at the technology that's available, do you think that there's maybe like a gateway technology that's an easier entry point for people who are looking to become more knowledgeable on the topic as a whole?
Katrina
I think continuous glucose monitors are a great place to start, both for the provider, but also the patient with diabetes as well. It can provide more insight into how a patient's medication regimen and their lifestyle choices are impacting their diabetes. And I think it's a great place when you're looking into learning more about technology. I feel like this is also a great next step because many patients are monitoring their glucose levels with finger pokes. This can be a piece of technology that can apply to many different types of patients.
Dana
One of the things we’ve talked about, and we hear this a lot from the clinicians we've talked to in the past, is the concept and the idea of time, and really lack of time. You only have so much time to spend with a patient, and sometimes there's a concern that if you or I am dealing with this technology, I'm going to have to spend more time than I have allotted. What do you think the simplest way to introduce technology is in a short period of time and without overwhelming anyone and everyone involved?
Katrina
That is a really, really good question. It is challenging. I think one of the best places to start is comparing it to technology that a patient is already familiar with. So that way you kind of have that base knowledge and that starting point. And then you can talk about with this new piece of technology, what are the potential advantages and disadvantages of incorporating that piece of technology? So for example, when we think of the continuous glucose monitor, we can talk about how is that different from doing the finger pokes and the blood glucose monitoring and then what are the advantages of switching over to a continuous glucose monitor.
Dana
Yeah, I know that's so important because there's still a lot of people who think this is going to be overly cumbersome. But honestly, once you get people started, it does become easier. And the data can seem overwhelming at first, but not once you truly understand the basics. And from what we hear, the data can be incredibly eye-opening, both for the clinician and the patient alike. Does this resonate with what you found?
Katrina
Definitely, and I feel like when you are limited on the amount of time when you're introducing that technology to a patient, it could be maybe that first visit you really start and focus on how to implement that piece of technology and then have a return visit to discuss the data and go more in depth on that piece.
Dana
Such a great foundation. So to give us more context, can you walk us through at a high level what the main diabetes technology device categories are? So what's out there today that clinicians, regardless of where they're at, really should be familiar with, at least at the most basic level?
Katrina
I would say that there are four main categories that I would consider. The first one would be a continuous glucose monitors. And this type of technology is really helping with monitoring glucose levels more continuously than blood glucose monitoring. With a CGM, it's measuring the glucose levels in the interstitial fluid. And there's two main types of continuous glucose monitors. We have the intermittently scanned continuous glucose monitors and the real-time glucose monitors. Now, with the intermittently scanned, that one does require the patient to manually scan to save the data, even though the data is being continuously collected through the CGM. Now this type of sensor is kind of being transitioned away from, I think, you know, for the most part, I feel like more and more sensors available on the market are more of the real time one where no scanning or interaction with the sensor is really needed while the patient is wearing the sensor. So another category of technology that's available for diabetes are the connected pens. Some of them are caps that you put on top of an already existing pen. Other ones are pens that have the technology already into it. You put just a cartridge of insulin inside. And this type of technology is great for patients who are looking for assistance with calculating their insulin doses or maybe wanting that ability to record their insulin doses as well into an app. And then we have insulin pumps. So there's two different types of insulin pumps. I feel like this category is pretty big. So insulin pumps in general, how they work are, it is giving rapid acting insulin at a set rate. So that kind of basal insulin. And then the patient kind of interacts with the pump to give the bolus for meal times. Now then there's the AID or automated insulin delivery, insulin pumps, and how that differs is that a CGM is communicating with the insulin pump and then there's an algorithm that then is used and will adjust the basal rates based off of the CGM data.
Dana
So with all these categories in mind, and I can't believe in about six months we'll have two more categories at least, how do you go about matching the right technology with the right patient? And at a higher level, I guess, who tends to benefit the most from each option?
Katrina
I think the best place to start is having a conversation with the patient. The patient provides great insight into themselves. They know themselves best. And they know what challenges they're running into and what they would find beneficial or what types of aspects they're looking for. And so with that conversation with the patient, you can kind of help figure out, what pieces of technology would fit best to meet their needs.
