Introduction: Self-monitoring blood glucose (BG) using a glucometer is the standard of care for patients with diabetes. However, up to 67% of patients fail to routinely monitor BG, which is one of the major challenges to optimize glycemic management. With an emergence of technology, continuous glucose monitoring devices (CGM) are now used by many patients for guiding therapeutic changes. However, such technology is not always available in low socioeconomic areas.
Objective: To examine the ability of professional CGM for guiding therapeutic changes in a population with limited access to technology to improve glycemic control as measured by A1c, patient glucometer data, hypoglycemia events, and total daily insulin requirements before and after the testing period.
Method: Professional CGM (Freestyle Libre Pro) was placed for 10-14 days in 19 patients age ≥ 18 years (mean age 47.6 years +/-19.6 SD, 58.42% female) with T1DM or T2DM on insulin therapy. CGM data was downloaded after the testing period, glucose results were retrospectively reviewed with the patient, and insulin dose adjustments were made.
Results: 66% of patients showed improvement in A1c with a median decrease of 0.8%. Mean A1c pre 9.2 and post 8.77 with the p value=0.13
Fewer hypoglycemic episodes and higher total daily use of insulin are noted in the post-CGM period. 7 episodes of severe hypoglycemic before and none following CGM use. There was an increase in the mean dose of insulin from 51.79 units to 56.93 units, p=0.14 post CGM.
Statistically significant decrease in episodes of hyperglycemia Post CGM (Pre 11.66 to Post 4.18, p=0.03).
Conclusion: Professional CGM is useful for improving glycemic control in a low socioeconomic population with limited access to current technology. Despite a relatively small sample size, our study showed that there was an improvement in HbA1c and the decrease in the number of episodes of hyperglycemia and hypoglycemia after CGM placement.
S. Hashmi: None. S. Mon: None.
