Effect Of Continuous Glucose Monitoring Research Articles

Techniques for Implementing Continuous Glucose Monitoring in Primary Care: Key CGM Updates and Highlights from the EASD2024 Conference [Podcast

This article discusses innovations, advancements, and discoveries in continuous glucose monitoring (CGM) that were presented at the European Association for the Study of Diabetes 2024 Conference in Madrid, Spain, held in September 2024. Specifically, the author will discuss data from studies that discuss the impact of CGM on hemoglobin A1C in people with type 2 diabetes; the impact of CGM use in hospitalization settings for people with diabetes; the effectiveness of CGM in those who have undergone cardiac surgery; the efficacy of real-time CGM in adults hospitalized with diabetic ketoacidosis; time in rage in older individuals; and new devices for glucose sensing.

The effectiveness of continuous glucose monitoring with remote telemonitoring-enabled virtual educator visits in adults with non-insulin dependent type 2 diabetes: A randomized trial

AimsEstimate the effectiveness of continuous glucose monitoring (CGM) with remote telemonitoring-enabled virtual diabetes educator visits for improving glycemic management in adults with type 2 diabetes, not on insulin. MethodsParticipants with type 2 diabetes, not on insulin, and HbA1c > 7.0 % were enrolled in an open-label randomized trial of 6 weeks of CGM with telemonitoring versus enhanced usual care. Both groups received educator visits. HbA1c was assessed at 12 weeks. ResultsOf 105 participants (mean age 57.3 years, 49.5 % females, mean baseline HbA1c 8.0 %), 86 remained at follow-up. Change in HbA1c was −0.69 % (CGM) versus −0.33 % (enhanced usual care). Adjusting for baseline HbA1c, CGM was superior (0.65 % greater HbA1c reduction [95 % CI 0.17–1.12 %], p = 0.008). CGM participants were 92 % (RR = 1.92, 1.19–3.06, p = 0.007) more likely to have an HbA1c reduction ≥ 0.5 %, lost more weight (difference in weight reduction 2.17 kg, 0.22–4.11, p = 0.029) and were more satisfied with their treatment. No treatment-related adverse events were observed. ConclusionsCGM with virtual diabetes educator visits is effective, safe, and acceptable in adults with type 2 diabetes not on insulin and should be considered as an alternative to drug therapy for improving blood glucose.

Continuous glucose monitoring for self-management of diabetes in people living with type 2 diabetes mellitus on basal insulin therapy: A microsimulation model and cost-effectiveness analysis from a US perspective with relevance to Medicaid.

Reducing the risks of complications is a primary goal of diabetes management, with effective glycemic control a key factor. Glucose monitoring using continuous glucose monitoring (CGM) technology is an important part of diabetes self-management, helping patients reach and maintain targeted glucose and glycated hemoglobin (HbA1c) levels. Although clinical guidelines recommended CGM use, coverage by Medicaid is limited, likely because of cost concerns. To assess the cost-effectiveness of FreeStyle Libre CGM systems, compared with capillary-based self-monitoring of blood glucose (SMBG), in US individuals with type 2 diabetes mellitus using basal insulin. A patient-level microsimulation model was used to compare CGM with SMBG for a population of 10,000 patients. A 10-year horizon was used, with an annual discount rate of 3.0% for costs and utilities. Model population characteristics were based on US national epidemiology data. Patient outcomes were based on published clinical trials and real-world studies. Annual costs, reflective of 2023 values, included CGM and SMBG acquisition costs and the costs of treating diabetic ketoacidosis, severe hypoglycemia, and diabetes complications. The effect of CGM was modeled as a persistent 1.1% reduction in HbA1c relative to SMBG based on US real-world evidence. Disutilities were based on published clinical trials and other relevant literature. The primary outcome was cost per quality-adjusted life-year (QALY) gained. Sensitivity analyses were performed to test the validity of the model results when accounting for a plausible variation of inputs. In the base case analysis, CGM was dominant to SMBG, providing more QALYs (6.18 vs 5.97) at a lower cost ($70,137 vs $71,809) over the 10-year time horizon. A $10,456 increase in glucose monitoring costs was offset by a $12,127 reduction in treatment costs. Cost savings reflected avoidance of acute diabetic events (savings owing to reductions in severe hypoglycemia and diabetic ketoacidosis were $271 and $2,159, respectively) and a reduced cumulative incidence of diabetes complications, particularly renal failure (saving $5,292), myocardial infarction (saving $1,996), and congestive heart failure (saving $1,061). Scenario analyses were consistent with the base case results, and the incremental cost-effectiveness ratio for CGM vs SMBG ranged from dominant to cost-effective. In probabilistic analysis, CGM was 100% likely to be cost-effective at a willingness-to-pay threshold of $50,000/QALY. CGM is cost-effective compared with SMBG for US patients with type 2 diabetes mellitus receiving basal insulin therapy. This suggests that state Medicaid programs could benefit from broader coverage of CGM.

