(51) The Development of a Protocol to Guide Diabetes Educators on Using Continuous Glucose Monitoring (CGM) to Educate Patients with Type 2 Diabetes in HK, China

Ms. Winnie Mei-Wan CHENG¹, Ms. Eva CY KAN1, Mr. Sum-Ming LEUNG², Ms.  Maggie MK WANG1, Ms.  Maisy PH MOK³, Ms.  Jo Jo YM  KWAN², Ms.  Annie YS LEUNG⁴, Ms.  Karen KC WONG^5
1Queen Elizabeth Hospital, Hong Kong SAR, ²Our Lady of Maryknoll Hospital, Hong Kong SAR, ³United Christian Hospital, Hong Kong SAR, ⁴Yan Chai Hospital, Hong Kong SAR, ⁵Queen Mary Hospital, Hong Kong SAR

Background
The advent of continuous glucose monitoring (CGM) devices has revolutionized diabetes care.  CGM improves clinical outcomes only when users understand and can use the data to make lifestyle and/or therapeutic adjustments.  In Hong Kong, a protocol to guide diabetes educators (DEs) in delivering CGM education is lacking.  A panel of 8 senior DEs was formed in March 2020 to address this deficiency.  The purpose of this presentation was to share the process of developing the protocol and the contents of this protocol. 

Content
Freestyle Libre (FSL) was the targeted CGM.  End-users had type 2 diabetes (T2DM) and at least a primary school education, were new to FSL, could handle smartphones, and were willing to adjust lifestyle or medications (if any) according to CGM. Protocol development proceeded through the following stages: 1. Literature search to identify pertinent models and concepts, with adoption of Bandura’s Reciprocal Determinism; 2. Consensus on use of three strategies for teaching - use of questions, feedback and reinforcement; 3. Design of a 3-session program; 4. Revision after discussion with diabetologists and 5. Revision after feedback from 10 DEs who performed pilot testing.  The 3-session program consisted of: Session 1 (day 1): explain concepts and pitfalls of FSL, initiate use, teach how to interpret values and trend arrows and take appropriate actions;  session 2 (day 7+/-3):  share interpretation of statistics and graphs, explore glucose fluctuations and coping strategies; session 3 (day 14): consolidate learnings, evaluate change in glucose metrics, reinforce successful interventions.

Outcomes
By November 2020, a protocol for education on use of FSL became ready for promulgation to all local DEs.

Conclusion
Development of a protocol that meets the need of guiding education on use of FSL actualized the 2P (progressive and productive) and 2C (cohesive and creative) spirit of DEs in Hong Kong.

back