ECE2021 Audio Eposter Presentations Late Breaking (114 abstracts)
Our Ladys hospital/ Navan, Meath, Ireland, General Medicine/ Endocrinology unit, Navan, Ireland
Introduction
In last two decades, new technological advances have permitted the use of novel approaches to the management of diabetes. Continuous Glucose Monitoring (CGM) has been linked to improved HbA1c and overall quality of life. The evidence, however, is limited to retrospective studies. This audit was designed to evaluate the effectiveness and impact of CGM before and after on HbA1c and quality of life in clinical practice setting during pandemic in our county for 12 patients in our local Diabetes Day Centre (DDC).
Methods
Data of diabetes patients identified from medical notes of DDC in Our Ladys hospital of Navan for patients commenced on DEXCOM CGM since we started using CGM in 2019. Total number of patients recruited for this audit is12. All patients have type I diabetes mean age of participant is 38 years for 1012 months duration.
Patients Contacted by phones to answer the following questions:
- Frequency of hypoglycemia (<4 mmol) episodes before and after getting CGM?
- HbaA1C before and after CGM? Collected from our lab system.
- Lifestyle quality after getting CGM system?
- Satisfaction: Are patients satisfied with DEXCOM CGM (less hypoglycemia, less stress in diabetes control, more confidence)? With rating (010) Score.
Results
Among 12 patients with type I diabetes who were commenced on CGM, it shows:
• All patients have no or very little hypoglycemia after CGM with hypoglycemia confidence.
• 90% of patients had reduced overall HbA1c after CGM and less diabetes distress.
• All patients noted remarkable improvement in quality of life.
• All patients satisfied with CGM technology and more than half of patients have 100% satisfaction and others more than 80% satisfaction.
Figure 1 Satifaction score of patients on technology.
Figure 2 Average HbA1c pre and post CGM.
Number | Hypoglycemia before CGM | Hypoglycemia after CGM |
HbAlc before CGM (mmol/mol) |
HbAlc after CGM (mmol/mol) | Life quality after CGM |
Satisfaction score 0–10 |
1 | up to few limes aclay, | Twice a month | 92 | 78 | improved | 7 |
2 | up to 5 times a month | Nil | 94 | 64 | improved | 10 |
3 | Once a month | Once a month | 74 | 70 | Improved | 10 |
4 | Once a clay | Once a month | 66 | 55 | Improved | 10 |
5 | Tree times/clay | 3 times/week | 88 | 73 | Improved | 10 |
6 | 4 times/week | One time/week | 66 | 58 | improved | 9 |
7 | Once every week | Once every 3 months | 80 | 64 | improved | 8 |
8 | Up to 8 per week | Up to 2 per week | 59 | 70 | improved | 10 |
9 | Once per month | No hypoglycemia | 113 | 91 | improved | 8 |
10 | Almost every day | No Hypoglycemia | 91 | 101 | improved | 10 |
11 | Once per month | No hypoglycemia | 85 | 70 | improved | 8 |
12 | Once every week | No Hypoglycemia | 50 | Not done | improved |
Conclusion
Obviously, it is highly recommended to consider CGM a common and useful tool in diabetes care who was at high risk of dysglycemia. It showed significant improvement in less time spent for day and nocturnal hypoglycemia. Patients feel safer and more confident during pandemic where the diabetes care facilities are very limited. It provided remarkable glycemic control and positive effects on HbA1c levels. Less dysglycemia, as a result, improved life quality.