Focused care improves glycemic control without heightened hypoglycemia risk
BOSTON — A brief focused program for the improvement of glycemic control without an increased risk for hypoglycemia was found to be effective in patients with type 2 diabetes, according to findings presented at the American Diabetes Association’s 75th Scientific Sessions.
“We did this study because we know the way to maintain better glycemic control is with intense therapy, however, what’s not been shown is that this improvement in glycemic control can be maintained once intense therapy is withdrawn,” Prue Haniak, RDN, CDE, of Vancouver Coastal Health, said during a presentation.
Haniak and colleagues evaluated 12 patients (mean age, 55 years) with uncontrolled glucose levels although they were taking insulin to determine the effect of a unique care approach that combined education, continuous glucose monitor (CGM) and weekly team contact on the importance of sustaining glycemic control improvement.
The program required participants to wear a CGM for 3 months, keep food records and maintain weekly contact with a registered dietician/registered nurse team. The educational component of the program was designed to help participants understand the unique effects of food choice on glucose levels by using the information from the CGM. After 3 months, patients were told to discontinue sensor use and weekly contact and return to usual care.
HbA1c at study entry was 8.2 ± 0.9% among all participants, which decreased to 7.1 ± -0.5% (P = .001) during the program period and did not increase during the 14.8 ± 6.9 months of patient follow-up.
The CGM was successful in documenting hypoglycemia (glucose < 4 mmol). At the beginning of treatment, the number of episodes was 3.5 ± 4.9 per week and was unchanged at the end of the study to 2.8 ± 2.5 (P = .59).
“In conclusion, our program empowered patients with the knowledge and skill to maintain glycemic control,” Haniak said. “Furthermore, this program is a very effective teaching tool for those patients with severe hypoglycemia to also sustain and maintain glycemic control.” – by Amber Cox
Haniak P, et al. Abstract 179-OR. Presented at: American Diabetes Association’s 75th Scientific Sessions; June 5-9, 2015; Boston.
Disclosure: Haniak reports no relevant financial disclosures.