Continuous Blood Glucose Monitoring Outcomes in Veterans With Type 2 Diabetes.

Abstract

Nearly 25% of patients served in the US Department of Veterans Affairs have been diagnosed with type 2 diabetes mellitus (T2DM). Patients with DM typically monitor their blood glucose using intermittent fingerstick self-testing. Continuous glucose monitoring (CGM) might offer improved disease management. We conducted a retrospective of VA patient records using a pre-post model. Average hemoglobin A1c (HbA1c) values were calculated for the year before and the year after CGM initiation. Our primary objective was to determine change in HbA1c from the year before CGM initiation to the year after. Secondary objectives included changes in blood pressure, weight, and DM-related hospital and clinic visits during the same time frame. Both the total population and the adherent subgroup showed reduction in HbA1c. The complete population showed a HbA1c change of -0.3, and the adherent subgroup had a change of -1.3. The total population had a mean change in weight of -1.9 lb (-0.9 kg), and the adherent subgroup had an average change of -8.0 lb. Average systolic blood pressure changes were -0.1 mm Hg in the total population and +3.3 mm Hg in the adherent subgroup. A decrease in total encounters for DM complications was observed in the total population (-0.3 total encounters per patient) and the adherent subgroup (-0.6 total encounters per patient). CGM did not correspond with clinically significant reductions in HbA1c. However, veterans with increased health care engagement were likely to achieve clinically significant HbA1c improvements. Adherent patients also had more reduction in weight and hospital or clinic visits with CGM compared with the total population.