Interdisciplinary health care teams that incorporate pharmacists, physicians, and nursing staff into diabetes care, as well as increased use of continuous glucose monitoring systems are likely to improve outcomes for these patients as evidenced by results presented at the American Society of Health-System Pharmacists Midyear Clinical Meeting & Exposition being held in Las Vegas this week.
In an interview with Drug Topics at the meeting, Maj. Jacob Mock, PharmD, of Eielson Air Force Base in Alaska noted his team routinely received complaints about their predominately military dependent and retiree diabetic population’s need to conduct blood glucose fingerstick measurements multiple times per day.
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From the spring of 2018 into the summer of 2019, the team started 61 patients on a continuous glucose monitoring (CGM) system. The patients were monitored by a collaborative care team that included physicians, nurses, and pharmacists. The physicians on the team would use glucose data from the CGMs to alter medications as needed and provide patient-specific recommendations, nurses on the team provided initial patient education and phone triage for needed supplies, and pharmacy staff dispensed the supplies and provided ongoing patient and provider support.
Patients were treated by medical staff based upon current guidelines appropriate to comorbidities, blood glucose, and hemoglobin A1c levels, regardless of whether or not the patient received CGM or continued their regular fingerstick measurements.
Maj Mock said that he was “blown away” but the number of patients whose hemoglobin A1c values dropped below 7% and 8% from baseline, with about 10 patients showing dramatic declines using the CGM system.
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Since the majority of the patients in the study were type 2 diabetics, the researchers noted that further research is needed to confirm the benefits of an intervention like this in patients with other types of diabetes.
Mock J, Worthington B, Willett A. Use of Continuous Glucose Monitoring (CGM) in a Military Outpatient Clinic Setting. Presented at ASHP Midyear Clinical Meeting & Exposition. December 8, 2019. Las Vegas, Nevada.