970-P: Effectiveness of Continuous Glucose Monitoring Use for Diabetes Management in an Academic Endocrinology Practice

Abstract

The achievement of individualized glycemic targets in patients with diabetes is often a significant challenge. Empowering patients with technological tools in the ambulatory setting can pave the way for improved glucose control. We retrospectively examined the records of 94 patients managed in an academic endocrinology practice who were referred for management of diabetes over a 12-month period. Forty-one patients (18 females and 23 males, average age 57.7 years), who had at least two hemoglobin A1c measurements and two 14-day periods of personal continuous glucose monitoring (CGM) data, were included in the analysis. Nine patients had type 1 and 32 patients had type 2 diabetes. Eight patients were not on any insulin therapy, 8 patients were on basal insulin, 18 were using multiple daily insulin injections, and 7 were managed with insulin pump therapy. A multidisciplinary management approach was utilized. The pharmacologic regimen, including both insulin and other medications, was adjusted every 2-4 weeks via in-person visits and remote data upload as necessary. The average A1c was 8.4% at initial visit and 7.1% at the most recent follow-up, a decrease of 1.3% (p=0.0002). Review of CGM data showed that the average time-in-range (70-180 mg/dl) increased from 63.6% at first CGM download to 74.1% at a mean follow-up of 301 days (p=0.0097), while the amount of time in the hyperglycemic range (time-above-range, >180 mg/dl) decreased from 33.5% to 22.1% (p=0.0079). Time-below-range (<70 mg/dl) remained statistically unchanged, signifying no worsening of hypoglycemia. In conclusion, in ambulatory patients with diabetes and suboptimal glucose control, frequent and tailored adjustments in insulin and noninsulin medications aided by CGM use with close follow-up can lead to significant improvement in glycemic control. The latter, if sustained, can translate to fewer complications and greater patient satisfaction in the long-term. Disclosure K.N.Grennan: None. A.A.Rizvi: None. A.Kathuria: None.