Evaluating the addition of real-time continuous glucose monitors to pharmacist intervention on glycated hemoglobin

To determine the impact of pharmacist intervention with real-time continuous glucose monitors (rtCGMs) on glycated hemoglobin (HbA1c) levels and the number of pharmacist touchpoints compared to standard of care (SOC).

Patients receiving care at a primary care clinic using an established pharmacist diabetes management protocol for patients with type 2 diabetes and an HbA1c value of 9% or higher despite taking basal insulin were included in this study. The SOC group comprised patients receiving ongoing care, while care for the rtCGM study group followed the same protocol with addition of Dexcom G6 rtCGMs. Data on patient demographics, comorbidities, and medications were collected for comparison. The primary outcome was the between-group difference in changes in HbA1c. The secondary outcome was the difference in pharmacist touchpoints, quantified as the number of patient telephone calls completed and attempted, along with medication interventions.

Fifty-seven patients were included in the final analysis: 30 in the SOC group who received pharmacist intervention and 27 in the combined pharmacist intervention and rtCGM group. The mean (SD) reduction in HbA1c in the SOC group at 90 days was 2.05% (1.20%) compared to 2.94% (1.18%) in the rtCGM group (P = 0.0165). The secondary outcome failed to reach statistical significance (P = 0.1413).

In suboptimally managed type 2 diabetes, augmentation of a standard diabetes management protocol with rtCGMs was associated with significantly greater HbA1c reduction.