Accepted for/Published in: JMIR Formative Research
Date Submitted: Jul 13, 2021
Open Peer Review Period: Jul 13, 2021 - Jul 21, 2021
Date Accepted: Feb 7, 2022
Date Submitted to PubMed: Feb 11, 2022
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Medication Optimization Among People With Type 2 Diabetes Participating in a CGM-Driven Virtual Care Program: Prospective Trial
ABSTRACT
Background:
The Onduo virtual care program for people with type 2 diabetes (T2D) includes a mobile app, remote lifestyle coaching, connected devices and telemedicine consultations with endocrinologists for medication management and prescription of real-time continuous glucose monitoring (RT-CGM) devices. In a previously described 4-month prospective study of this program, adults with T2D and baseline HbA1c ≥8.0% to ≤12.0% experienced a mean HbA1c decrease of 1.6% with no significant increase in hypoglycemia.
Objective:
The objective of this analysis was to evaluate medication optimization and management in the 4-month prospective T2D study.
Methods:
Study participants received at least 1 telemedicine consultation with an Onduo endocrinologist for diabetes medication management and used RT-CGM intermittently to guide therapy and dosing. Medication changes were analyzed.
Results:
A total of 48 (87%) out of 55 participants had a medication change consisting of a dose change, addition, or discontinuation. Of these, 15 (31%) of participants had a net increase in number of diabetes medications classes from baseline. Mean time to first medication change for these participants was 36 days. The percentage of participants taking a GLP-1 receptor agonist increased from 25% to 56%, while the percentages of participants taking a sulfonylurea or DPP-4 inhibitor decreased from 56% to 33% and 17% to 6%, respectively. Prescriptions of other anti-diabetic medication classes including insulin did not change significantly.
Conclusions:
The Onduo virtual care program can play an important role in providing timely access to guideline-based diabetes management medications and technologies for people with T2D. Clinical Trial: ClinicalTrials.gov NCT0386538
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