The association of continuous glucose monitoring with glycemic parameters in patients with uncontrolled type 2 diabetes: A prospective observational study.

Uncontrolled glycemic parameters in type 2 diabetes mellitus (T2DM) are a major concern. The present study aimed to evaluate the effectiveness of continuous glucose monitoring (CGM) on glycemic control in type 2 diabetics on insulin therapy. This prospective observational study was done in the Outpatient Department of General Medicine from January 1, 2021 till December 31, 2021 on patients with confirmed T2DM and on insulin therapy. Patients underwent detailed history and physical examination. The CGM device was inserted to record blood glucose levels throughout the day and night for monitoring. Parameters like glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), post-paradial blood sugar (PPBS), and lipid profile parameters [cholesterol, triglyceride (TG), and low-density lipoprotein (LDL)] were compared at baseline and after a follow-up of 3 months. P-value < 0.05 was used to indicate significant difference. Of 107 patients screened, 100 were included in the study and seven were excluded. The mean age of the patients was 60.6 ± 11.1 years. Fifty-six (56%) of the patients were males, and 44 (44%) were females. The mean body mass index (BMI) was 22.9 ± 2.4 kg/m2. Compared to baseline values, after 3 months of CGM, there was significantly decreased HbA1c (9.41 ± 0.83 vs 9.87 ± 1.16 g%, P < 0.001), FBS (194.640 ± 22.4587 vs 205.10 ± 35.7758 mg/dl, P = 0.002), PPBS (271.160 ± 29.1235 vs 299.180 ± 42.3798, P < 0.001), cholesterol (184.470 ± 28.5192 vs 198.430 ± 38.8367 mg/dl, P < 0.001), LDL (102.410 ± 22.8973 vs 112.040 ± 30.8859, P < 0.001), and TG (140.890 ± 18.0979 vs 146.730 ± 20.8665 mg/dl, P < 0.001). There was a significant improvement in the glycemic parameters and lipid profile parameters with the adoption of CGM. Overall, CGM is a novel method for practical use for management of patients with T2DM.

Effectiveness of Continuous Glucose Monitoring in Glucose Control and Quality of Life Among Type 1 Diabetic Patients in Madina City: A Cross-Sectional Study.

Diabetes is a growing global health problem, affecting millions of people worldwide and in Saudi Arabia in particular. Continuous glucose monitoring (CGM) offers real-time glucose levels, alerts, and 24/7 coverage, making it an affordable treatment option. The study aimed to assess CGM's effect on diabetes control and quality of life among type 1 adult diabetic patients in Saudi Arabia. This cross-sectional study enrolled Saudi adults diagnosed with type I diabetesand was conducted from 1 April 2024 to 30 May 2024 in Madinah City, Saudi Arabia. Data was collected from patients' medical records and the diabetes quality of life questionnaire (DQoL). This study enrolled 317 participants, mostly male (52.1%) and a mean age of 34.34±12.28 years. After three months, the HbA1c levels significantly decreased (p<0.001). Older participants reported lower overall quality of life and satisfaction with their level of well-being when using CGM. Univariate analysis found that age had a significant negative association with the total score (B=-0.062, P=0.049) and satisfaction (B=-0.109, P=0.011. Marital status significantly affected the impact score (B=0.567, P=0.024). Education level notably affected satisfaction (B=-0.906, P=0.008)and monthly income influenced satisfaction (B=-1.25, P=0.033). However, multivariate analysis showed that age, education level, and monthly income did not significantly (p>0.005) affect the CGM impact, quality of life, and satisfaction. These findings indicate that CGM significantly improved diabetes control, while improved quality of life was not significant. The impact, quality of life, and satisfaction were influenced by age, marital status, education, and income level, though not statistically significant independent predictors. Therefore, we recommend longitudinal studies, controlling for confounders.

