When I was studying to become a CDE, the students in our class who did not have diabetes were given the assignment to live as though we did have insulin-requiring diabetes for a period of time. It was very helpful. At that time, we did not have continuous glucose monitors (CGM), but we did have insulin, vials and syringes (not sure about the pens but I don’t recall those), glucose monitors, and other supplies. We gave ourselves normal saline as if it were insulin, checked our glucose at least four times/day, carb counted, and everything else required to manage our “diabetes” daily. One incident that stands out to me was a friend faking having a hypoglycemia event while waiting for her food at a restaurant. It was quite an eye-opening period of time for all of us.
From this, I learned to try to get the patient experience as much as possible. With new technology, it has been quite enlightening, and it’s helped me avert disasters for specific patients. Something else it helped was not having to take extra time to learn while I was in the office, causing the office to be backed up because I was late for other patients, etc.
One of many examples of the necessity to step into patients’ shoes is years ago, before we knew how annoying all the alarms could be, especially when we were not able to turn some off, I set tight alarms for myself. The CGM would alert me several times a night to warn me of impending hypoglycemia. Since my glucose levels were in 70’s and 80’s it would go off. It kept waking my husband up. From that experience, I learned how to set targets/alarms so they don’t go off as often. For my patients who don’t have hypoglycemic unawareness or about whom I am not concerned about having hypoglycemia, I often choose a system that doesn’t alarm.
When I wanted to personally try the CGM that doesn’t alarm, The Abbott Freestyle Flash, the first thing my husband said to me was, “I hope this thing isn’t going to wake me up all night.” I assured him it wouldn’t and it did not. It wasn’t a problem. He even wore one to check it out. So, not only did I learn how my patients would respond, but I also learned how family members and others in the household may respond.
I learned so much from wearing a CGM myself. See Lessons Learned to find out more. If you have tried to live like your patients and learned lessons, please do let us know.
- Purchasing or trying to purchase a system or sensor gave me a better understanding of what a patient needs to go through just to get one.
- Having taken my reader with me when I had labs drawn, I learned my glucose was the same as at the lab. That gave me more confidence in it. Also teach patients about the lag time so they will understand it may not be as close as expected, and hopefully have more confidence in their CGM.
- Helps me tell my patients what it feels like, and even warn them of the loud click at insertion.
- Helped me learn to warn patients about the things that can knock the sensor off such as hitting it on door openings, rubbing too vigorously with a towel after bathing or showering, and putting on and taking off shirts or bras that go over the head.
- Having forgotten to pick up my reader and carry it with me to bed one evening and having had skipped readings helped me warn them about the possibility of this. The next time I wear it, I will learn how to set it up on my phone and teach my patients how to do so. Most people do take their phone to bed.
- Having had what looks like hypoglycemia the first 24 hours of wearing a new sensor, I learned that unless at risk for hypoglycemia, they don’t need to worry about the hypoglycemia. Yes, they should still check with a fingerstick so when they do have an event, they will be able to see the difference at times like these.
- How to put on a sensor and take one off myself, which helped me teach patients do it themselves.
- How it feels when a sensor comes off.
- There’s nothing like experiencing what we ask of our patients.
Looking forward to hearing from you!
Joy Pape, FNP-CDE
Medical Editor, DiabetesInControl
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