Endocrine Abstracts

Background: As adoption of continuous glucose monitoring (CGM) continues to expand, lot more studies are investigating the effects of CGM on HbA1C and hypoglycaemia risks in people with Diabetes Mellitus (PwD). In PwD, established benefits of usage of CGM along with digital diabetes self-management and education (DSME) program in Indian real-world context are scarce. OneCare compares patients engaged in its “IMPACT’ DSME program alone vs program assisted by CGM.

Methods: A proof-of-concept, prospective study was conducted in PwD enrolled in the OneCare IMPACT program for 12 weeks. It is a virtual, personalized lifestyle program to support diabetes self-management through team of CDEs, yoga and physical trainer, emotional wellness coach and OneCare app to track patients’ everyday physical activity, self-monitoring of blood glucose, and dietary patterns. Patients in the group 1 (n=30) received the regular IMPACT program, while those in group 2 (n=27) had CGM (Abbott Libre) inserted on enrolment in addition to the program. CGM data were used by the health coach to educate and engage patients, (MetaSense- a sophisticated software and service layer) in the program. Data on HbA1c, weight, CGM metrics, were used for analysis.

Results: Upon enrolment to IMPACT program, both the patient groups had a significant decline in HbA1c (%) [group1 from 8.3 to 7.3 (P= <.001); group2 from 9.4 to 6.9 (P= <.001)]. Among patients on CGM, only 25 % had TIR >70 %, 37% of patients had a Time below range <90mg/dl. MetaSense usage in group2, however led to significantly better mean reductions in HbA1c (%) vs group1 [2.51±2.17 Vs 0.91±1.05; (P= <.001) respectively]. A significant difference in mean weight reduction was observed in group assisted with and without MetaSense respectively [2.2±0.8 vs 0.81 ±1.86 (P<0.001)]. MetaSense usage significantly predicted reduction in HbA1c on a simple linear regression model [HbA1c reduction=-.682+1.601*(MetaSense) where, MetaSense use: 0= No, 1 = Yes; (R² = .18, P= <.001)]. 18% of the variation in HbA1c is explained by MetaSense.

Conclusion: CGM can be a very useful tool to motivate, educate and teach PwD in clinical practice leading on to a better involvement of the patient in self-management issues. Addition of MetaSense to existing structed digital DSME “IMPACT’ program leads to better outcomes with respect to HbA1c and weight. However many other factors may also be influencing the outcome of this study. Hence a well-planned study is encouraged to delineate the role of MetaSense.