Jump to content

Choose locationChoose Location
  • Sign in or Enroll
    • Open I want to choose my medical group or hospital
    • Clear my location
Change Location

We've expanded your view

You are now viewing all services in the Sutter Health network. You can change your location above to narrow your view to a medical group, hospital, city or zip.
Sutter Health
  • Video Visits
  • Find Doctors
  • Find Locations
  • Treatments & Services
  • Locations
  • Sign in or Enroll
    • Video Visits
    • Find Doctors
    • Find Locations
    • Treatments & Services
    • COVID-19 Resources
    • Pay a Bill
    • Symptom Checker
    • Get Care Today
    • Diseases & Conditions
    • Health & Wellness
    • Classes & Events
    • Research & Clinical Trials
    • For Patients
    • About Sutter Health
    • Giving
    • Volunteering
    • Careers
    • News
    • For Medical Professionals
    • Other Business Services
Close Search
  • Home
  • Research
  • Diabetes, Insulin Resistance and Metabolic Syndrome
Content

Glycemic outcomes in adults with type 2 diabetes participating in a continuous glucose monitor-driven virtual diabetes clinic: prospective trial.

Description

Majithia AR, Kusiak CM, Armento Lee A, Colangelo FR, Romanelli RJ, Robertson S, Miller DP, Erani DM, Layne JE, Dixon RF, Zisser H., J Med Internet Res. 22(8):e21778. doi: 10.2196/21778., 2020 Aug 28

Investigators

Robert Romanelli, Ph.D., MPH, Associate Scientist

Abstract

Background: The Onduo virtual diabetes clinic (VDC) for people with type 2 diabetes (T2D) combines a mobile app, remote personalized lifestyle coaching, connected devices, and live video consultations with board-certified endocrinologists for medication management and prescription of real-time continuous glucose monitoring (RT-CGM) devices for intermittent use.

Objective: This prospective single-arm study evaluated glycemic outcomes associated with participation in the Onduo VDC for 4 months.

Methods: Adults aged ≥18 years with T2D and a baseline glycated hemoglobin (HbA1c) of ≥8% to ≤12% were enrolled from 2 primary care centers from February 2019 to October 2019. Participants were asked to engage at ≥1 time per week with their care team and to participate in a telemedicine consultation with a clinic endocrinologist for diabetes medication review. Participants were asked to use a RT-CGM device and wear six 10-day sensors (total 60 days of sensor wear) intermittently over the course of 4 months. The primary outcome was change in HbA1c at 4 months from baseline. Other endpoints included change in weight and in RT-CGM glycemic metrics, including percent time <70, 70-180, 181-250, and >250 mg/dL. Changes in blood pressure and serum lipids at 4 months were also evaluated.

Results: Participants (n=55) were 57.3 (SD 11.6) years of age, body mass index 33.7 (SD 7.2), and 40% (22/55) female. HbA1c decreased significantly by 1.6% (SD 1%; P<.001). When stratified by baseline HbA1c of 8.0% to 9.0% (n=36) and >9.0% (n=19), HbA1c decreased by 1.2% (SD 0.6%; P<.001) and 2.4% (SD 1.3%; P<.001), respectively. Continuous glucose monitoring-measured (n=43) percent time in range (TIR) 70-180 mg/dL increased by 10.2% (SD 20.5%; P=.002), from 65.4% (SD 23.2%) to 75.5% (SD 22.7%), which was equivalent to a mean increase of 2.4 hours TIR per day. Percent time 181-250 mg/dL and >250 mg/dL decreased by 7.2% (SD 15.4; P=.005) and 3.0% (SD 9.4; P=.01), respectively. There was no change in percent time <70 mg/dL. Mean weight decreased by 9.0 lb (SD 10.4; P<.001). Significant improvements were also observed in systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, and triglycerides (P=.04 to P=<.001).

Conclusions: Participants in the Onduo VDC experienced significant improvement in HbA1c, increased TIR, decreased time in hyperglycemia, and no increase in hypoglycemia at 4 months. Improvements in other metabolic health parameters including weight and blood pressure were also observed. In conclusion, the Onduo VDC has potential to support people with T2D and their clinicians between office visits by increasing access to specialty care and advanced diabetes technology including RT-CGM.

