Viswanathan Mohan1, Sunil Jain2, Jothydev Kesavadev3, Manoj Chawla4, Abhay Mutha5, Vijay Viswanathan6, Banshi Saboo7, Rajiv Kovil8, Ambrish Mithal9, Dharmen Punatar10, John Shin11. 1. Chairman and Chief Diabetologist, Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, Tamil Nadu. 2. Head of the Dept., Endocrinology TOTALL Diabetes Hormone Institute, Indore, Madhya Pradesh. 3. Chairman and Chief Diabetologist, Jothydev's Diabetes Research Centre, Trivandrum, Kerala. 4. Consulting Diabetologist, Lina Diabetes Care Centre, Mumbai, Maharashtra. 5. Consultant Diabetologist, President, Diabetes Care and Research Centre, Pune, Maharashtra. 6. Head ∧ Chief Diabetologist, M.V Hospital for Diabetes Research Centre, Chennai, Tamil Nadu. 7. Diabetologist and Metabolic Physician, Director, DIA Care Diabetes Care and Hormone Clinic, Ahmedabad, Gujarat. 8. Consulting Diabetologist, Dr. Kovil's Diabetes Care Centre, Mumbai, Maharashtra. 9. Chairman, Division of Endocrinology and Diabetes, Medanta - The Medicity, Gurgaon, Haryana. 10. Consulting Diabetologist, Diab Care Centre, Mumbai, Maharashtra. 11. Director, Clinical Research Biostatistics & Bioinformatics, Medtronic MiniMed Inc., Northridge, USA.
Abstract
BACKGROUND: Retrospective continuous glucose monitoring (CGM) studies may provide healthcare professionals (HCPs) with better understanding of glycemic patterns in patients with type 2 diabetes (T2D) and thereby support patient education and appropriate therapeutic interventions. METHODS: Adults with T2D and A1C values between 8% and 10% were eligible for this 3-month study. Patients were scheduled for 5 visits that included baseline and a month-2 retrospective CGM study (iPro2, Medtronic) followed by data review and therapy modifications. A1C values were determined at baseline and at study end. Questionnaires were completed at each visit. HCP questionnaires assessed perception of the utility of studies; patient questionnaires assessed understanding of the importance of compliance with HCP recommendations. Indices of glycemic variability and control were calculated from CGM data retrospectively. RESULTS: A total of 181 subjects enrolled and 148 completed the study (81.8%). There were no serious adverse device effects. Most subjects (91.2%) had > 1 therapy change after review of the first iPro2 test. Mean A1C decreased from 8.6% at baseline to 8.0% at month 3 (p<0.001). Questionnaire results from patients and HCPs indicated that both groups viewed the iPro2 studies and results as acceptable and useful. CGM-based glycemic variability metrics were similar in the two iPro2 tests. CONCLUSIONS: iPro2 studies provided HCPs with insights and opportunities for initiating changes to treatment regimens and to diet and exercise behaviors, and provided patients with improved knowledge of the importance of therapy compliance. Favorable reductions in A1C suggest that iPro2 tests can facilitate optimal management of T2D.
BACKGROUND: Retrospective continuous glucose monitoring (CGM) studies may provide healthcare professionals (HCPs) with better understanding of glycemic patterns in patients with type 2 diabetes (T2D) and thereby support patient education and appropriate therapeutic interventions. METHODS: Adults with T2D and A1C values between 8% and 10% were eligible for this 3-month study. Patients were scheduled for 5 visits that included baseline and a month-2 retrospective CGM study (iPro2, Medtronic) followed by data review and therapy modifications. A1C values were determined at baseline and at study end. Questionnaires were completed at each visit. HCP questionnaires assessed perception of the utility of studies; patient questionnaires assessed understanding of the importance of compliance with HCP recommendations. Indices of glycemic variability and control were calculated from CGM data retrospectively. RESULTS: A total of 181 subjects enrolled and 148 completed the study (81.8%). There were no serious adverse device effects. Most subjects (91.2%) had > 1 therapy change after review of the first iPro2 test. Mean A1C decreased from 8.6% at baseline to 8.0% at month 3 (p<0.001). Questionnaire results from patients and HCPs indicated that both groups viewed the iPro2 studies and results as acceptable and useful. CGM-based glycemic variability metrics were similar in the two iPro2 tests. CONCLUSIONS:iPro2 studies provided HCPs with insights and opportunities for initiating changes to treatment regimens and to diet and exercise behaviors, and provided patients with improved knowledge of the importance of therapy compliance. Favorable reductions in A1C suggest that iPro2 tests can facilitate optimal management of T2D.
Authors: Maneesh Shrivastav; William Gibson; Rajendra Shrivastav; Katie Elzea; Cyrus Khambatta; Rohan Sonawane; Joseph A Sierra; Robert Vigersky Journal: Diabetes Spectr Date: 2018-08
Authors: John Furler; David Norman O'Neal; Jane Speight; Irene Blackberry; Jo-Anne Manski-Nankervis; Sharmala Thuraisingam; Katie de La Rue; Louise Ginnivan; Jessica Lea Browne; Elizabeth Holmes-Truscott; Kamlesh Khunti; Kim Dalziel; Jason Chiang; Ralph Audehm; Mark Kennedy; Malcolm Clark; Alicia Josephine Jenkins; Danny Liew; Philip Clarke; James Best Journal: BMJ Open Date: 2018-07-17 Impact factor: 2.692