Continuous glucose monitoring shared medical appointments improve diabetes self‐efficacy and hemoglobin A1C

Abstract

AbstractIntroductionDiabetes self‐management education and support and professional continuous glucose monitoring (CGM) were combined into shared medical appointments (SMA) to provide care for people with diabetes. Although the individual components have evidence of efficacy, this combination has never been studied.ObjectivesThe purpose of this study is to assess the impact of CGM SMA on diabetes self‐efficacy and hemoglobin A1C (A1C) in persons with diabetes.MethodsAdults who attended a two‐part CGM SMA at a large academic medical center were included in this retrospective, pre‐post study. The CGM SMA incorporated diabetes education, peer support, and seven days of professional CGM. The primary outcome was change in diabetes self‐efficacy through a validated eight‐item Likert Scale instrument. Secondary objectives were changes in A1C, changes in diabetes medications, and type of planned lifestyle changes. Paired t tests were used to analyze change in A1C and diabetes self‐efficacy scores.ResultsA total of 171 participants were included in this analysis. Diabetes self‐efficacy scores increased by a mean of 1.63 ± 2.09 points (P < .001) out of 10 points maximum after participation in the two‐part CGM SMA. The A1C decreased by a mean of 0.80 ± 1.52% (P < .001), with a mean follow‐up A1C of 7.8 ± 1.60%. Those with an A1C > 8% (n = 101) experienced a decrease of 1.20%. Participants utilizing the unblinded device (n = 133) experienced a decrease in A1C by 0.75% compared with 1.0% in those that utilized a blinded device (n = 38). Most medication changes made in the CGM SMA were dosage adjustments and changes in administration time.ConclusionsThe CGM SMA is a novel practice model incorporating diabetes education, peer support, professional CGM, and interprofessional care that demonstrated improvements in diabetes self‐efficacy and A1C.