Healthcare Professionals Newsletter, November 2021

November 11, 2021
Science Based Brief

Using the Latest Technology to Monitor and Manage Blood Glucose

While there are countless advancements in science for diabetes these days, mobile health tools (mHealth) have become increasingly popular for their ability to transform the way people visualize their blood glucose (BG) levels in real time – and without finger sticks. Current data shows that continuous glucose monitoring (CGM) technology, which is a type of wearable mobile health (mHealth) tool, may positively impact a wide variety of diabetes outcomes, including better management of BG levels, reduced complications, and overall improvements in quality of life. With more patients asking about these devices and applications, many healthcare professionals are taking steps toward increasing their knowledge of how CGM works and its pros and cons.

Managing Diabetes with mHealth Tools
Monitoring and managing BG levels helps to avoid health complications from diabetes, and mHealth tools offer a promising solution to enhance BG management.1 mHealth tools include any type of device or technology that a patient can engage with, typically in real time, in an effort to manage their health.2 Many tools are available for BG surveillance, which not only benefit the patient, but can guide the healthcare provider (HCP) in giving targeted advice and bridges the gap in communication between the patient and healthcare team. Although measurement of hemoglobin A1C is a valuable way to track BG over time, certain mHealth options allow tracking of daily changes in BG which can help identify opportunities to adjust meals, medications, and lifestyle habits to help keep BG in a healthy range.3,4

mHealth Uses and Considerations
CGM reduces the need for the traditional finger stick blood samples used to measure BG and improves reliability of BG readings.1 Although many of the mHealth devices are easy to use, education for both HCPs and patients on their use can help to ensure compliance.

Orgain’s Nutrition Advisor Laura Andromalos, MS, RD, CSOWN, CDCES, states “While CGMs significantly reduce finger sticks, it’s important to remind patients that finger sticks are still necessary for calibrating most devices or confirming readings that seem inaccurate. It’s part of managing expectations when transitioning to CGM.”

It’s also important that HCPs know how to set up a CGM system and interpret the results of their patients. According to Andromalos, “When reviewing CGM reports, there is a lot of data! It can be overwhelming for patients and clinicians.  Upon downloading the report, there is a section titled ‘time in ranges’ that displays how many minutes the patient spends in their target range, as well as below and above it – this is a good place to focus. A goal of 70% “time in range” is common, although goals always must be individualized to your patient. If you’re supporting a patient to make changes to improve their time in range, start with the lows (low blood sugar). Hypoglycemia is typically more life-threatening than hyperglycemia. In the past, we only had A1C as our primary measure of glycemic management. With the development of CGM, we can use time in range to learn more about lows and highs on a daily basis versus just having an average blood sugar over three months with A1C.”

Most CGMs consist of 3 main parts:

  1. A monitor to display the information (this can be the smartphone using an app)
  2. A sensor/electrode is deposited on a needle that is inserted into the subcutaneous tissue of the patient
  3. A transmitter that sends the data to the monitor

Many CGM models update the BG display every 1 to 5 minutes.1,3 To put the data output into perspective, see the CGM report below, which includes the “Time in Ranges” section:

A Review of Common CGM Technology – Monitors, Apps and Software

Continuous Glucose Monitors
Continuous glucose monitors (CGMs) provide ongoing surveillance and identification of high or low BG levels and offers a better understanding and awareness of lifestyle and habits, which can finetune diabetes management and prevent complications.7 In addition to the BG, some of these handy monitors allow patients to see trends and alerts right from their mobile device and all are accessible to HCPs in an effort to help patients better manage BG within acceptable ranges.2

A narrative review found that the use of continuous glucose monitors, along with diet and exercise, showed improvement in glycemic and weight control in individuals with type 2 diabetes who had been counseled on appropriate BG ranges.4

Smartphone Apps
A review of mHealth apps shows promise for their use in disease management. However, with the cost of the device and low health literacy being potential barriers for widespread use, innovative solutions are needed to educate vulnerable populations in an effort to make these devices accessible.6

Smartphone apps offer many different functions for tracking health. These apps can connect with a CGM, glucometer or use patient-entered data. These can include ways to track diet, activity, and medication, and provide a vehicle for feedback from HCPs.6 However, a surge in nonregulated apps points to a need for regulation, standardization, and quality control.7 In the meantime, patients can seek guidance from their HCP when choosing an app.

