@Article{info:doi/10.2196/31629,
author="Majithia, Amit R
and Erani, David M
and Kusiak, Coco M
and Layne, Jennifer E
and Lee, Amy Armento
and Colangelo, Francis R
and Romanelli, Robert J
and Robertson, Scott
and Brown, Shayla M
and Dixon, Ronald F
and Zisser, Howard",
title="Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring--Driven Virtual Care Program: Prospective Study",
journal="JMIR Form Res",
year="2022",
month="Apr",
day="5",
volume="6",
number="4",
pages="e31629",
keywords="continuous glucose monitoring; digital health; GLP-1 receptor agonist; HbA1c; telemedicine; type 2 diabetes; monitoring; diabetes; optimization; medication; virtual care; prospective; app; lifestyle; coaching; self-management",
abstract="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 (HbA1c) ≥8.0{\%} to ≤12.0{\%} experienced a mean HbA1c 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 ",
issn="2561-326X",
doi="10.2196/31629",
url="https://formative.jmir.org/2022/4/e31629",
url="https://doi.org/10.2196/31629",
url="http://www.ncbi.nlm.nih.gov/pubmed/35147501"
}