Use of Continuous Glucose Monitoring (CGM) to improve outcomes for Indigenous clients with Type 2 diabetes living in Remote Communities of Australia. (Clinical Practice) — ASN Events

Use of Continuous Glucose Monitoring (CGM) to improve outcomes for Indigenous clients with Type 2 diabetes living in Remote Communities of Australia. (Clinical Practice) (#362)

Cathryn Dowey 1 , Bernadette Heenan 1 , Maureen Toner 1
  1. Apunipima Cape York Health Council, Cairns, Qld, Australia

Background – Continuous Glucose Monitoring (CGM) is predominantly aimed at clients with Type 1 Diabetes Mellitus.  However it also has a role to play for clients with Type 2.  For the past year we have been offering CGM to some Aboriginal and Torres Strait Islander clients living in remote communities to assist them to understand the glycaemic balancing act that they face on a daily basis on their journey towards self-management and improved outcomes.

Aim

  • To increase the understanding of the effects that lifestyle modification and medications can have on improving glycaemic control.
  • To encourage problem solving using the CGM reports as a tool to identify where changes can be made that would lead to better health outcomes.

Method

  • Study design – Clients with complex issues (insulin, food and exercise safety issues, hypoglycaemic events, co-morbidities) have been offered the CGM device.
  • Data collection – Client log sheets, CGM reports, HbA1c measures, and client and health practitioner management plans have provided the groundwork for interpretation.
  • Analysis – review of CGM reports, multidisciplinary team involvement and recommendations, and client goal setting reviews have eventuated from this groundwork.

Findings

  • Improved client literacy around glycaemic control and management options leading to improved clinical outcomes.
  • Enhancement of data available to Doctors and CDEs to reinforce behaviour modification and assist in medication titration.
  • Effective teaching tool to reinforce and influence behaviour change to assist in halting the progression of diabetes and its complications.

Conclusion – CGM has proved to be an effective tool for improving client engagement in self-management and hence, improved glycaemic outcomes.  It has allowed for the detection of overnight hypos, identified unstable glycaemic profiles and assisted Endocrinologists and other health providers to make informed decisions based on the provision of this valuable data.

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