Name of the Procedure:

Transmitter; external, for use with artificial pancreas device system (HCPCS Code S1036).

Summary

In simple terms, this procedure involves attaching an external transmitter to an artificial pancreas device system. This transmitter helps communicate blood sugar readings from a glucose sensor to the insulin pump, which automatically adjusts insulin delivery.

Purpose

The primary purpose of this procedure is to help manage blood sugar levels in people with diabetes, particularly type 1 diabetes. The goal is to maintain optimal glucose levels and reduce the risk of both high and low blood sugar episodes.

Indications

This procedure is suitable for patients with type 1 diabetes who use an artificial pancreas system. Indications include:

• Poor blood sugar control despite using other diabetes management methods.
• Frequent hypoglycemia or hyperglycemia.
• Patients seeking to improve quality of life by reducing the need for manual blood glucose monitoring and insulin delivery adjustments.

Preparation

Before the procedure:

• Follow any specific fasting instructions provided by your healthcare team.
• Review and adjust any medications as advised by your doctor.
• Ensure you have completed necessary diagnostic tests like blood glucose level assessments.

Procedure Description

1. The healthcare provider cleans the skin around the area where the glucose sensor will be attached.
2. A small glucose sensor is inserted under the skin, typically on the abdomen.
3. The external transmitter is attached to the sensor, where it will wirelessly transmit glucose readings to the insulin pump.
4. The insulin pump receives these readings and adjusts insulin delivery automatically.

Tools and equipment used:

• Glucose sensor.
• External wireless transmitter.
• Insulin pump.

Anesthesia is generally not required for this procedure; a local anesthetic cream may be used to numb the insertion site.

Duration

The entire procedure usually takes around 30 to 45 minutes.

Setting

This procedure is typically performed in an outpatient clinic setting.

Personnel

Healthcare professionals involved include:

• A certified diabetes educator or nurse who specializes in diabetes care.
• A physician to oversee the placement and provide medical guidance.

Risks and Complications

Common risks include:

• Minor skin irritation or infection at the insertion site.
• Transmitter or sensor failure, requiring reattachment or replacement. Rare risks:
• Severe allergic reaction to adhesives used in the transmitter.

Benefits

Expected benefits include:

• Improved blood sugar control.
• Reduced frequency of hypoglycemic and hyperglycemic episodes.
• Enhanced overall quality of life with less need for manual monitoring and adjustments. Benefits can typically be realized within a few days to a week of proper use.

Recovery

Post-procedure care includes:

• Keeping the insertion site clean and dry.
• Regularly checking the device to ensure it is working correctly. There may be no significant recovery time, but follow-up appointments are necessary to ensure the system’s proper functioning.

Alternatives

Alternative treatments include:

• Traditional continuous glucose monitors (CGMs) without automatic insulin delivery.
• Multiple daily insulin injections.
• Insulin pump therapy without continuous glucose monitoring. Each alternative has its own pros and cons, such as requiring more manual adjustments, different levels of convenience, and varying effectiveness in blood sugar management.

Patient Experience

Patients might feel a slight pinch during the sensor insertion but typically experience little to no pain thereafter. Pain management and comfort measures may include the use of numbing cream at the insertion site and the application of soothing lotions to prevent skin irritation post-procedure.