AGDT-AGPD Spectrum Group - Spectrum - Part 1 - Curriculum

4.3 Evaluating CGM data: introducing a systematic approach

4.4 Evaluating CGM data: practical exercise using data brought by patients

4.5 Task: My three goals until the next module

4.6 What’s next in Module 5

Module 5: Analyzing personal CGM data (Part 2)

5.1 Overview of topics for Module 5

5.2 In retrospect: the first weeks with the CGM system

5.3 Evaluating CGM data: Repetition of the systematic approach

5.4 Evaluating CGM data: practical exercise using data brought by patients

5.5 Task: My three goals until the next module

5.6 Good-bye and what’s next in Module 6

Module 6: CGM advanced training

6.1 Overview of topics for Module 6

6.2 In retrospect: the past weeks

6.3 Experience with the CGM system over the entire training course

6.4 CGM and physical activity

6.5 CGM in water and in the sauna

6.6 On vacation with the CGM system

6.7 With CGM in the hospital

6.8 Taking stock of the course, other goals, what’s next

6.9 Good-bye

We would like to welcome you to the circle of diabetes teams treating patients with continuous glucose monitoring (CGM). The SPECTRUM program is a structured, manufacturer-independent training and treatment program. The name SPECTRUM comes from „structured patient education for continuous glucose monitoring“.

Two working groups of the Deutsche Diabetes-Gesellschaft (DDG) (German Diabetes Association) participated in the creation of this program: the Arbeitsgemeinschaft Diabetes & Technologie (AGDT) (Diabetes & Technology Working Group of the German Diabetes Association) and the Arbeitsgemeinschaft Pädiatrische Diabetologie (AGPD) (Pediatric Diabetology Working Group of the German Diabetes Association). More than two dozen diabetologists, diabetes advisors, scientists and psychologists from the fields of adult and pediatric diabetology kindly contributed their knowledge, varied experience and Practical tips.

Upon completing SPECTRUM, patients with diabetes have the knowledge to safely and successfully use a CGM system. Contrary to a product training, SPECTRUM places the focus not on the device characteristics but rather on the therapeutic use of the measurement results and the practical use of the systems in daily life. Patients learn how to understand the information given by the CGM device, how to properly use the alarm functions and how to draw the correct therapeutic conclusions.

The SPECTRUM program offers you a training and treatment program which fulfills the needs of different target groups:

There is a SPECTRUM version for adults, one for children and their parents, as well as a version for teenagers with diabetes. The content of the training as well as the language and approach used are tailored to these target groups.

SPECTRUM can be used independently of the type of insulin therapy. Patients on injection therapy (MDI) or an insulin pump therapy (CSII) can use the same set of slides and can be trained in the same group.

SPECTRUM also takes into account that the glucose units mg/dl and mmol/l are both used in several countries. The sets of slides are available in both units of measure.

SPECTRUM thereby fulfills the quality requirements as specified in the National Medical Guideline „Diabetes – strukturierte Schulungsprogramme“ (Diabetes – structured training programs) as well as the standards defined by the International Diabetes Federation.

Many colleagues have worked on the program thus far but there are bound to be other good ideas – we look forward to your suggestions and feedback.

The authors wish you fun and success with SPECTRUM!

Yours sincerely

Bernhard Gehr,

Head of the adult version (AGDT)

Martin Holder,

Head of the pediatric versions (AGPD)

... on behalf of the author team: Eberhard Biermann, Sabine Carstensen, Dorothee Deiss, Guido Freckmann, Bernhard Gehr, Bettina Heidtmann, Lutz Heinemann, Martin Holder, Elke Kerth, Ralf Kolassa, Bernd Kulzer, Karin Lange, Andreas Liebl, Rosi Lohr, Carmen Ludwig-Seibold, Berthold Maier, Kerstin Remus, Claudia Sahm, Marcella Schulz-Braun, Sandra Schlüter, Thorsten Siegmund, Ulrike Thurm, Simone von Sengbusch, Tanja Wadien, Marita Wernsing, Ralph Ziegler.

The first section of this curriculum is intended to empower diabetes professionals to use the SPECTRUM program in its version for adults. Two more versions of SPECTRUM for pediatric target groups will be covered later in this curriculum.

On the following pages we would like to present the central ideas of SPECTRUM to explain this training and treatment program and the methodology we have chosen. You will also find information and tips to help you prepare and present the SPECTRUM course.

The attending physician is responsible for prescribing a continuous glucose monitoring system, for accompanying the start of CGM use with measures such as this training course, for the optimization of alarm settings and the regular evaluation of the saved CGM information.

In order for patients to properly use CGM in their day-to-day lives and for them to draw the correct conclusions for their insulin therapy, the consultations with the physician and diabetes advisor should go hand-in-hand with this training. For this reason, SPECTRUM places the emphasis on close cooperation between all parties for the evaluation of the measured glucose values, the interpretation of glucose trends and the individual definition of therapeutic consequences.

We would like to wish you much success in the use of SPECTRUM for adults!

Yours truly, the Author Team.

For several years now there have been systems available on the market for continuous glucose monitoring (CGM). Real-time CGM systems display a current glucose value and have various alarm functions (rtCGM).

SPECTRUM is intended to train all patients who have an indication for using an rtCGM system. The diabetes teams have the flexibility to adjust the content depending on the needs, possibilities and limitations of the patients. CGM helps handle complex metabolic problems and enables patients to live a more flexible lifestyle. Patients can only unlock the full potential of a sensor-based intensified insulin therapy with pens or with pump therapy if they receive proper training to optimally use the displayed CGM information and sensibly vary the alarm settings.

In order for patients to profit from SPECTRUM, they should fulfill the following prerequisites:

high personal motivation for performing insulin therapy and for dealing with diabetes,

the necessary cognitive abilities to understand complex metabolic connections and correctly interpret glucose trends and

the willingness to actively participate in the training course. This includes following glucose values and trends closely between the course sessions and implement and consolidate what they have learned with the help of tasks and exercises. It is also important for patients to be ready to share their observations in the course sessions and critically reflect upon therapy decisions.

Participation in the SPECTRUM training and treatment program is not recommended for patients who

expect CGM to be the solution for all their diabetes problems and place the responsibility for the success of their diabetes therapy on the course leader/doctor,