Dana
That's a great answer because again, it is evolving. I think years ago there was a belief that only certain people could benefit from technology. Some people might be overwhelmed that maybe it was for type one only and not type two or gestational. This is really no longer true. So you're right, probably often matching the right person to the right tech has everything to do with the person themselves, what they're interested in, what they're willing to take on, what they're trying to learn, and importantly, what they're trying to achieve. So along those lines, what clinical indicators or patient factors should healthcare professionals weigh in on before recommending a device?
Katrina
There's a variety of different factors that should be taken into consideration. Of course, patient preference is always something, but we do need to take into consideration the type of diabetes a patient has while technology is becoming more inclusive and is able to be used for both people with type 1 diabetes or type 2. There still are some that are indicated for only certain types of diabetes. Another thing we need to take into consideration is insurance coverage and cost, just because that's a factor when it comes to managing diabetes is certain things are preferred by certain insurance companies. And then also a patient's medication regimen should be considered as well too. Certain technology really can help reduce the burden of diabetes management when you have certain medications. For example, if someone's not on a multiple daily injection of insulin, one of those connected pens, wouldn't be appropriate in this type of setting.
Dana
That makes sense. And we've been talking about this primarily from the clinical side, but there's also a patient side here. In your experience, how did these tools, how have they changed the way patients engage with their own care?
Katrina
I think that these tools really help reduce some of the barriers that patients experience and also can help reduce with diabetes burnout as well too, because it can simplify their regimens. A lot of this technology helps with doing calculations or you're not having to think about diabetes as much. It takes less time to look and monitor your glucose level. And so because of that, I think using like a continuous glucose monitor, for example, can really help engage a patient in their diabetes management because they're able to see right then and there how their choices, you know, taking their medications or their lifestyle choices, they get a real time response and can see how their management is going.
Dana
Again, most of my career, my favorite phrase is you can't measure it, you can't manage it. So that step alone, I'm sure is very helpful and quite surprising. I would imagine to a number of people who are put on or choose to put on CGMs for the first time.
Katrina
Definitely. I have a lot of patients that are like, I had no idea that was going on at that time of day and they're really surprised, but it's valuable.
Dana
And the data is sort of fun and again surprising depending on who you are. So there's a lot of benefits to the patients using these technologies. Are there benefits to the health care professionals as well?
Katrina
Definitely. I feel like with this technology, a lot of it is doing recording of the data, whether it's recording the insulin dose and the injection, or it's recording the glucose values. And with that recording, then that information can be discussed between the provider and the patient, and can really help improve communication between the two. I also find that it's really valuable because you can then use that patient's data to discuss different concepts. And you can apply it to them themselves and how it would impact them, not just an abstract concept about diabetes management.
Dana
That's great. And even with all of these benefits, I have to imagine there's a lot of providers who are hesitant to talk about this or to recommend it. Are there common misconceptions you hear that might be preventing certain patients from getting this type of technology?
Katrina
I think one of the misconceptions is, you know, it used to be that this diabetes technology was only for certain types of diabetes. And that's really not the case anymore. People can benefit from using this technology, regardless of the type of medication regimen that they're on. And for continuous glucose monitors specifically, I feel like it can be especially valuable, not just if they're on medications, but to look at the lifestyle side.
Dana
Yeah, this has been really insightful. So let's do a wrap up question now. If you had just one piece of advice for healthcare professionals who are just getting started with diabetes technology, what would it be?
Katrina
I would recommend checking out the danatech website. Reason being, it's a great resource for expanding your knowledge on all the different types of technology that's available to patients. It has the continuous glucose monitors, it has the different types of insulin pumps and technology, and can be a great place just to get some basic information about technology.
Dana
That's terrific. Thank you. And I did not pay you to say that!
Katrina
No, you did not!
Dana
That’s great. Well, thank you, Katrina, for being here with us. This has really been a great overview of the basics of diabetes technology.
And that's a wrap for this episode of Danatech Talks, a special series from The Huddle from ADCES. I hope you found today's discussion valuable, and thank you again to Abbott for supporting this episode. Stay ahead of the curve with more expert-led conversations on diabetes technology. Explore additional topics at danatech.org for in-depth resources training and the latest in diabetes technology. And don't forget to subscribe to The Huddle so you never miss an episode. Thanks for tuning in and we'll see you next time.
The information in this podcast is for informational purposes only and may not be appropriate or applicable for individual circumstances. This podcast does not provide medical or professional advice and is not a substitute for consultation with a health care professional. Please consult your health care professional for any medical questions.