Software
Some patients and HCPs prefer to track and analyze data and communicate advice through a computer software system. CGM software allows for quick access to a variety of reports and can help patients and HCPs better understand and assess health-related insights and trends.

mHealth Tools Can Revolutionize Diabetes Management
Diabetes can be difficult to manage and typically requires self-monitoring, consistent communication with a healthcare team and a high level of health literacy.1 mHealth devices take the guesswork out of tracking BG and ultimately help patients and HCPs identify health habits leading to out-of-range BG readings and focus on safe and effective strategies to manage BG.1,7 This technology has revolutionized diabetes management and is becoming even more mainstream with companies such as Apple considering a non-invasive CGM feature built into an upcoming Apple Watch model. Although BG levels can be recorded with pen and paper, CGM captures ongoing, comprehensive changes that help patients and HCPs recommend lifestyle and medication habits for better BG management.2 With proper instruction for HCPs and patients on device capabilities, this technology can make tracking BG easier, more time efficient, and allow HCPs to provide targeted advice on BG management transforming diabetes care.6

Considerations in Counseling Patients on CGM
Identifying appropriate patients for CGM is crucial for the success of this BG monitoring format. To help better educate patients, healthcare professionals should not only review and understand the components of the selected device, app or software but familiarize themselves with CGM-specific vocabulary. Androlamos also offers this advice, “As diabetes clinicians, we can get excited and want to geek out about the amount of data that we can gather from our patient’s devices. Remember that there is a person behind the data! Your patient lived through those lows and highs and there may be emotions, such as fear or shame, connected to the numbers. Keep your counseling and education sessions patient-focused and use supportive language.” She recommends these helpful guidelines from The American Diabetes Association: The Use of Language in Diabetes Care and Education8

Resources
Please find below a list of popular apps and software used to track and help manage blood glucose. While this list is not inclusive of all technology, it offers a snapshot of some well-known options of which Orgain has no affiliation.

CGMs and Compatible Apps

Smartphone Apps

  • Glucose Buddy: Offers an option to self-test and manually log BG or connect to CGM.
  • Health2Sync: Offers an option to self-test and manually log BG or syncs with BG meter to log BG.
  • mySugr: Syncs with BG meter to log BG.
  • OneTouch Reveal: Offers a variety of meters and apps that connect for BG logging.
  • BeatO: Pairs with the BeatO glucometer. If using a different glucometer, manual logging is available.

Software

Grey Line

1 Shan R, Sarkar S, Martin SS. Digital Health Technology and Mobile Devices for the Management of Diabetes Mellitus: State of the Art. Diabetologia 2019; 62(6):877-887. doi: 10.1007/s00125-019-4864-7.

2 University of Illinois Chicago. How to Use Mobile Technology to Manage Diabetes. Available at: https://healthinformatics.uic.edu/blog/how-to-use-mobile-technology-to-manage-diabetes/, accessed 10/14/2021.

3 Reddy N, Verma N, Dungan K. Monitoring Technologies – Continuous Glucose Monitoring, Mobile Technology, Biomarkers of Glycemic Control. Endotext 2020. Available at: https://www.ncbi.nlm.nih.gov/books/NBK279046/, accessed 10/14/2021

4 Taylor PJ, Thompson CH, Brinkworth GD. Effectiveness and Acceptability of Continuous Glucose Monitoring for Type 2 Diabetes Management: A Narrative Review. Journal of Diabetes Investigation 2018; 9(4):713-725.  doi: 10.1111/jdi.12807.

