2040-P: Using CGM and RPM in Safety Net Clinics: Feasibility and Impact

Introduction and Objective: Lack of glucose data, limited access to technology and specialty expertise contribute to poor diabetes outcomes in safety net clinics(SNC). Our study evaluates impact of a diabetes care management program(DCMP) incorporating continuous glucose monitoring(CGM) and remote patient monitoring(RPM) on glycemic outcomes and patient satisfaction in SNC. Methods: We conducted a single arm, prospective, 24-week study in adults with type 2 DM with A1c >8%. Exclusion criteria included pregnancy, steroid use, mental impairment and recent CGM use. Participants initiated CGM and observed effect of lifestyle. Diabetes team reviewed RPM data weekly and contacted participants with suboptimal time in range (TIR) or no sensor data. Medical Alumni Volunteer Expert Network endocrinologists provided logistical expertise and clinician education. Change from baseline at Week 12 for TIR was assessed using a paired t-test and for A1c using a mixed model with week as the lone fixed effect and a random intercept defined using subject ID. Results: Table 1 summarizes demographics, A1c, TIR and patient satisfaction. TIR increased significantly (mean change from baseline =13.4%; p=.015) and A1c decreased (LS mean change = -1.59%; p=.001). Carbohydrate intake decreased in 94.7% . Conclusion: A DCMP incorporating CGM & RPM with access to endocrinology expertise can be successfully implemented in SNC with improvement in A1c and TIR. Long-term data is needed to evaluate sustainability of the program and glycemic outcomes. Disclosure S. Reddy: Consultant; Current; Dexcom, Inc.