Using continuous glucose monitors to boost patient care and satisfaction

As a physician who treats patients with diabetes, Dr. Bishow Shrestha has been working with more patients using continuous glucose monitoring systems.

Dr. Bishow Shrestha, an endocrinologist with the WellSpan Health System in Pennsylvania, says he's seen how continuous glucose monitoring systems have helped patients with diabetes change their behavior.

The devices help patients monitor their glucose levels and can alert them if they are facing problems. An endocrinologist with the WellSpan Health System in central Pennsylvania, Shrestha tells Chief Healthcare Executive® that he has seen patients use glucose monitor systems to help manage their diabetes more effectively.

“Most of my patients after wearing continuous glucose monitor systems, after our first visit or second visit, they will change their way of life,” Shrestha says. “They modify how they eat.”

Shrestha also says that he’s seeing greater patient satisfaction with the use of continuous glucose monitors. Shrestha also notes patients are feeling more connected to the health system and that they recognize someone is watching out for them.

“Almost all of my patients are satisfied with continuous glucose monitors,” Shrestha says. “They are so happy that they don't have to pick their fingers all the time, at least two or three times a day.”

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With continuous glucose monitoring, a small device is implanted in the patient’s skin, often under the arm, and patients can get readings of their blood sugar levels on their phones.

When Shrestha has appointments with patients, they’ll review the readings from continuous glucose monitors together and discuss days with changes in their sugar levels. They’ll talk about that day and in some cases, mention that it was a day when they ate well.

“And that will give them encouragement,” Shrestha says.

They’ll also examine days that showed less encouraging glucose levels.

“On some of the other days, then we'll talk about what happened,” he says. “What can we do on other days to improve it?”

When asked how continuous glucose monitors spur better decisions among patients, he offered an analogy of how consumers spend money. If a shopper uses a credit card, the consumer may be less conscious of how much money they are shelling out. “When you are giving cash, you feel like you are spending more money,” he says.

Some patients need that tangible device that gives them readings of their sugar levels, he says.

“This is more like a constant feedback to the patient that is alerting them, and subsequently they are changing their behavior,” Shrestha says.

Generally, Shrestha says he’s seeing strong adherence among patients with continuous glucose monitoring systems. Most of the patients that are concerned enough about their health and their diabetes to get the devices are using them consistently.

“When you are coming to see me, you're already motivated to change something,” Shrestha says.

He has seen some patients that struggled with consistently using the monitors become much more invested when they find out they are pregnant. Those patients then begin using the monitoring systems to track their glucose levels regularly. That’s a pattern Shrestha says he’s seen with a number of patients.

Patients are also getting alerted to signs of complications earlier, he says. If there’s a significant change in glucose levels, patients are alerted to problems and can get attention before encountering problems such as severe diabetic ketoacidosis.

Shrestha also says he’s hearing more from patients, and he notes he received calls from patients with changes in their readings after Halloween. He expects to potentially hear from other patients with Thanksgiving and Christmas coming soon.

Shrestha says he has seen strong benefits from patients using glucose monitoring systems. He says he’s seen a reduction in patients who end up in urgent care, the emergency department and needing admission to the hospital.

“It's actually a landmark device that's changing the perspective of diabetes,” he says.

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