989-P: The Effect of Continuous Glucose Monitoring on Postoperative Glucose Control in People with Type 2 Diabetes Mellitus Undergoing Coronary Artery Bypass Grafting—A Randomized Clinical Trial

989-P: The Effect of Continuous Glucose Monitoring on Postoperative Glucose Control in People with Type 2 Diabetes Mellitus Undergoing Coronary Artery Bypass Grafting—A Randomized Clinical Trial

611-P: Effect of Continuous Glucose Monitoring (CGM) vs. Blood Glucose Monitoring (BGM) during a Nutrition Intervention on Time in Range (TIR)

611-P: Effect of Continuous Glucose Monitoring (CGM) vs. Blood Glucose Monitoring (BGM) during a Nutrition Intervention on Time in Range (TIR)

Continuous glucose monitoring in pregnant women with pregestational type 2 diabetes: a narrative review.

Background: Type 2 diabetes (T2DM) in pregnancy is associated with poor perinatal outcomes; however, there are limited data on outcomes of continuous glucose monitoring (CGM) use in this population. Objective: We reviewed the literature on studies reporting CGM outcomes in pregnant women with T2DM. We aimed to synthesise in a narrative review, the effects of CGM on glycaemic and perinatal outcomes as well as current research gaps. Results: Of 34 articles screened, three reported CGM outcomes in T2DM pregnancies compared to self-monitoring of blood glucose (SMBG). Other feasibility and mixed population studies were also reviewed. CGM in T2DM has good feasibility, acceptability, and improved glycaemic control beyond SMBG. There were limited data to draw conclusions on its effect on maternal and fetal outcomes. Conclusion: Further studies of perinatal outcomes in pregnant women with T2DM are required to determine the impact of improved glycaemia with CGM.

Developing an intervention to support dietary change for shift workers living with type 2 diabetes: A stakeholder consultation.

Shift workers, compared to day workers, are more likely to be diagnosed with type 2 diabetes (T2D). Currently, there is no tailored programme of dietary support available to either shift workers living with T2D or employers. An intervention development consultation workshop was convened in June 2023 with the aim of evaluating potential interventions to identify those with a potential to take forward for further development. Findings from prior formative research into factors influencing dietary behaviour in shift workers with T2D were mapped to potential interventions addressing the barriers and enablers to healthy eating reported by shift workers with T2D. The findings of the Shift-Diabetes Study were presented in the context of the COM-B (Capability, Opportunity, Motivation, Behaviour) theoretical framework of behaviour change. Three interventions in turn were presented to attendees: (1) Educational resources and structured education, (2) Increasing availability and accessibility of food on a night shift and (3) Biofeedback and tailored advice. Seven workshop attendees were invited to express their thoughts, using the APEASE criteria (Affordability, Practicability, Effectiveness, Acceptability, Side-effects/Safety, Equity) to guide the discussion. The workshop was conducted online and recorded, and transcripts were thematically coded to the APEASE framework. The workshop highlighted the importance of multilevel interventions to support dietary behaviour change in this occupational group. Priority actions identified include (i) understanding barriers to 24/7 food availability, (ii) including shift workers in clinical diabetes studies and (iii) research to understand the effectiveness of continuous glucose monitoring in shift workers with T2D.

Clinical Effectiveness of Continuous Glucose Monitoring in Pregnancies Affected by Type 1 Diabetes.

