Objective: Intensive type 2 diabetes mellitus (T2DM) intervention programs can improve clinical outcomes for patients and reduce costs to patients, insurance providers, and health care systems. We piloted an intensive T2DM intervention program consisting of a multidisciplinary team of diabetes providers. We tested feasibility of our program and examined its impact on hemoglobin A1c (HbA1c) and glycemic time in range (TIR).
Methods: The program was piloted at a large, urban, academic hospital. Adults with T2DM and HbA1c >9% were enrolled in a 24-week program consisting of regular visits with a Nurse Practitioner, Certified Diabetes Care and Education Specialist, pharmacist, and social worker (if needed). There were a total of 12 individual provider visits and nine group T2DM lifestyle education classes. All participants were given continuous glucose monitors (CGMs).
Results: Ten participants were enrolled. Eight patients completed 12 weeks and seven patients completed the 24 week program (70% retention). Participants were 50% female and 80% Caucasian, with mean HbA1c 11.4 ± 1.4%. Mean HbA1c after 12 weeks was significantly reduced by 3.3 ± 2.5% (n=7; p=0.02). Change in HbA1c at 24 weeks approached statistical significance (-2.5 ± 3.4%, n=8, p=0.06). CGM TIR increased by 24 ± 26% after 24 weeks (n=6, p=0.03) and average glucose decreased by 23 ± 20 mg/dL (n=6, p=0.03).
Conclusion: We demonstrated the feasibility of a 24-week multidisciplinary diabetes intervention program for patients with uncontrolled T2DM. Overall time in range and average glucose via CGM improved. Future studies should evaluate sustained improvements in glycemic measure with intensive behavior change programs as well as their impact on health system utilization.
K. Grdinovac: Consultant; AmalgamRx. G. Davies: None. F. Steger: None.
