Abstract #1406876: Use of Continuous Glucose Monitoring in Conjunction with the GluCare Health Care Model in Patients with Prediabetes

Abstract

Prediabetes is a state which increases the risk of type 2 diabetes. Continuous Glucose Monitoring (CGM) provides data for glycaemic variability (GV) as a coefficient of variation (CV). GluCare Health is a hybrid, data-driven approach in the management of metabolic diseases and combines in-clinic treatment with Continuous Metabolic Monitoring (CMM) through wearables, so patients are in continuous contact with their care team in the cloud. This team consists of physicians, educators, nurses, dietitians, and coaches, and provides real-time support when the patient needs it most, not just during their clinical visits. Patients were also encouraged to log their meals via a picture using a connected app. Previous studies have shown improvement in models utilizing digital biomarker tracking in chronic diseases as diabetes and obesity and GluCare Health showed a relevant reduction in HbA1C in a population with diabetes in 2021. All patients visited a GluCare Center located in Dubai, UAE at the initial visit and were tested for HbA1C, fasting blood glucose (FBG) and provided with CGMs and other wearables. We retrospectively evaluated patients with prediabetes between 18-65 ages who wore CGMs for at least 2 weeks and compared the GV between the first and second weeks. All patients received feedback via a cause-and-effect approach primarily on nutritional choices which included advice from the team regarding glucose patterns-peaks and how to manage them. Change in glycaemic variability according to CGM device and gender is also evaluated. 26 patients who wore CGM were evaluated.10 patients were female and 16 patients were male. The mean age was 45.6. Mean HbA1C was 5.5%. Mean FBG was 103mg/dL (89-110),15 patients wore DEXCOM G6 and 11 patients wore Freestyle Libre. In the whole group, mean CV was 15.7% in the first week and 13.97% in the second week. There was a significant improvement in GV in the whole group (p< 0.01). CV decreased from 17.07% to 14.77% in DEXCOM G6 group which was statistically significant (p= 0.03) and 13.84% to 12.90% in Freestyle Libre group which could not reach significance (p= 0.06). CV significantly decreased from 15.16% to 13.59% in females (p=0.01) and from 15.74% to 14.0% (p= 0.06) in males which could not reach significance. This study showed GV can be improved in patients with prediabetes who used CGM devices along with the GluCare Health’s CMM. A continuous model of monitoring along with increased engagement in conjunction with CGM use, can be a better approach to tackling prediabetes, prevent progression to diabetes and improve glucose hemostasis, in comparison to episodic or usual care.