In the past 3-years, a retrospective observational cohort
study collected data from fifty-one patients with type 1 or type 2 Diabetes
Mellitus (DM), receiving a minimum of 3-to 4 insulin injections per day, and
self-monitoring their blood glucose (SMBG) 4-times a day, were derived from our
internal medicine residency primary care clinic. The patients were equipped
with a Continuous Glucose Monitoring (CGM) device that shared 24-hour glucose
data with the clinic. The medicine resident, in consultation with our
endocrinologist, assessed the patients' glucose management data and adjusted
their treatment regimens bi-weekly by calling the patients, and monthly by
seeing the patients in the clinic. The rationale of the study was to show that
in the Internal Medicine Residency clinic in a project governed by the medicine
residents, the CGM will lead to improvement in diabetes mellitus control
compared to SMBG and this can be done not only in specialized endocrine
clinics.
To assess for differences in A1C, TIR, average blood
glucose, percent of time spent in mild hypoglycemia, and percent of time spent
in pronounced hypoglycemia, five paired t-tests were conducted. A Bonferroni
correction was applied which set the new accepted alpha level at 0.01.
HbA1c was reduced from 9.9% to 7.6%, average blood glucose
decrement from 242 mg/dL to 169 mg/dl, reduction of the incidence of mild
hypoglycemia below 70 mg/dl to 54 mg/dl from 4.68% to 0.76% per day, and more
pronounced hypoglycemia with glucose less than 54 mg/dl from 3.1% per day to
0.2% per day. We observed a significant increase in the time in the range of blood
glucose from 33% to 67% per day. The participants were followed for 3 years.
This study affirms that CGM devices significantly improved
glycemic control compared to SMBG, supporting its efficacy in optimizing
glycemic control in real-world clinical practice.
Author(s)details:-
A. Manov
Internal Medicine and Transitional Year Residency Program, Mountain View
Hospital, Las Vegas, Nevada, United States of America and Sunrise Health GME
Consortium, Las Vegas, Nevada, United States of America.
J. Tam
Internal Medicine and Transitional Year Residency Program, Mountain View
Hospital, Las Vegas, Nevada, United States of America and Sunrise Health GME
Consortium, Las Vegas, Nevada, United States of America.
A. Donepudi
Internal Medicine and Transitional Year Residency Program, Mountain View
Hospital, Las Vegas, Nevada, United States of America and Sunrise Health GME
Consortium, Las Vegas, Nevada, United States of America.
A. Dhaliwal
Internal Medicine and Transitional Year Residency Program, Mountain View
Hospital, Las Vegas, Nevada, United States of America and Sunrise Health GME
Consortium, Las Vegas, Nevada, United States of America.
R. Haddadin
Internal Medicine and Transitional Year Residency Program, Mountain View
Hospital, Las Vegas, Nevada, United States of America and Sunrise Health GME
Consortium, Las Vegas, Nevada, United States of America
J. Badi
Internal Medicine and Transitional Year Residency Program, Mountain View
Hospital, Las Vegas, Nevada, United States of America and Sunrise Health GME
Consortium, Las Vegas, Nevada, United States of America.
A. Wang
Internal Medicine and Transitional Year Residency Program, Mountain View
Hospital, Las Vegas, Nevada, United States of America and Sunrise Health GME
Consortium, Las Vegas, Nevada, United States of America.
M. Sharaf
Internal Medicine and Transitional Year Residency Program, Mountain View
Hospital, Las Vegas, Nevada, United States of America and Sunrise Health GME
Consortium, Las Vegas, Nevada, United States of America.
K. Mefferd
Internal Medicine and Transitional Year Residency Program, Mountain View
Hospital, Las Vegas, Nevada, United States of America and Sunrise Health GME
Consortium, Las Vegas, Nevada, United States of America.
Please See the book
here :- https://doi.org/10.9734/bpi/mria/v4/505
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