Improvement of glucose control after successful introduction of Continuous Glucose Monitoring (CGM) in internal medicine residency continuity community clinic- retrospective, longitudinal one group study

Abstract

In our study we retrospectively looked at patients in which as a standard of care Continuous Glucose Monitoring (CGM) with Dexcom G6 Device was started in Internal Medicine Residency Continuity Community clinic in Mountain View Hospital, Las Vegas, Nevada in 10-patients with Type- II diabetes mellitus uncontrolled on 3-4 injections of Insulin per day-Multiple Injections of Insulin per day (MDI) who were Self- monitoring their blood glucose 4- times a day (SMBG). The CGM was initiated by Internal Medicine Residents, adjustment of the Insulin dose was done by them under the supervision of Board-Certified Endocrinologist. The goal was to show improvement of patients HbA1c measured by glucose management Indicator. The HbA1c was reduced in 3- months after introduction of the CGM from 10.0% to 7.87%. Time in range we achieved was 65% with the goal based on patient’s age and comorbid conditions between 50 and 70%. Based on the average age of the patient of 51- years this is compatible with the goals using CGM. The main objective of our study was that it was possible to show improvement of glucose control measured by changes in HbA1c after introduction of CGM in most difficult to treat patients with Type -II Diabetes Mellitus by Internal Medicine Residents under the supervision of Endocrine specialist. This can be adopted by other Internal Medicine Residency Programs in USA.