Endocrine Abstracts

Background: In recent years, continuous glucose monitoring (CGM) has emerged as a method for the assessment of glycemic control. Also CGM enables diabetic patients to understand their own blood glucose status and change their lifestyle.

Aims: We investigated the effect of CGM on the glycemic control in Korean type 2 diabetic patients.

Methods: We enrolled type 2 diabetic patients who met all the following criteria: 1) use of oral antidiabetic drug (OAD) or lifestyle change for diabetes control, 2) no change of OAD before the previous 3 months, 3) HbA1c levels, 7.0–8.9%, and 4) age, 30 to 75 years old. After informed consent, we applied the CGM (FreeStyle Libre) to the participants for 2 weeks. Participants were asked to record their diet and exercise while wearing the CGM on the apps. We educated the participants how to interpret the glucose profile and manage glucose. The participants were randomly assigned CGM or CGM+short message service (SMS) group. We sent educational feedback message for the each CGM glucose profile and lifestyle to the CGM+SMS group We compared the change of HbA1c, lifestyle, and diabetes treatment satisfaction questionnaire after 10 to 12 weeks.

Results: Fifty seven diabetic patients consented to the study. But 11 participants did not apply the CGM (no wearing CGM group). Twenty four were assigned to the CGM group. Twenty two were assigned to the CGM+SMS group. There were no differences in age (56.4±7.8 vs 58.5±7.3 years, P=0.429), DM duration (12.5±7.0 vs 12.4±6.5 years, P=0.946), baseline HbA1c (8.0±0.5 vs 8.0±0.3%, P=0.926) between wearing CGM (CGM and CGM+SMS group) and no wearing CGM group. The deltaHbA1c of CGM, CGM+SMS, no wearing CGM group was -0.35±0.65%, -0.32±0.73%, and -0.04±0.78% (P=0.478). There was no difference in the scan frequency per day (11.2±5.8 vs 10.9±4.8, P=0.825) and in walking time per week (219±170 vs 302±180 minutes, P=0.159) between CGM and CGM+SMS group. The self-care for diabetes was improved in both CGM and CGM+SMS group, especially in diet, exercise, and glucose monitoring. The DTSQ score was also improved in CGM (delta 4.0±7.6) and CGM+SMS group (delta 4.1±5.6). In the logistic regression analysis, time in range in CGM results was related to the prediction of glycemic control in this study.

Conclusions: CGM can be used as a motivational tool for diabetes management when integrates with diabetes education. It is presumed that the intuitive ambulatory glucose profile had an effect on diet and diabetes management.