Category: Federal Forum Posters
Purpose: In April 2018, we started using a continuous glucose monitoring product in 12 diabetic patients, the majority of which are Type 2. After seeing the preliminary results, we expanded the amount of patients in using this technology to approximately 45. We aimed to decrease Hemoglobin A1C levels and inuslin use in our patients as well as increase our clinic's metrics for percentage of patients with a Hemoglobin A1C under 7% and under 8%.
Methods: A physician champion saw the vast majority of our patients in the continuous glucose monitoring program and was responsible for ordering the readers, sensors and any diabetes medication the patient needed. Nursing staff was available to teach the patients how to use their devices and sensors and alert the physician champion when patients needed refills. Pharmacy staff dispensed the readers, sensors, any associated medications and tracked data for each individual as well as on the aggregate. Patients were also given the opportunity to attend a 90 minute long diabetes class once every two weeks, which was suggested but not required. This class was taught by the physician champion and covered various topics as well as an extensive question and answer session at the end of each class.
Results: We were able to increase our percentage of patients with a Hemoglobin A1C under 8% by 12.9% and under 7% by 13.5% in 9 months. This allowed our clinic to improve from well below average when compared to other Air Force clinics to well above average. We also had significant Hemoglobin A1C reductions in individual patients, as well as decreases in the amount of basal and mealtime insulins used.
Conclusion: Due to multiple reasons, we have found continuous glucose monitoring to be an integral part of our diabetes practice for both our Type 1 and Type 2 diabetics. First, we have found this technology to be helpful in identifying time of the day when a patient's glucose is high and develop strategies to target these points. Second, we have found that the on-demand nature of the technology allows a patient to more closely meet dietary goals. Lastly, we believe that the technology motivates patients who no longer fear judgment from a provider about their diabetes control.