5 Aminuddin HB, Jiao N, Jiang Y, Hong J, Wang W. Effectiveness of smartphone-based self-management interventions on self-efficacy, self-care activities, health-related quality of life and clinical outcomes in patients with type 2 diabetes: A systematic review and meta-analysis. International Journal of Nursing Studies 2021; (116)103286. doi.org/10.1016/j.ijnurstu.2019.02.003

6 Sneha S, Thalla S, Rischie I, Shahriar H. Health Internet Technology for Chronic Conditions: Review of Diabetes Management Apps. JMIR Diabetes 2021; 6(3):e17431). doi: 10.2196/17431

7 Cappon G, Vettoretti M, Sparacino G, Facchinetti A. Continuous Glucose Monitoring Sensors for Diabetes Management: A Review of Technologies and Applications. Diabetes & Metabolism Journal 2019; 43(4): 383–397. doi: 10.4093/dmj.2019.0121

8 Dickinson JK, Guzman SJ, Maryniuk MD, O’Brian CA, Kadohiro JK, et al. The Use of Language in Diabetes Care and Education. American Diabetes Association Diabetes Care 2017; 40(12): 1790-1799. https://doi.org/10.2337/dci17-0041

From the Founder

Continuous Glucose Monitoring Q&A with Dr. Andrew Abraham, CEO & Founder, Orgain

As a personal user of CGM devices, Dr. Andrew Abraham shares the device he has found to be the most accurate, including its benefits and limitations.

1. Which continuous glucose monitoring (CGM) device have you found to be most accurate?

Dexcom G6

2. Have you tried CGM apps, and if so, which have you found the most success with?

I’ve only used the Dexcom G6 app and have found it to be accurate and really helpful in guiding my dietary choices.

3. What have you found to be most beneficial about using CGM devices?

Every individual is a bit different and as a result, we react a bit differently to the foods we eat, different types of exercise, fasting, etc.  CGM devices help provide a blueprint for what works and what doesn’t for each individual. It also helps you identify foods that really cause a glucose spike versus others that may not be as reactive. As an example, I was shocked that grapes raised my blood sugar higher than nearly anything else I consumed.

4. What have you found to be the greatest limitation in CGM devices?

The costs associated with a CGM, along with the commitment to being consistent with their usage, is currently the greatest limitation, but I see this improving with time.

Orgain Podcast

The Good Clean Nutrition Podcast – NEW Episodes!

With a 5-star rating and recognition as one of the most popular nutrition podcasts on Apple Podcasts, The Good Clean Nutrition Podcast released three new episodes that you won’t want to miss! Join our host Mary Purdy, MS, RDN, an integrative dietitian and nutrition educator, as she speaks with subject-matter experts in three newly-released episodes, available now on topics including intuitive eating, nutrition for athletes, and plant-based eating for chronic disease management and prevention. Also, visit healthcare.orgain.com/podcast to listen to more podcast episodes!

Learn more about the latest episodes below, and be sure to subscribe now on Apple Podcasts, Spotify or anywhere you listen to podcasts so you never miss a new episode!

Podcast

Episode 5: Dismantling Diet Culture and Embracing Intuitive Eating with Cara Harbstreet, MS, RD, LD
Listen to this myth-busting episode for clarity about the concept of intuitive eating, the truth about the Health At Every Size approach and best practices for equipping patients or clients with healthy and sustainable nutrition habits.

Listen Now >


Podcast

Episode 6: Nutrition for Optimal Athletic Performance: RD Secrets Revealed with Scott Sehnert, MS, RD, CSCS, CSSD
Gain insights into the importance of nutrition for athletic performance, including the best foods to eat pre- and post-workout, why carbohydrates are crucial for training and performance and the science-backed benefits of collagen supplementation for athletes.

Listen Now >


Podcast

Episode 7: Plant-Powered Eating for the Prevention and Management of Chronic Disease with Alison Tierney, MS, RD, CD, CDO
Tune in to learn the key findings from the latest research about plant-based eating to manage and even prevent chronic diseases such as cancer, plus actionable tips for those who are following or considering a plant-forward approach to eating.

Listen Now >


Product Spotlight

New Product Alert!

Pancakes

Keto Protein Pancake & Waffle Mix
If your clients are following a keto diet and craving a new breakfast idea, try Orgain’s new Keto-Friendly Protein Pancake & Waffle Mix , available now on Orgain.com! Made with almond flour and oat flour, this delicious mix lends to a light and fluffy product and boasts 10g of plant-based protein, 5g net carbs and only 1g sugar. Considering this mix is vegan, non-GMO, and gluten free, it is a great option for those with gluten allergies or intolerances and/or seeking to include more plant-based foods in their meal repertoire.

