TY  - JOUR
AU  - Majithia, Amit R
AU  - Erani, David M
AU  - Kusiak, Coco M
AU  - Layne, Jennifer E
AU  - Lee, Amy Armento
AU  - Colangelo, Francis R
AU  - Romanelli, Robert J
AU  - Robertson, Scott
AU  - Brown, Shayla M
AU  - Dixon, Ronald F
AU  - Zisser, Howard
PY  - 2022
DA  - 2022/4/5
TI  - Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring–Driven Virtual Care Program: Prospective Study
JO  - JMIR Form Res
SP  - e31629
VL  - 6
IS  - 4
KW  - continuous glucose monitoring
KW  - digital health
KW  - GLP-1 receptor agonist
KW  - HbA1c
KW  - telemedicine
KW  - type 2 diabetes
KW  - monitoring
KW  - diabetes
KW  - optimization
KW  - medication
KW  - virtual care
KW  - prospective
KW  - app
KW  - lifestyle
KW  - coaching
KW  - self-management
AB  - 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 
SN  - 2561-326X
UR  - https://formative.jmir.org/2022/4/e31629
UR  - https://doi.org/10.2196/31629
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35147501
DO  - 10.2196/31629
ID  - info:doi/10.2196/31629
ER  -