Laura Buchanan MD, MHP and Matt Calkins MD, demonstrated improvements for subjects in A1c, weight, somatic symptoms, anxiety, depression, irritability, and food addiction
Drs. Laura Buchanan MD, MHP and Matt Calkins MD each participated in the Poster Presentation during the recent Symposium for Metabolic Health held in Boca Raton, FL, January 13-15, 2023.
The doctors developed a quality improvement project during their residency program, and their work sought to improve the quality of group medical visits (GMVs) for subjects with type 2 diabetes by giving patients continuous glucose monitors (CGMs) with special programming during the GMVs regarding how to use them effectively.
The following was reported by Drs. Buchanan and Calkins:
Two 8-subject cohorts were recruited. Subjects wore CGMs for 14 weeks and attended 120-minute group visits every other week for a total of 7 sessions.
The GMVs consisted of a brief powerpoint review of each subject’s glycemic graphs from the prior two weeks. The remaining time was devoted to patient-driven discussion of how foods, stress, sleep, and activities impact their glycemia.
Three subjects dropped out due to events unrelated to the intervention. Of the 13 completers, all but one improved their average glucose.
There was a statistically significant improvement in A1c (-0.4%) and weight (-6.4 lbs). Somatic symptoms improved, with 92% reporting improvement in fatigue, 53% reporting improvement in bloating, and 46% reporting improvement in anxiety, depression, and irritability. Most impressive were the improvements seen in food addiction symptoms. At the beginning of the study, 4 subjects had symptoms of mild food addiction, 1 had moderate symptoms, and 1 had severe symptoms. At the end of the study, no subject had food addiction.
We can not infer which aspect of the intervention was responsible for the improvement seen in HbA1c, weight, symptoms, and food addiction. However our quality improvement project did demonstrate improvement in patient satisfaction with subjects reporting that the CGMs kept them “vigilant” and to “consider alternative foods” and that CGMs were effective in facilitating patient engagement.
Dr. Buchanan’s poster focused on subjective symptoms experienced by the subjects, and Dr. Calkins’ poster examined specific metrics for each subject, including A1c, blood pressure, and cholesterol.