1280-P: Effect of Professional CGM (pCGM) on Glucose Management in Type 2 Diabetes Patients in Primary Care

Abstract

Background: Very little data exists regarding the impact of CGM in the primary care management of type 2 diabetes (T2D). We initiated a QI project in a large health care system to determine the effect of pCGM on glucose management. We evaluated a MD model, and an RN/Certified Diabetes Educator (CDE) model. Methods: Patients (pts) with T2D for >1 year, A1C ≥7.0 and <11.0%, managed with any T2D regimen, and willing to use pCGM were included. Baseline A1C was collected and pts wore a pCGM (Libre Pro) up to 2 weeks followed by a visit with MD or RN/CDE (MD consultation if needed) to review CGM data including Ambulatory Glucose Profile (AGP). Shared decision making was used to modify lifestyle and medication regimen. Clinic follow-up in 3-6 months included an A1C and in a subset a repeat CGM. Results: Sixty-eight pts average age 61.6 years, average duration of T2D 15 years, mean A1C 8.8%, were identified. Pre to post pCGM lowered A1C from 8.8 ± 1.2% to 8.2 ± 1.3% (n=68, p=0.006). The time in range (TIR) and time in hyperglycemia improved along with slightly more hypoglycemia in the subset of 37 pts who wore a second pCGM (Table). Glycemic improvement was largely due to lifestyle counseling (68% of pts) and intensification of current therapy (65% of pts), and not due to addition of medications. Conclusion: Using pCGM in a primary care setting, with an MD or RN/CDE model, is effective at lowering A1C, increasing TIR and reducing time in hyperglycemia. Disclosure T.W. Martens: Research Support; Self; Abbott Laboratories, Dexcom, Inc., Medtronic, Novo Nordisk Inc. R.M. Bergenstal: Research Support; Self; Abbott, Boehringer Ingelheim Pharmaceuticals, Inc., Dexcom, Inc., Glooko, Inc., Hygieia, JDRF, Johnson & Johnson Medical Devices Companies, Lilly Diabetes, Medtronic MiniMed, Inc., Merck & Co., Inc., National Institute of Diabetes and Digestive and Kidney Diseases, Novo Nordisk Inc., Roche Diabetes Care, Sanofi. Other Relationship; Self; Abbott, Helmsley Charitable Trust, Hygieia, Lilly Diabetes, Novo Nordisk Inc., Onduo LLC, Sanofi, UnitedHealth Group Inc. M.L. Johnson: Research Support; Self; Abbott, Calibra Medical, CeQur Corporation, Dexcom, Inc., Medtronic, National Institute of Diabetes and Digestive and Kidney Diseases, Novo Nordisk Inc., Sanofi. J.L. Davidson: None. G. Simonson: Advisory Panel; Self; Merck & Co., Inc. Research Support; Self; Abbott. Funding Abbott Laboratories