Case Studies From India: Management of Diabetes Using Continuous Glucose Monitoring

TL;DR

This paper presents case studies from India showing how continuous glucose monitoring helps manage diabetes effectively in various adult patients.

Contribution

The study demonstrates CGM's effectiveness in diverse diabetes cases in an Indian clinical setting.

Findings

CGM enabled optimal glycemic control in a patient with chronic liver disease.

Gestational diabetes patients achieved excellent control with minimal complications using CGM and insulin.

CGM improved glucose management in patients with diabetes and comorbidities like hypertension and coronary artery disease.

Abstract

Continuous glucose monitoring (CGM) has significantly advanced diabetes management by enabling real-time glucose tracking. However, many patients with diabetes still fail to achieve optimal glycemic control. This case series reviews the role of CGM by analyzing case studies from various clinical departments of a quaternary care center in Northern India. We identified four cases: a 46-year-old male patient with chronic liver disease on CGM who achieved optimal glycemic control (average glucose, 105 mg/dL; estimated glycated hemoglobin (HbA1c), 5.8%) by maintaining a time in range (TIR) of 98%; a 31-year-old female patient diagnosed with gestational diabetes mellitus (GDM) who maintained excellent glycemic control (estimated HbA1c, 6%; TIR, 96%) using basal insulin, with minimal glucose variability and no significant complications; a 28-year-old female patient with diabetes in pregnancy (DIP) who achieved a 100% TIR for over 14 days, with an average glucose of 106 mg/dL and estimated HbA1c of 5.8%. The patient was on insulin Degludec (Tresiba®, Novo Nordisk A/S, Bagsværd, Denmark) and experienced two minor low-glucose events but no major complications; a 69-year-old male patient with diabetes, hypertension, and coronary artery disease who had a TIR of 56% on Tresiba® and oral medications, with an average glucose of 177 mg/dL and estimated HbA1c 7.5%, controlled glucose variability, and no hypoglycemic events. These cases highlight the effectiveness of CGM in managing diabetes across diverse clinical conditions in adults. The CGM system enables tailoring of treatment regimens to improve glycemic control and reduce the risk of hypoglycemia, all of which are essential for optimizing patient outcomes.