Diabetes Dialogue: Technology Guidelines and Uptake in Diabetes, with Grazia Aleppo, MD

With mountains of research has been conducted and published in recent years, some have begun to question whether technology guidelines have begun to outpace the real-world adoption of these technologies. This discussion was the subject of a symposium led by Grazia Aleppo, MD, professor of Medicine at the Northwestern Medicine Feinberg School of Medicine, during the 16th annual conference on Advanced Technologies & Treatments for Diabetes (ATTD 2023).

With a primary clinical interest of the intersection of diabetes and technology, including use of pump therapy and real-time continuous glucose monitoring use in diabetes, Aleppo is a leader in the field of advancing care through leveraging technology in diabetes, evidenced by her participation in the writing committee responsible for the American Diabetes Association’s Standards of Care—2023. At ATTD 2023, Aleppo also presented data related to the feasibility and efficacy of establishing a comprehensive care virtual diabetes clinic model including initiation and support for CGM use.

In this study, which included 234 adults with diabetes using basal-bolus insulin, a certified diabetes care and education specialist was assigned to each patient to provide telehealth support, including remote CGM training. Patients were followed for 6 months to assess for changes in CGM use, glycemic control, and quality of life. Results indicated the mean HbA1c reduction from baseline to 6 months was 0.6% (P <.001) among those with T1D and 1.0% (P <.001) among those with T2D.

Further analysis suggested mean glucose levels were reduced from 183 mg/dL to 165mg/dL among those with T1D and from 199 mg/dL to 166 mg/dL in those with T2D from baseline to 6 months. When assessing time in range during the follow-up period, results indicated the mean percentage of time in range 70-180 mg/dL increased from 50% at baseline to 61% in those with T1D and from 48% to 66% in those with T2D.

The hosts of Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives, Diana Isaacs, PharmD, an endocrine clinical pharmacist at the Cleveland Clinic, and Natalie Bellini, DNP, an endocrine nurse practitioner with R&B Medical Group, to learn more about her ongoing work and learn about her perspective on data from the meeting.