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Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring–Driven Virtual Care Program: Prospective Study

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) de...

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Autores principales: Majithia, Amit R, Erani, David M, Kusiak, Coco M, Layne, Jennifer E, Lee, Amy Armento, Colangelo, Francis R, Romanelli, Robert J, Robertson, Scott, Brown, Shayla M, Dixon, Ronald F, Zisser, Howard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9019640/
https://www.ncbi.nlm.nih.gov/pubmed/35147501
http://dx.doi.org/10.2196/31629
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author Majithia, Amit R
Erani, David M
Kusiak, Coco M
Layne, Jennifer E
Lee, Amy Armento
Colangelo, Francis R
Romanelli, Robert J
Robertson, Scott
Brown, Shayla M
Dixon, Ronald F
Zisser, Howard
author_facet Majithia, Amit R
Erani, David M
Kusiak, Coco M
Layne, Jennifer E
Lee, Amy Armento
Colangelo, Francis R
Romanelli, Robert J
Robertson, Scott
Brown, Shayla M
Dixon, Ronald F
Zisser, Howard
author_sort Majithia, Amit R
collection PubMed
description 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 glycated hemoglobin (HbA(1c)) ≥8.0% to ≤12.0% experienced a mean HbA(1c) 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: Of 55 participants, 48 (87%) had a medication change consisting of a dose change, addition, or discontinuation. Of these, 15 (31%) participants had a net increase in number of diabetes medication classes from baseline. Mean time to first medication change for these participants was 36 days. The percentage of participants taking a glucagon-like peptide-1 receptor agonist increased from 25% (12/48) to 56% (n=27), while the percentages of participants taking a sulfonylurea or dipeptidyl peptidase 4 inhibitor decreased from 56% (n=27) to 33% (n=16) and 17% (n=8) to 6% (n=3), respectively. Prescriptions of other antidiabetic 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. TRIAL REGISTRATION: ClinicalTrials.gov NCT03865381; https://clinicaltrials.gov/ct2/show/NCT03865381
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spelling pubmed-90196402022-04-21 Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring–Driven Virtual Care Program: Prospective Study Majithia, Amit R Erani, David M Kusiak, Coco M Layne, Jennifer E Lee, Amy Armento Colangelo, Francis R Romanelli, Robert J Robertson, Scott Brown, Shayla M Dixon, Ronald F Zisser, Howard JMIR Form Res Original Paper 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 glycated hemoglobin (HbA(1c)) ≥8.0% to ≤12.0% experienced a mean HbA(1c) 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: Of 55 participants, 48 (87%) had a medication change consisting of a dose change, addition, or discontinuation. Of these, 15 (31%) participants had a net increase in number of diabetes medication classes from baseline. Mean time to first medication change for these participants was 36 days. The percentage of participants taking a glucagon-like peptide-1 receptor agonist increased from 25% (12/48) to 56% (n=27), while the percentages of participants taking a sulfonylurea or dipeptidyl peptidase 4 inhibitor decreased from 56% (n=27) to 33% (n=16) and 17% (n=8) to 6% (n=3), respectively. Prescriptions of other antidiabetic 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. TRIAL REGISTRATION: ClinicalTrials.gov NCT03865381; https://clinicaltrials.gov/ct2/show/NCT03865381 JMIR Publications 2022-04-05 /pmc/articles/PMC9019640/ /pubmed/35147501 http://dx.doi.org/10.2196/31629 Text en ©Amit R Majithia, David M Erani, Coco M Kusiak, Jennifer E Layne, Amy Armento Lee, Francis R Colangelo, Robert J Romanelli, Scott Robertson, Shayla M Brown, Ronald F Dixon, Howard Zisser. Originally published in JMIR Formative Research (https://formative.jmir.org), 05.04.2022. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.
spellingShingle Original Paper
Majithia, Amit R
Erani, David M
Kusiak, Coco M
Layne, Jennifer E
Lee, Amy Armento
Colangelo, Francis R
Romanelli, Robert J
Robertson, Scott
Brown, Shayla M
Dixon, Ronald F
Zisser, Howard
Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring–Driven Virtual Care Program: Prospective Study
title Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring–Driven Virtual Care Program: Prospective Study
title_full Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring–Driven Virtual Care Program: Prospective Study
title_fullStr Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring–Driven Virtual Care Program: Prospective Study
title_full_unstemmed Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring–Driven Virtual Care Program: Prospective Study
title_short Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring–Driven Virtual Care Program: Prospective Study
title_sort medication optimization among people with type 2 diabetes participating in a continuous glucose monitoring–driven virtual care program: prospective study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9019640/
https://www.ncbi.nlm.nih.gov/pubmed/35147501
http://dx.doi.org/10.2196/31629
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