The largest challenge for appropriate adjustment of insulin doses for PCPs is lack of time and for patients is provision of enough blood glucose values. Potential solutions to these two issues are CIDAA for PCPs and CGM for patients. The combination of these two innovations was evaluated in a FQHC serving a poor, mostly minority, medically underserved population.
Poorly controlled diabetic patients (A1C levels >9.0%) are referred to a specially trained clinical pharmacist (CP). The pharmacy department supported CGM (Free Style Libre Pro) for 13 patients, 10 on basal insulin alone and 3 on basal/bolus who had ≥2 visits. Their downloaded CGM results were analyzed by FDA-cleared CIDAA and a report containing recommendations for dose adjustments that the CP could modify or accept was provided within 30 seconds. The mean number of reports was 4.8 which covered a period of 97 days. The glycemic responses are shown in the Table. Total insulin doses increased by 42%.
Conclusion: Analysis of CGM results by CIDAA addresses the two largest challenges of adjusting insulin doses for PCPs and patients. Using both together has the potential of markedly improving A1C levels in poorly controlled insulin-requiring diabetic patients.
M.B. Davidson: None. J. Davidson: Employee; Self; Mellitus Health.