Background: Continuous glucose monitoring (CGM) is now considered as a standard of care for glycemic status assessment and therapy adjustment in all patients with T1DM and T2DM patients treated with intensive insulin therapy. CGM has been available to people with diabetes for more than a decade, however, it is used by only about 15% in T1DM and fewer in T2DM. There is even more disparity in the access of its availability in the community with low socio-economic status (SES). The purpose of this study was to examine potential benefits of CGM in patients with limited access to technology.
Method: CGM (Freestyle Libre Pro) was placed for 10-14 days in 36 patients, age (mean age 63.4 years +/- 15.4), 61.1% female, BMI (mean 34.2 +/- 8.33 kg/m2 with T2DM (83.4% on Insulin therapy). The patients were asked to keep food and activity logs during the testing period. CGM data was downloaded after the testing period and glucose results were retrospectively reviewed with patients. Individuals also received self-management education. Shared decision making was encouraged to improve knowledge of how their choices affected their diabetes control using CGM data.
Results: Thirty-three (91.7%) patients were able to use CGM for ≥72 hours and had a follow-up visit with the endocrinologist for interpretation of the data and discussion of medication adjustments as well as behaviors that may have led to BG excursions based on food and activity logs. A1C at baseline (8.23+/-1.88%) slightly improved to mean A1C (7.86+/-1.41%) at follow-up. (p value 0.28).
Conclusion: CGM may be a useful supplement to assess glycemic control, to make therapeutic adjustment and to provide educational feedback on patients’ behaviors among T2DM with low SES who have limited access to technology otherwise. Our study favors a slight improvement in overall glycemic control through patient education and recognition of glucose patterns informed by the professional CGM especially in those with low SES.
N. Mehrotra: None. D. Sistla: None. M.T. Korytkowski: None. S. Mon: None.