Pubmed Abstract

Pubmed AbstractOpens New Window

Associated Topics

  • Diabetes Type 2
  • Diabetes, Insulin Resistance and Metabolic Syndrome
  • Disease Management
  • Endocrinology and Metabolism

Related Publications

Adiposity, inflammation, genetic variants and risk of post-menopausal breast cancer findings from a prospective-specimen-collection, retrospective-blinded-evaluation (PRoBE) design approach.

Yan XS, Barnholtz-Sloan J, Chu X, Li L, Colonie R, Webster J, Smelser D, Patel N, Prichard J, Stark A.
Springerplus. 2:638. doi: 10.1186/2193-1801-2-638. eCollection 2013.
2013 Nov 27

Nudging physicians and patients with autopend clinical decision support to improve diabetes management.

Panattoni L, Chan A, Yang Y, Olson C, Tai-Seale M.
Am J Manag Care. 24(10):479-483.
2018 Oct 01

A Latino Patient-Centered, Evidence-Based Approach to Diabetes Prevention.

Rosas LG, Lv N, Lewis MA, Venditti EM, Zavella P, Luna V, Ma J.
J Am Board Fam Med. 31(3):364-374. doi: 10.3122/jabfm.2018.03.170280.
2018 May 01

The Electronic CardioMetabolic Program (eCMP) for patients with cardiometabolic risk: a randomized controlled trial.

Azar KM, Koliwad S, Poon T, Xiao L, Lv N, Griggs R, Ma J.
J Med Internet Res. 18(5):e134. doi: 10.2196/jmir.5143.
2016 May 27

Evaluation of a culturally-adapted lifestyle intervention to treat elevated cardiometabolic risk of Latino adults in primary care (Vida Sana): a randomized controlled trial.

Rosas LG, Lv N, Xiao L, Lewis M, Zavella P, Kramer MK, Luna V, Ma J.
Contemp Clin Trials. pii: S1551-7144(16)30029-5. doi: 10.1016/j.cct.2016.03.003. [Epub ahead of print]
2016 Mar 16
The Sutter Health Network of Care
Expertise to fit your needs
Primary Care

Check-ups, screenings and sick visits for adults and children.

Specialty Care

Expertise and advanced technologies in all areas of medicine.

Emergency Care

For serious accidents, injuries and conditions that require immediate medical care.

Urgent Care

After-hours, weekend and holiday services.

Walk-In Care

Convenient walk-in care clinics for your non-urgent health needs.

About Sutter

  • About Our Network
  • Annual Report
  • Awards
  • Community Benefit
  • Contact Us
  • News
  • Giving
  • Find Care

  • Birth Centers
  • Care Centers
  • Emergency Rooms
  • Hospitals
  • Imaging
  • Labs
  • Surgery Centers
  • Urgent Care
  • Walk-In Care
  • View All >
  • Featured Services

  • Behavioral Health
  • Cancer Services
  • Family Medicine
  • Home Health and Hospice
  • Orthopedics
  • Pediatrics
  • Pregnancy
  • Primary Care
  • Women's Health
  • View All >
  • Patient Resources

  • Accepted Health Plans
  • Classes and Events
  • Estimate Costs
  • Flu Resources
  • Health and Wellness
  • Medical Records
  • Medicare
  • My Health Online
  • Pay a Bill
  • Symptom Checker
  • Our Team

  • For Employees
  • Physician Careers
  • Recruiting Events
  • Sutter Careers
  • Vendors
  • Volunteers
    • ADA Accessibility
    • Contact
    • Privacy
    • Do Not Sell My Personal Information

    • LinkedIn Opens new window
    • YouTube Opens new window
    • Facebook Opens new window
    • Twitter Opens new window
    • Glassdoor Opens new window
    • Instagram Opens new window

    Copyright © 2021 Sutter Health. All rights reserved. Sutter Health is a registered trademark of Sutter Health ®, Reg. U.S. Patent & Trademark office.

    Cookie Policy

    We use cookies to give you the best possible user experience. By clicking on "Accept Cookies", closing this pop-up banner or by continuing to use the site, you agree to the use of cookies. Privacy Policy   Cookie Preferences