Introduction: Since many new diabetic medications are costly and often have side effects, quick feedback would allow for timely decisions. The current study present the role of CGM in titrate medication to achieve glycemic target of diabetes mellitus patients using 14 days CGM report (AGP).
Methodology: Retrospective AGP of 214 patients was collected from 2017 to 2019. Target glucose range was considered as 70-180 mg/dL, hypoglycemia was categorized as low (54-69 mg/dL) and very low (<54 mg/dL) and hyperglycemia as high (180-250 mg/dL) and very high (>250 mg/dL). The % of time a patient spent in above ranges was illustrated as time in target range (TIR), time below range (TBR), and time above range (TAR), respectively. The glycemic variability (GV) parameters included standard deviation (SD) and coefficient of variation (CV). Changes in diabetic medications were done, if required, after first week of CGM. Variation in TIR, TAR, TBR and CV were analyzed before (first week) and after medication (last week).
Results: Improvement was observed in mean glucose values and SD from 152.1 to 135.5 and 41.0 to 35.1 mg/dL, respectively, % of time in TIR from 57.9 to 64.5% and TAR from 25.9 to 16.9% (high: 16.9 to 12.6% and very high: 9.0 to 4.3%) from first to last week. However, % of time in hypoglycemia (TBR) was increased from 7.9 to 11.2% (low: 6.6 to 8.8% and very low: 1.3 to 2.4%). The patients count with high glycemic variability (CV >36) was reduced from 27 to 21. The average eA1C was improved by 0.6 units (6.9 to 6.3).
Conclusion: The patients who were hyperglycemic were well controlled with medication, albeit with episodes of hypoglycemia during night-time. The treating clinicians can focus on these soft spots after first week instead of waiting long to intervene if they use CGM to titrate the medication. Thus, CGM can be instrumental in giving quick feedback in maintaining desired glycemic targets.
M. Sabharwal: None. S. Palukuri: None. S. Deka: None. G. Chanana: None. R. Kumar: None.