Visual Abstract
The Onduo Virtual Diabetes Clinic (VDC) for people with T2D combines a mobile app, remote lifestyle coaching and video consultations with endocrinologists for medication management and prescription of RT-CGM devices for intermittent use in high risk participants. This analysis examined change in A1c at 1-yr in VDC participants with and without CGM use. Subgroup analysis was performed for participants with 6-mo and 1-yr data. Of the cohort (n=772), 45.9% (n=354) used CGM and 54.1% (n=418) did not use CGM. At baseline the CGM group was significantly younger (mean±SD): 53.3±8.6 vs. 55.1±9.4 yr, had higher A1c: 7.9%±1.8 vs. 7.6%±1.7, and greater insulin use: 36.2% vs. 28.5%. Change in A1c at 1-yr is presented in the Table. The increase in participants meeting the HEDIS target of A1c <8.0% was greater in the CGM group, 55.1% to 78.3%, vs. no CGM, 60.8% to 74.0% (p=0.002). Subgroup analysis (n=468, 60.6%) revealed significant improvement in A1c at 6-mo and 1-yr for both CGM and no CGM groups with a baseline A1c >8.0% (p<0.001). On average participants meeting the ADA treatment target at baseline remained at target at 6-mo and 1-yr.
In conclusion, participation in the Onduo VDC was associated with a significant reduction in A1c at 1-yr in those not meeting treatment targets, with approximately 2-fold greater improvement with CGM use. These results suggest that improvement in A1c observed at 6-mo was maintained at 1-yr.
J. E. Layne: Employee; Self; Onduo LLC. R. M. Bergenstal: Advisory Panel; Self; Abbott Diabetes, Eli Lilly and Company, Novo Nordisk, Onduo LLC., Roche , Sanofi, United Healthcare , Consultant; Self; Abbott Diabetes, Ascensia , Dexcom, Inc., Eli Lilly and Company, Hygieia, Johnson & Johnson, Medtronic, Novo Nordisk, Onduo LLC., Roche, Sanofi, United Healthcare, Other Relationship; Self; HealthPartners Institute, Research Support; Self; Abbott Diabetes, Dexcom, Inc., Eli Lilly and Company, Helmsley Charitable Trust, Hygieia, Johnson & Johnson, Medtronic, NIDDK, Novo Nordisk, Onduo LLC., Roche, Sanofi, United Healthcare. N. A. Barleen: Employee; Self; Onduo LLC. R. F. Dixon: None. H. Zisser: Employee; Self; Verily Life Sciences, Stock/Shareholder; Self; Verily Life Sciences.
