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A Digital Diabetes Self-Management Education and Support Program Integrated With Continuous Glucose Monitoring

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A digital diabetes self-management and education support (DSMES) program combined with continuous glucose monitoring (CGM) improved glycemic control in adults with type 2 diabetes. This integrated approach showed significant benefits in key glucose management indicators over six months.

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Area of Science:

  • Endocrinology and Metabolism
  • Digital Health and Telemedicine
  • Diabetes Management

Background:

  • Continuous glucose monitoring (CGM) use alongside in-person diabetes self-management and education support (DSMES) programs improves glycemic control in type 2 diabetes.
  • Limited evidence exists on the benefits of digitally-delivered DSMES combined with real-time CGM for adults with type 2 diabetes.

Purpose of the Study:

  • To evaluate the impact of a digitally-delivered DSMES program integrated with CGM on hemoglobin A1c (HbA1c) and CGM-derived glycemic measures in adults with type 2 diabetes over a 6-month period.
  • To compare the intervention group (digital DSMES + CGM) against a usual care group.

Main Methods:

  • Randomized controlled trial involving adults with type 2 diabetes and HbA1c ≥8% not using mealtime bolus insulin.
  • Participants were assigned to either a digital DSMES + CGM integrated solution (n=51) or usual care (n=49) for 6 months.
  • Primary outcome: HbA1c. Secondary outcomes: glucose management indicator (GMI), time in range (TIR), time above range (TAR), time below range (TBR), and mean glucose, analyzed using linear mixed effects models.

Main Results:

  • HbA1c was significantly lower in the intervention group at 3 months (difference=-0.7%; P=.03) and showed a trend at 6 months (difference=-0.6%; P=.12).
  • Significant improvements were observed at 6 months in the intervention group for GMI (difference=-0.9%; P=.03), TIR (difference=14.6%; P=.04), TAR (difference=-14.9%; P=.04), and mean glucose (difference=-36.4 mg/dL; P=.03) compared to usual care.
  • The study was registered on ClinicalTrials.gov (NCT05368454).

Conclusions:

  • The combination of a digital DSMES program and CGM is effective in supporting adults with type 2 diabetes management.
  • This integrated approach demonstrates potential for reducing the risk of long-term diabetes-related health complications.