Background: Continuous glucose monitoring (CGM) improves neonatal outcomes in type 1 diabetes pregnancies; however, its effectiveness has not been assessed in a real-world setting in the United States. Objective: The Triple C Study aimed to examine the clinical effectiveness, assessed through maternal glucose control and gestational health outcomes, of CGM use compared with self-monitoring of blood glucose (SMBG) in pregnancies associated with type 1 diabetes in a real-world setting. Research Design and Methods: We retrospectively identified 160 type 1 diabetes pregnancies at the Barbara Davis Center for Diabetes managed with CGM therapy (n = 109) or SMBG (n = 51) over a 6.5-year period (2014-2020). Obstetric care was provided at multiple practices. CGM use was defined as ≥60% wear in the second and third trimesters of pregnancy. Data were obtained from the electronic medical record system, hospital records, and vital statistics departments (Colorado and Wyoming). We used Student's t-test for continuous variables and chi-square test for categorical variables to compare outcomes between groups. Results: The CGM group had more participants meeting trimester-specific hemoglobin A1C (HbA1c) goals throughout pregnancy and postpartum (P < 0.01 in each time period). The CGM group had fewer participants never meeting HbA1c goals in any trimester than the SMBG group (P < 0.001). There were no significant differences in neonatal outcomes between groups, other than for macrosomia (12.8% CGM vs. 29.4% SMBG, P = 0.01). Infants of CGM users required a neonatal intensive care unit admission less often (52.9% CGM vs. 68.3% SMBG, P = 0.0989). Conclusions: CGM use was associated with improved maternal glucose levels in a diverse real-world cohort.

Effects of Continuous Glucose Monitoring on Glycemic Control in Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Systematic review was performed according to PRISMA criteria. The search was conducted for articles published until 31 May 2023 in PubMed, CINAHL, Cochrane Library, EMBASE, ClinicalKey, etc. The meta-analysis involved the synthesis of effect size; tests of homogeneity and heterogeneity; trim and fill plot; Egger's regression test; and Begg's test for assessing publication bias. 491 studies were searched, of which 17 studies that met the selection criteria were analyzed. The overall effect on HbA1c was -0.37 (95% CI, -0.63~-0.11, p < 0.001), with HbA1c decreasing significantly after CGM interventions. Sub-analyses showed that the study was statistically significant in those aged 60 years or older, when rt-CGM was used and when the study was performed in multiple centers. The results of this study showed that intervention using CGM was effective in reducing HbA1c in type 2 diabetes. The factors identified in this study can be used as guidelines for developing future CGM intervention programs.

Modern methods for assessing compensation of diabetes mellitus. Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes

Background. An integral part of diabetes mellitus (DM) management is its timely diagnosis. The reference method to study the quality of glycemic control is evaluating the level of glycated hemoglobin (HbA1c) as one of the most accessible and informative tools. However, the introduction of novel technologies, namely the use of continuous glucose monitoring (CGM), has given patients with DM, their relatives and healthcare professionals an access to new indicators of glycemic control such as time in range (TIR), time above range and time below range. These indicators are criteria for compensation of carbohydrate metabolism according to the 2023 American Diabetes Association guidelines. The purpose of the study was to compare the effectiveness of using glucometers and the FreeStyle Libre system for flash glucose monitoring in patients with DM. Materials and methods. An examination of 60 patients with type 2 DM who received insulin therapy was conducted. They were aged 45–65 years, with DM duration of 5 ± 2 years. All participants were divided into two equal groups of 30 people each. The first group consisted of patients with CGM devices, the second group used glucometers for daily glycemic control. Additional CGM parameters were used: glucose coefficient of variation, glucose management indicator, which shows the probable level of HbA1c. Results. When evaluating the data obtained from patients who used CGM, it is important to note their high adherence to the use of flash glucose monitoring. The use of CGM made it possible to achieve compensation of carbohydrate metabolism faster compared to patients who used glucometers to correct glycemia. Discontinuation of CGM resulted in poorer glycemic control. The obtained results prove that the compensation of patients depends primarily on their motivation, willingness to follow medical prescriptions, careful glycemic control, and compliance with medical recommendations. Conclusions. For better control of the DM course, patients should use CGM. In order to assess diabetes compensation, it is not enough to consider only TIR. Time below range indicating hypoglycemia, time above range indicating hyperglycemia, glucose management indicator should also be taken into account. Discontinuation of CGM resulted in a loss of approximately half of the initial TIR gain achieved while using CGM. CGM is more favored among patients than a 7-point self-monitoring of blood glucose.

