medwireNews: A short period of intermittently scanned continuous glucose monitoring (isCGM) prior to a first endocrinologist consultation can improve glycemic outcomes for people with type 2 diabetes, report the SPOT FIRST study researchers.
Presenting the findings at the 16th ATTD conference in Berlin, Germany, Akshay Jain (University of British Columbia, Vancouver, Canada) noted that people may have to wait many months to see a specialist after their referral from primary care.
His team’s research shows that arriving at that first consultation armed with isCGM data may help to maximize the benefit from the appointment.
None of the 92 study participants had previously used CGM; 56 of them were given an isCGM device to use for 14 days prior to their first specialist consultation, whereas the other 40 attended the appointment with only their self-monitored blood glucose data.
The presenter emphasized that both groups self-monitored their blood glucose as usual between their initial and first follow-up appointments, an average of 133 days later.
At baseline, the average HbA1c level was 8.3% in the isCGM group and this fell to 7.2% by the time of the follow-up appointment, whereas the control group achieved only a slight reduction, from 8.4% to 8.2%.
The difference between the two groups at the time of the follow-up consultation was statistically significant, with isCGM use “thereby optimizing the outcome of the initial consultation visit,” said Jain.
Moreover, the difference remained significant, with average levels at 7.2% versus 8.4% in the isCGM and control groups, by their second follow-up appointment, despite all participants relying on self-monitored blood glucose in the interim.
Jain highlighted that the majority of the study participants were not using insulin, but the improved HbA1c with isCGM versus self-monitoring at both follow-up visits was seen for insulin users and nonusers, albeit not always statistically significant because of the smaller numbers in these subgroups.
In addition, both groups wore an isCGM device for 14 days prior to the first follow-up appointment, revealing that the isCGM group had a significantly higher time in target glucose range, at 74.00% versus 71.97%.
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