Systematically interpret a Medtronic CareLink or MiniMed 780G Daily Review download in a structured 6-step clinical workflow — covering Time in Range, insulin delivery, day/night patterns, hypo and hyperglycemia root causes, and a prioritised action plan. Trigger when a clinician uploads or shares a CareLink report, MiniMed download, 780G Daily Review, pump download, or asks to review a patient's CGM or insulin pump data.
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Guidance for clinicians managing pregnant individuals with preexisting diabetes mellitus (PDM) who are evaluating daily carbohydrate intake; consider a carbohydrate-restricted diet (<175 g/day) or usual diet (>175 g/day) based on patient factors. Trigger when assessing nutrition in pregnancy for PDM, especially when discussing glycemic targets, weight gain, or fetal growth concerns.
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Recommends real-time continuous glucose monitoring (RT-CGM) for adult patients with type 1 diabetes mellitus (T1DM) whose hemoglobin A1C is above individualized target. Consider when clinician notes 'T1DM A1C above goal, consider RT-CGM' or 'Patient willing to wear CGM daily, A1C elevated'.
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This skill guides clinicians to reassess glucose monitoring frequency when discontinuing continuous subcutaneous insulin infusion (CSII) or transitioning to multiple daily injections (MDI). It is triggered by phrases such as 'Plan for glucose monitoring after pump stop' or 'Determine SMBG/CGM frequency post-pump' to ensure individualized glycemic goals are met.
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Performs a structured pre‑prescription evaluation of mental/psychological status, prior diabetes self‑care adherence, willingness/interest in CSII, and availability for follow‑up visits. Triggers include: 'Evaluating pump candidacy', 'Pre‑pump checklist: psych, adherence, motivation, follow-up'.
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The skill suggests using real-time continuous glucose monitoring (CGM) combined with algorithm-driven insulin pumps (ADIPs) rather than multiple daily injections (MDIs) with self-monitoring of blood glucose (SMBG) three or more times daily for adults and children with type 1 diabetes (T1D) to lower hypoglycemia incidence. Clinical triggers include discussions about insulin pump therapy, CGM use, or reducing hypoglycemia in T1D patients on intensive insulin regimens.
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Suggests that clinicians continue CSII in hospitalized patients with type 1 or type 2 diabetes when the institution has clear protocols for evaluating pump candidates and appropriate monitoring and safety procedures. Trigger phrases include: 'Admitted patient on pump, check hospital pump policy' and 'Inpatient with diabetes using pump, verify institutional guidelines'.
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Assesses the patient’s ability to troubleshoot insulin pump malfunctions such as occlusion, battery failure, or error messages. Trigger phrases include “Review pump alarm responses” and “Ensure patient knows steps for pump error”.
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Suggests initiating inpatient continuous glucose monitoring (CGM) for select hospitalized patients at high risk for hypoglycemia, combined with periodic point-of-care glucose checks for accuracy. Triggers include planning glucose monitoring for inpatients with prior severe hypoglycemia, renal or hepatic dysfunction, or age 65 years or older.
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Assesses the patient’s ability to prevent, detect, and treat hypoglycemia, including recognition of symptoms, appropriate carbohydrate treatment, and use of emergency glucagon. Triggered when clinicians review the hypoglycemia action plan or check whether the patient recognizes low symptoms and treatment steps.
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Assesses a patient’s ability to operate an insulin pump and make setting changes, evaluating dexterity, vision, mental health, and cognition for independent or assisted use. Triggered by phrases such as 'Check patient can manipulate pump controls' and 'Evaluate dexterity and vision for pump use'.
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This skill reassesses the insulin plan when discontinuing continuous subcutaneous insulin infusion (CSII) and transitioning to multiple daily injections (MDI). It is triggered by phrases such as 'Review planned basal-bolus regimen after pump' and 'Confirm MDI dose calculations and schedule'.
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Assesses whether a patient performs self-monitoring blood glucose (SMBG) fingerstick calibrations as required for their real-time CGM system. Triggers include: 'Verify patient performs fingerstick calibrations', 'Ensure calibration schedule is followed'.
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Reassesses annually the patient’s ability to use CGM trend information to adjust insulin doses. Triggered by yearly CGM skills check or annual review of trend-based dosing competence.
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Suggests continuous subcutaneous insulin infusion (CSII) for adults with type 1 diabetes mellitus who desire increased insulin delivery flexibility or improved treatment satisfaction and are capable of using the device. Clinical triggers include statements such as 'Patient wants more lifestyle flexibility with insulin' or 'Consider pump for improved satisfaction in T1DM'.
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Recommends continuing a patient’s personal continuous glucose monitor (CGM) in the hospital with or without algorithm-driven insulin pump (ADIP) therapy rather than discontinuing it for individuals already using CGM outpatient. Use when deciding whether to maintain personal CGM during admission or when a patient requests to keep their device, particularly in those at high risk for hypoglycemia.
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Reassesses annually the patient’s use of self-monitoring blood glucose to calibrate the CGM system. Triggered by ‘Yearly calibration practice review’ or ‘Annual check of SMBG calibration adherence’.
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Recommends postpartum endocrine care (diabetes management) in addition to usual obstetric care for individuals with preexisting diabetes (including those with pregnancy loss or termination). Triggered by postpartum care planning for patients with diabetes after delivery.
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Assesses patient's ability to identify the receiver, sensor, and transmitter components of a real-time CGM system. Triggered by clinician requests to review CGM parts or verify patient can name sensor, transmitter, and receiver.
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This skill evaluates infusion site health and rotates sites appropriately to prevent lipohypertrophy or infection. It is triggered when clinicians inspect pump sites for irritation or lumps or review site rotation practice at visit.
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Recommends continuing insulin pump therapy in hospitals with pump expertise; otherwise transitioning to scheduled subcutaneous basal bolus insulin if anticipated length of stay exceeds 1–2 days before pump discontinuation. Consider this when anticipating a hospital stay >2 days, lacking pump expertise, or needing to conserve supplies.
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This skill guides evaluation of venous thromboembolism (VTE) risk factors in Cushing's syndrome patients to prevent thrombotic complications. Use when assessing a CS patient for thrombotic risk, especially perioperatively; triggers include preoperative assessment, postoperative period (within 4-6 weeks), or presence of CS with additional risk factors such as prior VTE, immobilization, malignancy, or estrogen use.
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This skill advises against using a single 24-hour CGM target <140 mg/dL when managing glucose in pregnancy for patients with preexisting diabetes. Trigger when a clinician is determining CGM-based glucose targets for pregnant individuals with type 1 or type 2 diabetes.
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Suggests encouraging patients to use appropriately adjusted embedded bolus calculators in CSII and to provide education regarding their use and limitations. Triggers include: 'Patient starting pump, discuss bolus calculator', 'Review bolus calculator education at pump initiation'.
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