EVALUATION OF CONTINUOUS GLUCOSE MONITORING (isCGM) ON TYPE 2 DIABETES PATIENTS TREATED WITH BASAL – BOLUS INSULIN THERAPY

SUMMARY&#x0D; Objective: Evaluate effectiveness of continuous glucose monitoring (isCGM) on type 2 diabetes patients treated with basal – bolus insulin therapy. Method: Descriptive and interventional study on 29 type 2 diabetes patients treated with basal – bolus insulin therapy at Department of Endocrinology and Diabetes, Bachmai Hospital from 1/2023 to 7/2023. Results: Average age is 61.4 ± 17.4. The majority oral antidiabetic drug is Metformin combined with Anti DDP4 (37%), bolus insulin is Regular (73%), basal insulin is Glargine U100 (97%). Average HbA1c is 10,8 ± 2,8 %, average serum glucose on arrival is 17.2 ± 11.6 mmol/L. Time in range on 14th day 66,2 ± 16.9% higher than the 1st day 55.1 ± 29.0% (p=0.03). CGM can detect more hypoglycemia events than point-of-care capillary blood glucose (34.2% versus 17.2%). Adverse reaction rate is 3.4% only. Conclusion: Continuous glucose monitoring is not only useful in controlling blood glucose level but also in detecting more hypoglycemia events than point-of-care capillary blood glucose.

HTA75 Evaluation of the Clinical and Economic Effectiveness of Continuous Glucose Monitoring in Adults With Type 1 Diabetes Mellitus in the Healthcare System of the Republic of Kazakhstan

HTA75 Evaluation of the Clinical and Economic Effectiveness of Continuous Glucose Monitoring in Adults With Type 1 Diabetes Mellitus in the Healthcare System of the Republic of Kazakhstan

Effectiveness of Continuous Glucose Monitoring on Metrics of Glycemic Control in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

To provide a systematic review and meta-analysis synthesizing the findings of randomized controlled trials (RCTs) of continuous glucose monitors (CGMs) in the management of adults with type 2 diabetes mellitus (T2DM) on glucose control and clinical outcomes. MEDLINE, Embase, and Cochrane were searched for RCTs that assessed the effectiveness of real-time CGM (rt-CGM) or flash CGM (FGM) in adults (≥18 years) with T2DM that reported on at least 1 of the following outcomes: hemoglobin A1c (HbA1c), time in range, time in hyperglycemia, or time in hypoglycemia. The GRADE approach was used to assess certainty of evidence for primary outcomes. Fourteen RCTs assessing CGM were included, with 825 patients in 9 RCTs using rt-CGM and 822 in 5 RCTs using FGM. Moderate certainty of evidence indicated that use of CGM had a modest but statistically significant reduction in HbA1c levels of about 0.32%. Our analyses of each device type separately showed similar reductions in HbA1c (0.34% and 0.33%, respectively, for rt-CGM and FGM), with trends for improvement in other glucose metrics favoring rt-CGM over self-monitored blood glucose. Both rt-CGM and flash CGM led to modest but statistically significant declines in HbA1c among individuals with T2DM, with little heterogeneity in the results. However, the duration of the included RCTs was relatively short and few studies reported on important clinical outcomes, such as adverse events, emergency department use, or hospitalization. Longer term studies are needed to determine if the short-term improvements in glucose control leads to improvements in clinically important outcomes.

The Benefits Of Continuous Glucose Monitoring In Pregnancy.

