%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 6
%N 4
%P e31629
%T Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring–Driven Virtual Care Program: Prospective Study
%A Majithia,Amit R
%A Erani,David M
%A Kusiak,Coco M
%A Layne,Jennifer E
%A Lee,Amy Armento
%A Colangelo,Francis R
%A Romanelli,Robert J
%A Robertson,Scott
%A Brown,Shayla M
%A Dixon,Ronald F
%A Zisser,Howard
%+ Department of Medicine, University of California San Diego School of Medicine, Biomedical Research Facility II (3A19), 9500 Gilman Drive, La Jolla, CA, 92093, United States, 1 858 822 0727, amajithia@ucsd.edu
%K continuous glucose monitoring
%K digital health
%K GLP-1 receptor agonist
%K HbA1c
%K telemedicine
%K type 2 diabetes
%K monitoring
%K diabetes
%K optimization
%K medication
%K virtual care
%K prospective
%K app
%K lifestyle
%K coaching
%K self-management
%D 2022
%7 5.4.2022
%9 Original Paper
%J JMIR Form Res
%G English
%X 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 
%M 35147501
%R 10.2196/31629
%U https://formative.jmir.org/2022/4/e31629
%U https://doi.org/10.2196/31629
%U http://www.ncbi.nlm.nih.gov/pubmed/35147501