358-OR：在资源不足的环境中对 2 型糖尿病 (T2D) 患者进行远程 CGM 监测

IF 6.2 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes Pub Date : 2024-06-24 DOI:10.2337/db24-358-or

VALERIE F. RUELAS, ANNE L. PETERS

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引用次数: 0

摘要

目标：在一家安全网诊所对接受治疗的 T2D 患者实施 CGM 和远程监控，以便在例行就诊间隙对患者进行外联，并向医疗服务提供者（HCP）提供反馈，以便进行基于算法的药物管理。方法为患者提供 Libre 2 CGM，并通过 LibreView 对其进行跟踪。PI 对基线临床数据和 AGP 进行评估，并将管理建议发送给患者的 HCP。项目人员每天查看 LibreView 门户网站，并与血糖值高于 250 mg/dl 或低于 70 mg/dl 超过 5% 的受试者联系，提供糖尿病教育。根据需要（从每周到每月）向 PI 发送临床数据更新和 AGP，以便提供额外的糖尿病管理建议。对基线、6 个月和 12 个月的测量结果进行了 Shapiro-Wilk 正态性评估和配对依赖性 t 检验。双侧α值为 0.05。结果200 名受试者中的 137 人（52 人未使用胰岛素，85 人使用胰岛素）的中期结果显示，从基线到 6 个月，以下指标均有所改善：平均基线 A1C = 9.0% 在 6 个月时降至 7.8% (-1.2 +/- 1.7 (SD), p<.001)。TIR 平均增加 12.5 +/- 27.7（标清），p<.001。GMI 下降了-.591 +/- .59，p<.001。抑郁程度略有降低-0.847 +/- 4.6（PHQ8，p= 0.036）。糖尿病压力量表（DDS）显示，非胰岛素使用者的压力减少了-1.23 +/- 3.5，p= .012；胰岛素使用者的压力减少了-2.8 +/- 4.6，p= .005。根据向保健医生发送的建议，保健医生执行建议的比例为 75%，GLP-1 RA 的使用率增加了一倍。对完成 12 个月治疗的 91 名受试者进行的分析表明，治疗效果得以持续。结论远程监控与向保健医生提供的教育和用药建议相结合，改善了使用胰岛素和非胰岛素疗法的 T2D 患者的糖尿病治疗效果。披露 V.F. Ruelas：无。A.L. Peters：顾问团；礼来糖尿病、Vertex Pharmaceuticals Incorporated、Medscape。研究支持：雅培、Insulet Corporation。

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358-OR: Remote CGM Monitoring in People with Type 2 Diabetes (T2D) in an Under-resourced Setting

Objective: To implement CGM and remotely monitor patients with T2D treated in a safety net clinic to allow for patient outreach between routinely scheduled visits and provide feedback to health care providers (HCP’s) for algorithm-based medication management. Methods: Patients were provided a Libre 2 CGM and followed via LibreView. Baseline clinical data and AGP’s were evaluated by the PI and management recommendations were sent to the patient’s HCP. Project staff reviewed the LibreView portal daily and contacted subjects who had glucose values either above 250 mg/dl or below 70 mg/dl more than 5% of the time and provide diabetes education. Clinical data updates and AGPs were sent to the PI based on need (from weekly to monthly) so additional diabetes management recommendations could be provided. Measures administered at baseline, 6 months and 12 months were assessed for Shapiro-Wilk normality and paired dependent t-tests. A 2-sided alpha of 0.05 was used. Results: Interim results of 137 of 200 enrolled subjects (52 not on insulin and 85 on insulin) showed improvements in the following measures from baseline to 6 months: Mean baseline A1C = 9.0% decreased to 7.8% by 6 months (-1.2 +/- 1.7 (SD), p<.001). TIR mean increase was 12.5 +/- 27.7 (SD), p<.001. GMI was reduced by -.591 +/- .59, p<.001. A slight reduction in depression was seen -0.847 +/- 4.6 (PHQ8, p= .036). Diabetes Distress Scale (DDS) showed reduced stress for non-insulin users -1.23 +/- 3.5, p= .012 and for insulin users -2.8 +/- 4.6, p = .005. HCPs implemented recommendations 75% of the time and use of GLP-1 RA’s doubled, based on recommendations sent to HCP’s. Analysis of 91 subjects who completed 12 months show sustained outcomes. Conclusions: Remote monitoring coupled with education and medication recommendations provided to HCPs improved diabetes outcomes in people with T2D, on insulin and non-insulin therapies. Disclosure V.F. Ruelas: None. A.L. Peters: Advisory Panel; Lilly Diabetes, Vertex Pharmaceuticals Incorporated, Medscape. Research Support; Abbott, Insulet Corporation.

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来源期刊

Diabetes 医学-内分泌学与代谢

CiteScore

12.50

自引率

2.60%

发文量

1968

审稿时长

1 months

期刊介绍： Diabetes is a scientific journal that publishes original research exploring the physiological and pathophysiological aspects of diabetes mellitus. We encourage submissions of manuscripts pertaining to laboratory, animal, or human research, covering a wide range of topics. Our primary focus is on investigative reports investigating various aspects such as the development and progression of diabetes, along with its associated complications. We also welcome studies delving into normal and pathological pancreatic islet function and intermediary metabolism, as well as exploring the mechanisms of drug and hormone action from a pharmacological perspective. Additionally, we encourage submissions that delve into the biochemical and molecular aspects of both normal and abnormal biological processes. However, it is important to note that we do not publish studies relating to diabetes education or the application of accepted therapeutic and diagnostic approaches to patients with diabetes mellitus. Our aim is to provide a platform for research that contributes to advancing our understanding of the underlying mechanisms and processes of diabetes.