학술논문

Glycemic Outcomes in Adults With Type 2 Diabetes Participating in a Continuous Glucose Monitor–Driven Virtual Diabetes Clinic: Prospective Trial
Document Type
article
Source
Journal of Medical Internet Research, Vol 22, Iss 8, p e21778 (2020)
Subject
Computer applications to medicine. Medical informatics
R858-859.7
Public aspects of medicine
RA1-1270
Language
English
ISSN
1438-8871
Abstract
BackgroundThe Onduo virtual diabetes clinic (VDC) for people with type 2 diabetes (T2D) combines a mobile app, remote personalized lifestyle coaching, connected devices, and live video consultations with board-certified endocrinologists for medication management and prescription of real-time continuous glucose monitoring (RT-CGM) devices for intermittent use. ObjectiveThis prospective single-arm study evaluated glycemic outcomes associated with participation in the Onduo VDC for 4 months. MethodsAdults aged ≥18 years with T2D and a baseline glycated hemoglobin (HbA1c) of ≥8% to ≤12% were enrolled from 2 primary care centers from February 2019 to October 2019. Participants were asked to engage at ≥1 time per week with their care team and to participate in a telemedicine consultation with a clinic endocrinologist for diabetes medication review. Participants were asked to use a RT-CGM device and wear six 10-day sensors (total 60 days of sensor wear) intermittently over the course of 4 months. The primary outcome was change in HbA1c at 4 months from baseline. Other endpoints included change in weight and in RT-CGM glycemic metrics, including percent time 250 mg/dL. Changes in blood pressure and serum lipids at 4 months were also evaluated. ResultsParticipants (n=55) were 57.3 (SD 11.6) years of age, body mass index 33.7 (SD 7.2), and 40% (22/55) female. HbA1c decreased significantly by 1.6% (SD 1%; P9.0% (n=19), HbA1c decreased by 1.2% (SD 0.6%; P250 mg/dL decreased by 7.2% (SD 15.4; P=.005) and 3.0% (SD 9.4; P=.01), respectively. There was no change in percent time