More than a year has passed since NICE updated its glycaemic monitoring guidance around the use of continuous glucose monitoring (CGM), for people with both type 1 and type 2 diabetes.
Great strides have been taken to increase access to this life changing technology, yet resistance remains across the healthcare system. The noise on the ground about "Who's job is it?", "We don't have capacity" or "It’s for specialist only" suggests that the real benefits of CGM haven't fully reached non-diabetes specialists working within the NHS. A position that was echoed at a fringe event at this year’s RCN Congress, where 77% of respondents said they needed more training when asked what support they needed with CGM.
Let’s go back to a time when urine testing for glucose was commonplace, or when blood glucose meters became available in their droves. Each had their own unique features we had to learn and navigate. We were trained and their use became the norm. CGM will become no different over time, but right now, there is undoubtedly an increased need for education and training for health care professionals. This will need to detail not only the features of the available devices but also the ability to understand and interpret the data to support people with diabetes and the changing standard of care.
To support this, your RCN Diabetes Forum recommend the following online education modules which support the basic skills required to initiate CGM right through to more advanced modules covering data interpretation and beyond:
- Implementing Glucose Sensing in Primary Care
- Sensor Technology For Community Nurses: A Practical Toolkit
DTN-UK Resources
And of course, don’t forget the websites of the technology companies too.
So, in addressing the noise, it will become everybody’s job to know about CGM. Regardless of your area of nursing you will see people with diabetes. As access to CGM technology grows, more and more people admitted to hospital, attending an outpatient appointment, or seeing a GP or practice nurse, will be utilising health related technology. Understanding the basics, supporting self-management, and referring on only when required, will support in not only managing the revolving door of overburdened specialist teams, but also in reducing heath related appointments, reducing hospital admissions, increasing the confidence of people with diabetes, and enabling them to actively self-manage.
If we are to challenge the current standard of care and make a real difference to the lives of people with diabetes, we must embrace the changes advocated by NICE, learn new skills – some which may currently be out of our comfort zone and then implement them into our daily clinical practice.