$3.6M grant will help International Diabetes Center improve type 2 diabetes management

Funding will determine whether new technology that continuously monitors blood glucose is more effective than the conventional finger stick approach to monitoring glucose in a primary care setting

July 13, 2020 – BLOOMINGTON, Minn. – The International Diabetes Center (IDC) received $3.6 million from the Patient Centered Outcomes Research Institute to determine whether continuous glucose monitors are more effective than the conventional finger stick method at managing blood sugars in patients with type 2 diabetes who are using insulin.

“There’s a growing number of these wearable devices on the market that could provide an effective and less burdensome way for patients with type 2 diabetes to monitor their blood sugars,” said Thomas Martens, MD, co-principal investigator on the project and medical director at IDC, which is part of HealthPartners Institute. “But when it comes to a real-world setting, we need to show if these devices are any better than what’s been available for the past 30 years.”

Type 2 diabetes occurs when a person’s body does not use insulin properly, resulting in abnormally high blood sugar levels. Extended periods of time living with high blood sugar levels can cause serious health issues, like nerve, kidney and eye damage. Additionally, individuals using insulin to manage their type 2 diabetes can be a risk for low blood sugar levels, which can be uncomfortable and dangerous.

To monitor blood sugar levels, until recently patients would need to stick their finger to draw a small drop of blood and measure their glucose level at that moment using a glucose meter.

However, newer wearable devices called continuous glucose monitors (CGM) allow patients to monitor their blood sugars every few minutes based on readings from a small sensor worn on the body and transmitted to a reader or to their cell phones, without having to stick their fingers. Among patients with type 1 diabetes, these devices have been shown to improve blood sugar management and are becoming the standard of care. But there is a need for more data among patients with type 2 diabetes. While clinical trials have shown promise for CGM to also improve type 2 diabetes management, no data exists to compare CGM and finger stick glucose meter technologies in a real-world primary care setting.

Old vs. New

Researchers from IDC will enroll more than 350 patients with type 2 diabetes who use insulin but do not yet have optimal glucose levels. The patients will be recruited from 20 primary care clinics in the HealthPartners care system. Half will use finger stick testing to manage the disease in the way they find most useful and at a frequency recommended by their provider. The second group will use continuous glucose monitors for day-to-day glucose monitoring, also in the way they find most useful and as recommended by their provider. All participants will be followed for a year and will be asked to share blood glucose data with their provider at in-person or remote clinic visits.

Researchers will evaluate blood sugar control among each group, including hemoglobin A1c levels, time spent with “optimal” blood sugar levels, and time spent with dangerously low blood sugar levels, which is called hypoglycemia. They will also look at how each glucose monitoring method impacts diabetes-related stress and expenses.

If continuous glucose monitors prove to be more effective, IDC researchers say the devices could also expand remote diabetes care strategies because clinicians can access patients’ blood glucose data remotely.

“Perhaps now more than ever, there’s a need to figure out how we can help patients manage their blood sugars without always seeing them in the clinic,” said Richard Bergenstal, MD, co-principal investigator and executive director of IDC. “Hopefully, after this study we’ll have more definitive data to build effective and efficient remote management strategies.”