Learn More >


Chocolate Coconut Bar

Orgain Protein Bar – Chocolate Coconut
We are excited to introduce a new flavor to our delicious line of plant-based Organic Protein Bars, Chocolate Coconut! With 10g of plant protein and 150 calories per bar, they are the ideal nutritious snack to grab and enjoy on-the-go. These clean ingredient energy bars not only taste delicious, but suit a variety of dietary preferences as they are organic, gluten-free and made without dairy or soy ingredients.

Learn More >


Professional Education

Upcoming Live Webinars by
Subject Matter Experts

Register below for upcoming Orgain webinars or view our current library of on-demand webinars at your convenience on our recently revamped webpage: Orgain Professional Education Series.

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Calorie Restriction, Longevity and Muscle Function: Emerging Research and Clinical Considerations

Jacob T. Mey, Ph.D., R.D.

Approved for 1.0 CPEU for RDNs and DTRs
January 27, 2022 at 2 PM EDT

REGISTER HERE
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Reducing Cancer Recurrence with Plant-Based Nutrition

Alison Tierney, MS, RD, CD, CO

Approved for 1.0 CPEU for RDNs and DTRs
Febraury 17, 2022 at 2 PM EDT

REGISTER HERE
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First 1,000 Days of Life: Relationship Between Early Life Nutrition and Future Health Outcomes

Dr. Nicole Avena, Ph.D.

Approved for 1.0 CPEU for RDNs and DTRs
March 3, 2022 at 2 PM EDT

REGISTER HERE
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Open Wide: Optimizing Oral Health Through Diet

Sara Karlin, DDS & Ellen Karlin MMSc, RDN, LDN, FADA

Approved for 1.0 CPEU for RDNs and DTRs
April 21, 2022 at 2 PM EDT

REGISTER HERE
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Sustainability & Eating – The Connection to Our Environment & Role of Health Practitioners

Mary Purdy, MS, RDN

Approved for 1.0 CPEU for RDNs and DTRs
May 19, 2022 at 2 PM EDT

REGISTER HERE
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Eating Disorder Discovery and Recovery: A Health Professional’s Guide to Collaborative Treatment and Care

Susan Weiner, MS RDN, CDCES, FADCES

Approved for 1.0 CPEU for RDNs and DTRs
June 9, 2022 at 2 PM EDT

REGISTER HERE
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Improved Outcomes in CKD with a Plant Forward Approach

Melanie Betz MS, RD, CSR, CSG

Approved for 1.0 CPEU for RDNs and DTRs
July 21, 2022 at 2 PM EDT

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The Physiological Connections Between Diet & Sleep and Associated Risks for Developing Chronic Diseases

Marie-Pierre St-Onge, Ph.D, CCSH, FAHA

Approved for 1.0 CPEU for RDNs and DTRs
August 18, 2022 at 2 PM EDT

REGISTER HERE
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Nutrition & Yoga Combination Therapy: Why Together It May Better Treat Common GI Ailments

Beth McCall, MS, RD, LDN, CSSD, RYT

Approved for 1.0 CPEU for RDNs and DTRs
September 22, 2022 at 2 PM EDT

REGISTER HERE
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Everything Your Clients Need to Know About Intermittent Fasting

Erin Palinski-Wade, RD, CDCES, CPT

Approved for 1.0 CPEU for RDNs and DTRs
October 20, 2022 at 2 PM EDT

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Measuring & Improving Metabolic Health to Prevent or Reverse Disease

Dr. Tom Rifai MD FACP

Approved for 1.0 CPEU for RDNs and DTRs
November 17, 2022 at 2 PM EDT

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Promoting Gut Barrier Function for Better Health: Addressing Leaky Gut Through Diet

Colleen Webb, MS, RDN

Approved for 1.0 CPEU for RDNs and DTRs
December 8, 2022 at 2 PM EDT

REGISTER HERE
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