8122 CGM use and its Impact on Diabetes Self-Management Behaviors: Insights from a Pilot Study Paving the Way for Targeted Interventions in Specialty Clinic

Abstract

Abstract Disclosure: K.M. St. Jean: None. P. Underwood: None. R. Longo: None. J. Keels: None. J. Upadhyay: None. Introduction: Continuous glucose monitor (CGM) use is increasing. While the relationship between CGM use and improved diabetes (DM) clinical outcomes is well known (lower hemoglobin A1c (A1c), reduced hypoglycemia events), the mechanisms underlying this association are unknown. Further, the factors that contribute to successful CGM use by patients and whether CGM use influences diabetes self-management behavior (DMB) change are still undetermined. Objective: To understand the extent to which personal CGM use influences DMB versus user-blind CGM. In addition, patient satisfaction and provider perspective were evaluated during the study. Methodology: A pilot-randomized control trial (RCT) was conducted on 30 patients (15 libre-professional CGM and 15 libre 2 CGM). Adults (18-80y) with an ICD-10 diagnosis of DM within the past 12 months, A1c >8% measured within the past 6 months, stable weight within the past 3 months (BMI ± 2 units), able to speak, read, and write English, and a negative pregnancy test for women of childbearing age seen in the Lahey Endocrine Clinic were included.Exclusion criteria included evidence of personal CGM device use prior to the trial, addition of new oral or injectable hypoglycemic agents within 3 months of trial start, current or anticipated acute use of steroids, pregnancy, medical conditions that, per investigator determination, make it unsafe to target A1c <8%, severe psychiatric illness, homeless, current substance abuse, vision or hearing impairment that may affect the use of CGM. All participants were given information on how to incorporate the CGM into daily DM management and general diabetes self-management education (DSME). DMB was measured using the Diabetes Self Care Inventory-Revised scale, which was provided at visit 1 (baseline), visit 2 (2 weeks), and visit 3 (3-6 months). Additional outcome variables, including Diabetes Distress, sleep quality, exercise habits, and nutrition, were obtained. A1c was measured at baseline and at the end of visit 3. Provider satisfaction with patient CGM use was also evaluated using a newly developed provider satisfaction survey. Results: This study remains active for enrollment. Thus far, 14 patients have been recruited (7 in Libre 2 arm and 7 in Libre Pro User blind arm). Based on initial results, personal-CGM use supports improved diabetes self-care. Further, improvements in A1c, glucose time in target range, and lower rates of hypoglycemia are evident in all CGM users. Further, 100% of the providers felt that CGM use by their patients was very effective and helped their clinical decision-making during the visit. Providers did not feel that reviewing CGM data prolonged their visit. Conclusion: This pilot suggests that personal CGM use improves diabetes self-management behavior and reaffirms that CGM use in patients with poorly controlled diabetes is associated with improved DM clinical outcomes. Presentation: 6/3/2024