Spectrum - Part 1: Curriculum. AGDT-AGPD Spectrum Group
suggestions and feedback.
The authors wish you fun and success with SPECTRUM!
Yours sincerely
Bernhard Gehr,
Head of the adult version (AGDT)
Martin Holder,
Head of the pediatric versions (AGPD)
... on behalf of the author team: Eberhard Biermann, Sabine Carstensen, Dorothee Deiss, Guido Freckmann, Bernhard Gehr, Bettina Heidtmann, Lutz Heinemann, Martin Holder, Elke Kerth, Ralf Kolassa, Bernd Kulzer, Karin Lange, Andreas Liebl, Rosi Lohr, Carmen Ludwig-Seibold, Berthold Maier, Kerstin Remus, Claudia Sahm, Marcella Schulz-Braun, Sandra Schlüter, Thorsten Siegmund, Ulrike Thurm, Simone von Sengbusch, Tanja Wadien, Marita Wernsing, Ralph Ziegler.
Dear Users,
The first section of this curriculum is intended to empower diabetes professionals to use the SPECTRUM program in its version for adults. Two more versions of SPECTRUM for pediatric target groups will be covered later in this curriculum.
On the following pages we would like to present the central ideas of SPECTRUM to explain this training and treatment program and the methodology we have chosen. You will also find information and tips to help you prepare and present the SPECTRUM course.
The attending physician is responsible for prescribing a continuous glucose monitoring system, for accompanying the start of CGM use with measures such as this training course, for the optimization of alarm settings and the regular evaluation of the saved CGM information.
In order for patients to properly use CGM in their day-to-day lives and for them to draw the correct conclusions for their insulin therapy, the consultations with the physician and diabetes advisor should go hand-in-hand with this training. For this reason, SPECTRUM places the emphasis on close cooperation between all parties for the evaluation of the measured glucose values, the interpretation of glucose trends and the individual definition of therapeutic consequences.
We would like to wish you much success in the use of SPECTRUM for adults!
Yours truly, the Author Team.
1. Frequently asked questions on SPECTRUM (adult version)
What is the target group for SPECTRUM?
For several years now there have been systems available on the market for continuous glucose monitoring (CGM). Real-time CGM systems display a current glucose value and have various alarm functions (rtCGM).
SPECTRUM is intended to train all patients who have an indication for using an rtCGM system. The diabetes teams have the flexibility to adjust the content depending on the needs, possibilities and limitations of the patients. CGM helps handle complex metabolic problems and enables patients to live a more flexible lifestyle. Patients can only unlock the full potential of a sensor-based intensified insulin therapy with pens or with pump therapy if they receive proper training to optimally use the displayed CGM information and sensibly vary the alarm settings.
In order for patients to profit from SPECTRUM, they should fulfill the following prerequisites:
high personal motivation for performing insulin therapy and for dealing with diabetes,
the necessary cognitive abilities to understand complex metabolic connections and correctly interpret glucose trends and
the willingness to actively participate in the training course. This includes following glucose values and trends closely between the course sessions and implement and consolidate what they have learned with the help of tasks and exercises. It is also important for patients to be ready to share their observations in the course sessions and critically reflect upon therapy decisions.
Participation in the SPECTRUM training and treatment program is not recommended for patients who
expect CGM to be the solution for all their diabetes problems and place the responsibility for the success of their diabetes therapy on the course leader/doctor,
are overwhelmed by the high volume of data and information, both for cognitive and psychological reasons,
react with strong, dysfunctional fear when dealing with CGM data and/or who might be at risk for trying to handle their fears by using excessive control strategies,
are affected by insufficiently controlled psychological problems, abnormalities and disorders (e.g. fear or obsessive-compulsive disorders, addiction or dependence disorders).
How is SPECTRUM for adults set up?
An information session („Module 0“) and a consultation with the diabetes team should precede the actual CGM training course so that patients are informed well enough to decide for or against using CGM. This module contains the basic information on CGM. Module 0 can be used as part of an MDI or insulin pump training or, for example, as part of an information evening as per the possibilities and plans of the diabetes center.
Modules 1 to 6 are intended for people with diabetes who have already decided to use CGM. This modules contain information for participants on the practical use of CGM and participants then practice using it in daily life. Any knowledge or skills already present are refreshed, brought up-to-date and delved into. The modules intend to convey information and skills on using CGM and also to exchange both the experience of daily life with diabetes as well as solutions for difficulties with CGM.
What are the focal points of the modules?
Module 0 conveys basic information on the topic of CGM in order to help patients make an informed decision for or against CGM.
Module 1 delves deeper into the most important CGM basics (e.g. CGM display, lag time, calibration).
In Module 2, the first sensor is inserted, the alarm settings are set and the start rules for the initial days are stipulated.
Module 3 deals with the interpretation of the CGM information on the display and with the further optimization of the alarm settings.
In Modules 4 and 5, the saved CGM data is evaluated together by all participants who then exchange their practical experience from the initial weeks of CGM use.
Module 6 assists patients in using CGM over a longer period of time and under special circumstances (e.g. physical activity or traveling).
| Modul | Thema |
| Module 0 | Introduction and help making a decision |
| Module 1 | CGM basics |
| Module 2 | CGM start Inserting the first sensor |
| Module 3 | CGM display and alarms |
| Module 4 | CGM evaluation I |
| Module 5 | CGM evaluation II |
| Module 6 | CGM under special circumstances |
Tab. 1: SPECTRUM modules (for adults) and main content
What time frame is sensible?
A time frame of approximately 8 weeks is intended for participation in the entire training and treatment program (4–12 weeks, see Table 2 for the time frame).
Module 0 can be presented at any point in time before beginning the course.
Patients who have decided to participate in SPECTRUM are first taught the basics of CGM in Module 1 before inserting the sensor and beginning with CGM one week later as part of Module 2.
To get off