Previous studies have consistently demonstrated the positive effects of continuous glucose monitoring (CGM) on glycemic outcomes and complications of diabetes in people with type 1 diabetes. Guidelines now consider CGM to be an essential and cost-effective device for managing type 1 diabetes. As a result, insurance coverage for it is available. Evidence supporting CGM continues to grow and expand to broader populations, such as pregnant people with type 1 diabetes, people with type 2 diabetes treated only with basal insulin therapy, and even type 2 diabetes that does not require insulin treatment. However, despite the significant risk of hyperglycemia in pregnancy, which leads to complications in more than half of affected newborns, CGM indications and insurance coverage for those patients are unresolved. In this review article, we discuss the latest evidence for using CGM to offer glycemic control and reduce perinatal complications, along with its cost-effectiveness in pregestational type 1 and type 2 diabetes and gestational diabetes mellitus. In addition, we discuss future prospects for CGM coverage and indications based on this evidence.

SAT666 Feasibility, Acceptability And Preliminary Efficacy Of Continuous Glucose Monitoring In Adolescents With Obesity

Abstract Disclosure: S. Chimatapu: None. S. Mittelman: None. M. Habib: None. L. Wisk: None. A. Klomhaus: None. A.P. Vidmar: None. Background: Childhood obesity is a global health concern that presents as a multifaceted challenge requiring comprehensive interventions targeting nutritional, physical activity and behavioral domains. Despite this, treatment outcomes have been modest due to challenges in adherence and individual variability in response. Wearable technologies, such as Continuous Glucose Monitors(CGMs), offer a unique solution to promote consistent weight control in youth. These devices provide real-time biofeedback, allowing youth to make timely and informed decisions about their lifestyle choices. To date, no trial has explored the feasibility and efficacy of CGM use as a standalone intervention for adolescents with obesity. Hypothesis: We hypothesize that this study will demonstrate feasibility, acceptability and preliminary efficacy of CGMs in facilitating weight management among adolescents with obesity. Furthermore, we postulate that the unblinded CGM use will lead to greater changes in diet and physical activity compared to blinded use; emphasizing the use of biofeedback as a motivator for behavior change in this population. Methods: Adolescents with obesity have been recruited into a six-week cross-over trial. All participants wear the CGM daily for six weeks. For three weeks subjects will wear the CGM in a blinded manner, and for the other three weeks they will have access to the real-time CGM data, with blocks assigned in a random, cross-over manner. Outcomes will include recruitment and retention rate, adherence, CGM metrics, sleep, dietary intake, physical activity, eating behaviors and change in weight compared between study arms. Results: We have so far recruited 16 of a goal of 30 adolescents (15.3± 2.4 years old, 68% female, 75% Hispanic). Baseline A1c was 5.6 ± 0.3%. Four participants completed the study; one was lost to follow up, and 11 are currently enrolled in the study. Data logs from weekly telephone calls revealed high continuous engagement throughout the six weeks of the study. Our qualitative analysis of participant feedback suggest that they engaged with their real-time device data during the unblinded window. Device itself was deemed comfortable to wear, fit properly, without adverse effects or negative impacts on daily functioning. One participant reported 2 lbs. weight loss in 2 weeks after wearing the CGM by modifying their behaviors based on the glucose readings. Conclusions: Our preliminary findings suggest that CGM use in youth with obesity is a feasible, acceptable and well-tolerated tool. CGMs also have the potential to bring forth sustainable changes in youth behavior and could be a powerful intervention to enhance lifestyle changes in pediatric weight management programs. Further analyses will be pursued to help understand effect of continuous glucose monitoring on glycemic variability, body composition and self-reported health behaviors in youth with obesity. Presentation: Saturday, June 17, 2023

Characteristics of pregnancy complicated with type 1 and type 2 diabetes.

