PMID- 36735841
OWN - NLM
STAT- MEDLINE
DCOM- 20230703
LR  - 20230821
IS  - 2327-6924 (Electronic)
IS  - 2327-6886 (Linking)
VI  - 35
IP  - 7
DP  - 2023 Jul 1
TI  - Improving glucose control in patients with type 2 diabetes using retrospective 
      continuous glucose monitoring.
PG  - 425-433
LID - 10.1097/JXX.0000000000000831 [doi]
AB  - BACKGROUND: The prevalence and cost of type 2 diabetes mellitus (T2DM) is rising. 
      Diabetes care should be individualized based on patient risk factors and goals. 
      Professional continuous glucose monitoring (CGM) is a tool for primary care 
      providers to assist patients with diabetes management. LOCAL PROBLEM: Nurse 
      practitioners at an outpatient primary care practice began using CGM in patients 
      with T2DM in 2019 to guide treatment due to the high number of patients not 
      reaching glucose targets. There was no policy in place to guide patient selection 
      for CGM. METHODS: This quality improvement (QI) project, conducted in an 
      outpatient primary care clinic, evaluated the effect of retrospective CGM use in 
      patients with T2DM through a retrospective chart review to create a policy for 
      use. INTERVENTIONS: Hemoglobin A1c (HbA1c) measurements pre-CGM and post-CGM use 
      were compared. CGM reports were evaluated for the presence of hypoglycemia. 
      Additionally, number of times a patient used CGM between HbA1c laboratory 
      examinations as well as insulin status were determined by reviewing the 
      electronic health record. RESULTS: Patients using CGM for HbA1c higher than goal 
      (n = 60) noted a 1.01% decrease in HbA1c ( p < .01). The decrease was similar 
      regardless of exogenous insulin status. Hypoglycemia was detected in 54.3% of 
      patients (n = 44), including 45% (n = 27) of those with elevated HbA1c levels. 
      CONCLUSIONS: Retrospective CGM is a cost-effective tool to individualize 
      management of patients with T2DM in primary care. A policy was created to guide 
      CGM use in patients not reaching glucose goals and those with concern for 
      hypoglycemia.
CI  - Copyright (c) 2023 American Association of Nurse Practitioners.
FAU - Diamond, Katlyn
AU  - Diamond K
AUID- ORCID: 0000-0001-8984-8718
AD  - Day Medical Center, Stuart, FL.
LA  - eng
PT  - Journal Article
DEP - 20230701
PL  - United States
TA  - J Am Assoc Nurse Pract
JT  - Journal of the American Association of Nurse Practitioners
JID - 101600770
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/therapy
MH  - Blood Glucose
MH  - Glycated Hemoglobin
MH  - Hypoglycemic Agents/adverse effects
MH  - Blood Glucose Self-Monitoring
MH  - Retrospective Studies
MH  - *Hypoglycemia
MH  - Insulin
COIS- Competing interests: The author reports no conflicts of interest.
EDAT- 2023/02/04 06:00
MHDA- 2023/07/03 06:41
CRDT- 2023/02/03 14:42
PHST- 2022/07/28 00:00 [received]
PHST- 2022/12/08 00:00 [accepted]
PHST- 2023/07/03 06:41 [medline]
PHST- 2023/02/04 06:00 [pubmed]
PHST- 2023/02/03 14:42 [entrez]
AID - 01741002-202307000-00007 [pii]
AID - 10.1097/JXX.0000000000000831 [doi]
PST - epublish
SO  - J Am Assoc Nurse Pract. 2023 Jul 1;35(7):425-433. doi: 
      10.1097/JXX.0000000000000831.