Remote CGM monitoring may improve glycemic outcomes
Remote patient monitoring using continuous glucose monitoring was associated with greater reductions in hemoglobin A1c among patients with type 2 diabetes receiving care at a safety-net hospital, according to a retrospective cohort study published in
Endocrine Practice.
The researchers, led by Katherine Cuan, DO, of the Division of Endocrinology at Montefiore Medical Center in Bronx, New York, evaluated a pilot remote patient monitoring (RPM) diabetes program designed to improve care in a region with high rates of type 2 diabetes and limited access to primary care services.
Investigators compared patients enrolled in the RPM program at Montefiore Medical Center, a safety net hospital, with a control cohort receiving standard care at the same institution. Eligible participants were adults with type 2 diabetes, with baseline hemoglobin A1c (HbA1c) greater than 8.5%, and prescriptions for basal insulin and continuous glucose monitoring (CGM). Patients in the RPM program completed monthly telemedicine visits with an endocrinology specialist for 3 to 6 months.
The analysis included 41 RPM participants and 766 control patients, with baseline HbA1c levels of 10.5% and 10.6%, respectively. At follow-up, HbA1c levels declined by 3.0 percentage points in the RPM group compared with 2.1 percentage points in controls (P = .004).
A target HbA1c below 7.5% was achieved in 60% of RPM participants versus 36% of controls, corresponding to an adjusted odds ratio of 2.53 (95% CI, 1.31–4.88; P < .01).
Medication adjustments during the program most commonly involved insulin, glucagon-like peptide-1 receptor agonists, and dual GLP-1/glucose-dependent insulinotropic polypeptide receptor agonists.
"This retrospective cohort study demonstrates the effectiveness of RPM paired with CGM in improving glycemic outcomes among adults with T2DM with HbA1c above target in an urban, under-resourced setting," researchers wrote. "Compared to standard care, RPM participants experienced greater reductions in HbA1c, and were significantly more likely to achieve glycemic targets, even after adjusting for initial HbA1c, sex, and race/ethnicity."
Researchers did note that further studies are needed to evaluate the implementation of similar programs at a larger scale.
The authors reported no relevant conflicts of interest.
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