TABLE 1

Team Approach to Optimizing the Use of Diabetes Technologies to Enhance Outcomes

Technology CategoryClinician-Does-It-All ParadigmTeam Approach Solution
Clinician ResponsibilitiesPotential OutcomesClinician ResponsibilitiesCDCES or Digital Champion ResponsibilitiesEnhanced Outcomes
BGMClinician prescribes blood glucose meter.Patient picks up meter but does not use it, uses it sporadically, or uses it regularly but does not use data for self-management and does not bring data to follow-up medical visits.Clinician prescribes blood glucose meter.Team member teaches the patient how to use the device and instructs the patient on structured testing and how to use the data to effectively self-manage. Patient downloads an app to facilitate data interpretation and remote sharing with the care team.
CGMClinician prescribes CGM system.Patient begins to use the device but does not understand how to use the data, including trend arrows, to appropriately self-manage glucose levels. Patient is frustrated by alarms and data overload. Clinician cannot access data.Clinician prescribes CGM system.Team member teaches the patient how to insert a sensor, connect to a mobile device, and set up data-sharing with care team; when to do confirmatory BGM; and how to use glucose and trend arrows to inform self-management (i.e., adjustments in food, physical activity, and medications, including insulin).Patient is more engaged with diabetes self-management. Clinician is able to review data and recommend appropriate adjustments to the treatment plan.
Connected health devices*Clinician asks patient to increase physical activity.Patient agrees to be more active but fails to follow through.Clinician asks patient to increase physical activity.Team member recommends an app that connects to devices and tracks activity and other health parameters.
Healthy-eating supportClinician may not have the time or knowledge to discuss food choices or makes general suggestions only.Patient does not get healthy-eating support.Clinician may not have the time or knowledge to discuss food choices or makes general suggestions only.Team member recommends an app that provides healthy-eating support. Patient learns healthy-eating behaviors and tracks food choices.
Insulin-dosing supportClinician prescribes a fixed dose of insulin with a correctional scale.Patient takes insulin but is confused about the correctional scale. Glucose levels are not improved.Clinician prescribes a fixed dose of insulin with a correctional scale.Team member explains the insulin regimen to patient and helps patient download an app that provides an insulin bolus calculator and tracks insulin dosing. Glucose levels begin to improve.
  • * For example, for monitoring physical activity, sleep, blood pressure, or weight.