Authors (including presenting author) :
Wong TW(1)(3), Leung HT(1)(3), Chong YC(1)(3), Chan WS(2)(3), Kwok KP(2)(3), Chan SW(2)(3), Wong WM(2)(3), Leung JYY(1)(3), Au KY(2)(3)
Affiliation :
(1)Department of Medicine and Geriatrics, (2)Nursing Services Division, (3)Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
Evidence has shown that CGM reduces hypoglycaemic events, glycaemic variability, and HbA1c level. It reveals glycaemic patterns that allow a more personalized approach in diabetes management.
Objectives :
The aim of this study was to assess how short term personal CGM with professional support would affect treatment decisions and glucose control in T1D and T2D treated with insulin in clinical practice.
Methodology :
This was a single center retrospective cohort study of insulin treated diabetes who attended the diabetes clinic between March 2021 and March 2022 in Ruttonjee Hospital. It included 90 people with diabetes who were offer a physician-initiated 10 to 14-day personal CGM in addition to usual care (CGM group), and 90 people with diabetes with usual care alone (control group) after propensity score matching. Upon completion of CGM, the downloaded report paired with a food diary was read by physician for treatment advice (CGM group).
Result & Outcome :
Of the 90 CGM participants, 50 received Dexcom G6 and 40 received Freestyle Libre. 25 (27.8%) were T1D, and 65 (72.2%) were T2D. Mean age was 58.5 years (±12.9 years), mean duration of DM was 18.5 years (±8.6 years), and mean baseline HbA1c was 8.41% (±1.19%). There were no significant differences in baseline characteristics between CGM group and control group. A significant mean HbA1c reduced from 8.41% at baseline to 7.77% at follow-up (12-20 weeks) in the CGM group (adjusted group difference, -0.40%; 95% CI, -0.68 to -0.12; p=0.005). Among T2D, mean HbA1c decreased in the CGM group compared with the control (adjusted group difference, -0.46%; 95% CI, -0.78% to -0.15%; p=0.005). Among T1D, mean HbA1c decreased in the CGM group compared with the control (adjusted group difference, -0.23%; 95% CI, -0.82% to 0.36%; p=0.440). As a result of CGM intervention, 69% in the CGM group had additional pharmacological adjustment, 60% had dietary advice, and 13.3% had corrected matching of insulin doses to carbohydrate. This study demonstrated that a 10 to 14-days CGM with professional support is beneficial in improving glucose control for people with diabetes treated with insulin in outpatient clinic
