Abstract
BackgroundThe study objective was to evaluate the effects of professional continuous glucose monitoring (CGM) as an adjuvant educational tool for improving glycemic control in patients with type 2 diabetes (T2D).MethodsWe conducted a three-month quasi-experimental study with an intervention (IGr) and control group (CGr) and ex-ante and ex-post evaluations in one family medicine clinic in Mexico City. Participants were T2D patients with HbA1c > 8% attending a comprehensive diabetes care program. In addition to the program, the IGr wore a professional CGM sensor (iPro™2) during the first 7 days of the study. Following this period, IGr participants had a medical consultation for the CGM results and treatment adjustments. Additionally, they received an educational session and personalized diet plan from a dietitian. After 3 months, the IGr again wore the CGM sensor for 1 week. The primary outcome variable was HbA1c level measured at baseline and 3 months after the CGM intervention. We analyzed the effect of the intervention on HbA1c levels by estimating the differences-in-differences treatment effect (Diff-in-Diff). Additionally, baseline and three-month CGM and dietary information were recorded for the IGr and analyzed using the Student’s paired t-test and mixed-effects generalized linear models to control for patients’ baseline characteristics.ResultsOverall, 302 T2D patients participated in the study (IGr, n = 150; control, n = 152). At the end of the three-month follow-up, we observed 0.439 mean HbA1C difference between groups (p = 0.004), with an additional decrease in HbA1c levels in the IGr compared with the CGr (Diff-in-Diff HbA1c mean of − 0.481% points, p = 0.023). Moreover, compared with the baseline, the three-month CGM patterns showed a significant increase in the percentage of time in glucose range (+ 7.25; p = 0.011); a reduction in the percentage of time above 180 mg/dl (− 6.01; p = 0.045), a decrease in glycemic variability (− 3.94, p = 0.034); and improvements in dietary patterns, shown by a reduction in total caloric intake (− 197.66 Kcal/day; p = 0.0001).ConclusionProfessional CGM contributes to reducing HbA1c levels and is an adjuvant educational tool that can improve glycemic control in patients with T2D.Trial registrationClinicalTrials.gov: NCT04667728. Registered 16/12/2020
Highlights
The study objective was to evaluate the effects of professional continuous glucose monitoring (CGM) as an adjuvant educational tool for improving glycemic control in patients with type 2 diabetes (T2D)
Professional CGM contributes to reducing Hemoglobin A1c (HbA1c) levels and is an adjuvant educational tool that can improve glycemic control in patients with T2D
Most participants were women (CGr 65.3%; intervention groups (IGr) 71.7%); their average age ranged between (IGr) and years (CGr); and most had completed high school or a university degree (CGr 62%; IGr 59.2%). Both groups had a high prevalence of overweight/obesity (CGr 86%; IGr 81.6%)
Summary
The study objective was to evaluate the effects of professional continuous glucose monitoring (CGM) as an adjuvant educational tool for improving glycemic control in patients with type 2 diabetes (T2D). Diabetes is a global health threat due to the high morbidity, disability-adjusted life years, premature mortality, and healthcare costs attributed to the disease. Glycemic control is the primary mechanism for preventing acute and chronic complications, disability, and premature mortality among diabetes patients [2, 3], it is achieved by only 20.9–24.9% of diabetes patients living in LMICs [4]. HbA1c is not an indicator for daily glucose variability, including hypoglycemic events. To assess daily blood glucose variability, determine individual glycemic targets, and provide personalized treatment of diabetes, patients must perform selfmonitoring of blood glucose (SMBG). SMBG fails to provide a complete picture of blood glucose trends and detect hyperglycemic events [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