Diabetes in pregnancy is a major risk factor for adverse perinatal outcomes such as congenital anomalies, hypertensive disorders of pregnancy (HDP), and macrosomia. For the mechanism of onset of type 1 and type 2 diabetes are different, we focused on the difference in perinatal outcomes between the type 1 and type 2 diabetes groups. We retrospectively reviewed 22 pregnancies with type 1 diabetes and 15 pregnancies with type 2 diabetes, who were managed in our single center, with regard to maternal diabetes conditions during pregnancy and neonatal birthweight and blood glucose level. Furthermore, we checked the effect of continuous glucose monitoring and continuous subcutaneous insulin injection in pregnancies with type 1 diabetes. Type 1 diabetes in pregnancy was less controllable and increased neonatal birth weight and neonatal hypoglycemia within 2h after birth after neonatal care unit admission. Continuous glucose monitoring and continuous subcutaneous insulin injection that are convenient to use, had a similar effect in the management of type 1 diabetes during pregnancy, compared with conventional diabetes treatment. In contrast, maternal BMI and HDP were increased in women with type 2 diabetes. In the management of pregnancy with diabetes, we should pay attention to the difference in pregnancy prognosis between type 1 and type 2 diabetes.

The Effectiveness of Continuous Glucose Monitoring Devices in Managing Uncontrolled Diabetes Mellitus: A Retrospective Study.

This retrospective study aimed to assess the effectiveness of continuous glucose monitoring (CGM) devices in managing uncontrolled diabetes mellitus (DM). The study cohort comprised 25 patients with uncontrolled diabetes who received treatment at an internal medicine resident clinic. The objective was to evaluate the impact of transitioning from self-monitoring of blood glucose (SMBG) to CGM devices on glycemic control, as measured by changes in hemoglobin A1c (HbA1c) levels, average blood glucose levels, hypoglycemic events, time spent within the target blood sugar range, and glucose variability. The findings indicated significant improvements in glycemic control with the adoption of CGM devices, highlighting their potential benefits for optimizing diabetes management. The study is particularly interesting because it was done in an internal medicine continuity clinic with the main participation of the internal medicine residents under the supervision of an endocrinologist. It was not done as the majority of the other studies used CGM in specialized endocrinology clinics.

253-OR: Effect of Continuous Glucose Monitoring on Hypoglycemia, Diet Liberalization, and Quality of Life in Post-bariatric Hypoglycemia

Post-bariatric hypoglycemia (PBH), affecting up to 39% of patients with Roux-en-Y gastric bypass (RYGB), is associated with episodes of disabling hypoglycemia, chronic diet restriction and reduced quality of life (QoL). We evaluated the effects of unblinded vs blinded CGM on hypoglycemia, dietary liberalization, and QoL. 15 RYGB patients with confirmed PBH wore in random order, a Dexcom G6 Pro for 10 days blinded and 10 days unblinded with alarm set to 65 mg/dL. The Hypoglycemia Fear Survey II (HFS-II) was administered after each phase to assess hypoglycemia-based worries and behaviors. The number of hypoglycemia events &amp;lt;70, 54, and 40 mg/dL and proportion of time below each threshold was assessed (diurnal and nocturnal) and adjusted for meal intake. The number of diurnal hypoglycemic events &amp;lt;40 and &amp;lt;54 mg/dL were reduced by 66% and 25% respectively, and proportion of time was reduced by 71% and 50% respectively during unblinded vs blinded CGM use, though neither measure reached statistical significance. Diet liberalization was significantly greater during unblinded CGM use (54 vs 45 glucose spikes/10-day period, p=0.012). HFS-II showed improvement in 16/19 worry measures, reaching statistical significance in six. CGM use in patients with PBH enabled diet liberalization, reduced hypoglycemia-based worries, and reduced diurnal hypoglycemia, indicating improved QoL. Disclosure S.Ramanujan: None. N.Turk: None. E.M.Ayhan: None. C.M.Craig: Employee; Eiger BioPharmaceuticals, Stock/Shareholder; Eiger BioPharmaceuticals. T.Mclaughlin: Board Member; January, Inc., Research Support; Merck &amp; Co., Inc., Stock/Shareholder; Eiger Bio. Funding American Diabetes Association (1-19-ICTS-073 to T.M.)