This month's guest contributor is Michelle Taub. Michelle Taub MS, RD LD CDCES BC-ADM is a native Houstonian. She completed her undergraduate degree in Nutrition Sciences at the University of Houston and her Master’s degree at Texas Woman’s University in the Texas Medical Center. She currently is a CDCES in pediatric endocrinology at Texas Children’s Hospital and also part time at Baylor College of Medicine’s Young Adult Diabetes Clinic. She has been at Texas Children’s for eight years and her experience includes research assistant for Vitamin D studies in neonates at the Children’s Nutrition Research Center and diabetes education for Maternal Fetal Medicine at Pavilion for Women. Her areas of interest include diabetes technology and women’s health. Thank you Michelle for your contribution!
By Michelle Taub, RD LD CDCES BC-ADM
It feels a bit taboo to bring up the giant elephant in the room that has seemingly taken 2020 by storm and turned many of our worlds upside down however I think it is valuable for us as diabetes educators to take a pause and reflect how virtual healthcare has impacted our education visits and our patients.
Many healthcare systems prior to this year were dabbling in the virtual realm of healthcare tools and many felt there could be a possible benefit to it in the future. Covid-19 however sped this process up for many of us. We suddenly needed to be able to provide virtual visits to ensure the safety of and reduce possible exposure for staff and patients. It came on like a whirlwind with many questions wondering how will we get data prior to visits, labs, how will we bill and most importantly will patients know how to utilize the virtual tools for a successful visit? These are questions we are still navigating and trying to pick through with a fine tooth comb to decipher what is working and what isn’t however we have made some progress along the way.
Let’s talk data. In the past 10 years diabetes technology and access to glucose data has taken off. Thank goodness for CGMS (Continuous Glucose Monitoring Systems) and the ability for data to be shared. If we did not have a case prior to this of why most people would benefit from CGMS use we now do for sure! Another source for data is insulin pump reports, Bluetooth insulin pen devices and Bluetooth glucose monitors. The need for this information to be obtained prior to clinic visits opened up a knowledge gap for many of my patients that I was not aware of. Many knew how to share their data with family however they did not know how to share their data with their clinic. With diabetes technology evolving with multiple software platforms from Clarity, Libreview, Glooko, Tidepool, T-Connect, Carelink and many more there’s no wonder patients may be a bit confused on what they are downloading and to where exactly. This opened up my eyes as an educator that although I am sure most of my patients have been taught at some point in time how to download their devices or share data—this was not something they were doing on a regular basis. Since this information is imperative for education visits and provider visits I have now incorporated it as a standard in my education to make sure patients know how to download their data and utilize those apps to their advantage on a regular basis. Although COVID has brought a handful of stressors and uncertainty to healthcare this year, it has also taught us lessons. For me specifically, incorporating a more thorough education of technology to many of my patients has resulted in several benefits. It has provided the benefit of more frequent glucose adjustments, increased data for providers prior to visits, and increased patient autonomy to work on pattern management between visits.
As we close out the last few months of 2020 I encourage us all to take a moment to reflect how this year has affected you as a CDCES and your patients and try to find the lessons we can take forward for the years to come to make sure we continue to provide progressively enhanced care to all people living with diabetes.
For any questions or comments regarding this topic, please feel free to comment below or contact Michelle directly here.
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