Assessing Patterns of Continuous Glucose Monitoring Use and Metrics of Glycemic Control in Type 1 Diabetes and Type 2 Diabetes Patients in the Veterans Health Care System: Integrating Continuous Glucose Monitoring Device Data with Electronic Health Records Data.

IF 5.7 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Diabetes technology & therapeutics Pub Date : 2024-11-01 Epub Date: 2024-06-11 DOI:10.1089/dia.2024.0083
Tomoki Okuno, Sharon A Macwan, Donald Miller, Gregory J Norman, Peter Reaven, Jin J Zhou
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引用次数: 0

Abstract

Objective: To integrate long-term daily continuous glucose monitoring (CGM) device data with electronic health records (EHR) for patients with type 1 and type 2 diabetes (T1D and T2D) in the national Veterans Affairs Healthcare System to assess real-world patterns of CGM use and the reliability of EHR-based CGM information. Research Design and Methods: This observational study used Dexcom CGM device data linked with EHR (from 2015 to 2020) for a large national cohort of patients with diabetes. We tracked the initiation and consistency of CGM use, assessed concordance of CGM use and measures of glucose control between CGM device data and EHR records, and examined results by age, ethnicity, and diabetes type. Results: The time from pharmacy release of CGM to patients to initiation of uploading CGM data to Dexcom servers averaged 3 weeks but demonstrated wide variation among individuals; importantly, this delay decreased markedly over the later years. The average daily wear time of CGM exceeded 22 h over nearly 3 years of follow-up. Patterns of CGM use were generally consistent across age, race/ethnicity groups, and diabetes type. There was strong concordance between EHR-based estimates of CGM use and Dexcom CGM wear time and between estimates of glucose control from both sources. Conclusions: The study demonstrates our ability to reliably integrate CGM devices and EHR data to provide valuable insights into CGM use patterns. The results indicate in the real-world environment that CGM is worn consistently over many years for both patients with T1D and T2D within the Veterans Affairs Healthcare System and is similar across major race/ethnic groups and age-groups.

评估退伍军人医疗保健系统中 T1D 和 T2D 患者的 CGM 使用模式和血糖控制指标:整合 CGM 设备数据与 EHR 数据。
目的将退伍军人事务医疗保健系统中 1 型和 2 型糖尿病患者的长期每日连续血糖监测(CGM)设备数据与电子健康记录(EHR)进行整合,以评估 CGM 的实际使用模式以及基于 EHR 的 CGM 信息的可靠性:这项观察性研究使用了与电子病历关联的 Dexcom CGM 设备数据(从 2015 年到 2020 年),研究对象是一大批全国性糖尿病患者。我们追踪了 CGM 使用的开始时间和一致性,评估了 CGM 设备数据和 EHR 记录之间 CGM 使用和血糖控制测量的一致性,并按年龄、种族和糖尿病类型对结果进行了检验:从药房向患者发放 CGM 到开始将 CGM 数据上传到 Dexcom 服务器的平均时间为三周,但个体差异很大;重要的是,这一延迟时间在后来几年明显缩短。在近三年的随访中,每天佩戴 CGM 的平均时间超过 22 小时。不同年龄、种族/族裔群体和糖尿病类型的 CGM 使用模式基本一致。基于电子病历的 CGM 使用估计值与 Dexcom CGM 佩戴时间之间以及这两种来源的血糖控制估计值之间具有很强的一致性:这项研究表明,我们有能力可靠地整合 CGM 设备和电子病历数据,为 CGM 的使用模式提供有价值的见解。研究结果表明,在退伍军人事务医疗保健系统中,1 型和 2 型患者在实际环境中多年持续佩戴 CGM,并且在主要种族/民族和年龄组中具有相似性。
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来源期刊
Diabetes technology & therapeutics
Diabetes technology & therapeutics 医学-内分泌学与代谢
CiteScore
10.60
自引率
14.80%
发文量
145
审稿时长
3-8 weeks
期刊介绍: Diabetes Technology & Therapeutics is the only peer-reviewed journal providing healthcare professionals with information on new devices, drugs, drug delivery systems, and software for managing patients with diabetes. This leading international journal delivers practical information and comprehensive coverage of cutting-edge technologies and therapeutics in the field, and each issue highlights new pharmacological and device developments to optimize patient care.
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