The use of diabetes technology is growing at a rapid pace because of the positive impact technology has on diabetes outcomes and quality-of-life (QOL).1 Sadly, not all people with diabetes (PWD) have access to this technology for reasons including therapeutic inertia and racial-ethnic disparities. Some clinical practices are also “late adopters” of diabetes technology. As a result, Diabetes Care and Education Specialists (DCES) are being called to take the lead in helping to address this problem.2
Therapeutic inertia has been implicated as a major factor limiting optimal diabetes outcome measures.2 However, the DCES can help drive progression of treatments through their role in education and support with the use of the Identify, Configure and Collaborate (ICC) Framework. The ICC framework can facilitate the optimization of care with the use of technology by systematically breaking down the process to overcome therapeutic inertia and consequently helping to bridge the disparities gap in technology use among PWD.
By being the technology champion, the DCES can help a patient Identify which technology is right for them. Through the DCES assessment, characteristics of the PWD can be identified such as their current technology use, readiness to learn new technology, physical and cognitive abilities, financial means, and digital health literacy. This assessment can then help frame the conversation and ultimately lead to shared decision-making by accounting for patient preferences and openness and/or acceptance of new technology.
Next the PWD and their care team can collectively Configure their chosen technology around the PWD’s lifestyle. Optional features of diabetes technology can be activated or deactivated as determined during this open discussion. Individualizing the treatment in this way can also potentially lead to greater satisfaction for both the PWD and their care team. Moreover, the PWD will have the tools needed for day-to-day living while the care team will have the data needed to help make treatment adjustments.
This finally leads to Collaboration which can take place when the data from the technology is reviewed and treatment adjustments are made. This will give more clarity into as to what the glucose patterns are or what insulin doses have been taken. Data from the insulin pump, CGM and/or smart insulin pen can all facilitate this high level of understanding for treatment decisions going forward.
It is important to note that it will be necessary to repeat this process at future visits with the PWD as personal circumstances can frequently change, leading to new barriers to care (for example: a change in insurance). Also, new advanced technology options often become available and may offer additional benefits to further optimize diabetes care. Ultimately, the goal of using technology is not to add more burden to the PWD and care team, but rather to decrease the already existing burden and help improve overall care.2
If clinic practices have not yet adopted a systematic way to fully introduce and utilize technology with their patients, the DCES is perfectly positioned to step-up as the technology champion at this level of care. There are numerous training opportunities to learn about new technology as well. In fact, the Association of Diabetes Care and Education Specialists (ADCES) regularly offers training through conferences and publications. Medtronic Diabetes hosts a full array of professional education opportunities as well. To learn more, visit the Medtronic Diabetes Healthcare professional website.
And as always, you can also ask your local Medtronic representatives for more information about in-person or virtual medical education opportunities.
Dovc K, Battelino T. Evolution of Diabetes Technology. Endocrinol Metab Clin North Am. 2020;49(1):1-18.
MacLeod, J., Scher, L., Greenwood, D., et al. Technology Disparities and Therapeutic Inertia A Call to Action for the Diabetes Care and Education Specialist. In Practice. 2021; Sept.34-41.