Continuous Glucose Monitoring in Internal Medicine Residency Clinic: Prospective Open-label trial – Two- and four-months changes in HbA1c, Average blood glucose, and time in range data after switching from Self-monitoring blood glucose

This prospective study aimed to evaluate how continuous glucose monitoring (CGM) use affects Glycemic Management Indicator (GMI) levels, which reflect HbA1c (estimated HbA1c), average blood glucose, and time in range (TIR) in patients who require multiple insulin injections—primarily those with Type 2 diabetes—and a patient with Type 1 diabetes mellitus. The goal of the project was to assess the role of Internal Medicine Residents in CGM management following education and subsequent supervision by an endocrinologist in the Internal Medicine residency clinic. If successful, our goal is to expand to other Internal Medicine residency programs across the USA and to integrate it into the Internal Medicine residency curriculum as an ACGME requirement.
Patients were recruited from the Internal Medicine Residency Clinic. Eligibility criteria included an initial HbA1c level between 7% and 14%, self-monitoring of blood glucose (SMBG) four times daily, and qualification for CGM use. 
Additionally, the study includes patients with Diabetes Mellitus who use three to four daily insulin injections, with or without other diabetic medications. Patients share their CGM data with the Internal Medicine Clinic. All residents work under the supervision of a board-certified endocrinologist, who oversees the project and is also part of the clinic. The CGM team adjusts the patient’s treatment every 2 weeks. The study is planned to last 24 months. Currently, we have 4 months of data from 24 patients, providing insight into patient outcomes to date. The data show that after switching from SMBG to CGM, the GMI decreased from 9.92% to 7.74% at 2 and 4 months. The average blood glucose decreased from 275 mg/dl to 176 mg/dl, and the TIR increased from 30% to 57%. The major improvement in glycemic control occurred primarily during the first 2 months after the switch from SMBG to CGM.