Flash glucose monitoring feasible as prevention tool for adults with prediabetes
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A small cohort of adults with prediabetes responded favorably toward wearing flash glucose monitoring sensors for 28 days to track glucose and slow their progression toward diabetes, according to a brief report published in Diabetes Care.
In findings from a diverse group of 32 adults with prediabetes in California, all of the participants wore a flash glucose monitoring sensor during the study period as directed, with most of the participants reporting high satisfaction and being influenced to make positive behavior changes based on their glucose levels.
“Findings from this study are important because, currently, flash glucose monitoring system sensors are only indicated in people with diabetes, not prediabetes,” Joyce Lee, PharmD, APh, FCCP, BCPS, BCACP, CDCES, health sciences clinical professor, advanced practice pharmacist and certified diabetes care and education specialist in the School of Pharmacy and Pharmaceutical Sciences at University of California, Irvine (UCI), and José Mayorga, MD, executive medical director at UCI Health Family Health Center and associate clinical professor in the department of family medicine at UCI, told Healio. “This also means that people with prediabetes do not have access to flash glucose monitoring system sensors; and sensors are also not covered by the insurance for the indication of prediabetes. This pilot study provided evidence for the first time in the literature that flash glucose monitoring system sensor wear is acceptable and feasible in people with prediabetes.”
Lee, Mayorga and colleagues conducted a prospective study of adults with prediabetes at two health centers. Eligible adults were invited through a provider referral to wear flash glucose monitoring system sensors for 28 days. Study feasibility was defined as having 30 participants enroll during a 3-month period, with an adherence rate of at least 70% for the first sensor and 60% for the second sensor and an 85% retention rate for the full 28-day study. An interview consisting of the 11-item flash glucose monitoring system satisfaction scale and four open-ended questions was conducted at the end of the study.
Flash glucose monitoring feasible in prediabetes
Among 136 adults referred for the study, 32 chose to enroll (14 women; mean age, 52 years; 31.3% Hispanic; 31.3% Asian). About one-third of those referred for flash glucose monitoring were uncontactable, 17.6% were undecided on whether to participate and 25% declined due to no interest or lack of time. All of the participants adhered to wearing the first sensor, followed by the second sensor. The cohort wore a sensor for a mean of 25 days.
“Our study site is a federally qualified health center, providing outpatient care to approximately 25,000 patients with the majority living below the federal poverty line,” Lee and Mayorga said. “Although it is well documented in the literature that due to multitude of barriers, recruitment of minority populations is substantially challenging, it is nevertheless necessary to reduce health disparities. Many of our patients change residencies frequently and use limited cellphone plans. Despite the challenge, our study still met the predetermined sample size for the feasibility and acceptability study.”
Flash glucose monitoring receives positive feedback
In the post-study questionnaire, most participants had a largely positive response to flash glucose monitoring, and 68.8% agreed or strongly agreed that they would be willing to pay a copay for sensors if insurance covered them.
In the open-ended questions, most participants said the two best things about wearing a sensor were positive behavior change and the improved understanding from real-time feedback. Most of the cohort said the mechanics of the sensor was the worst thing about wearing them. When asked about an appropriate duration for wearing a flash glucose monitoring sensor, 90.6% responded at least 1 month and then periodically as a form of reinforcement. Most of the cohort added that people with prediabetes should try flash glucose monitoring and said the visual feedback from the sensor allowed them to make lifestyle changes to prevent progression to diabetes.
“As primary care providers, we are constantly advocating for our patients,” Lee and Mayorga said. “Our hope is that this study will lend to more research and benefit so that we can curtail the rise of diabetes.”
For more information:
Joyce Lee, PharmD, APh, FCCP, BCPS, BCACP, CDCES, can be reached at j.lee@uci.edu.
José Mayorga, MD, can be reached at jmayorga@hs.uci.edu.
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