New-age CGMS based intervention makes an impact on Diabetes!

16 Jun 2020 | 6 min read

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Complications of Type 2 diabetes are varied. It affects all the vital organs of the body. Nonetheless, one of its complications, namely hypoglycaemia, gets unrecognized and is often left untreated. Patients with type 2 diabetes have huge glycaemic variabilities which can result in episodes of both hyper and hypoglycemia

Case history

A 58-year old male patient presented with multiple recurrent episodes of hypoglycaemia and high BMI of 28.9 kg/m2.

He was diagnosed with type 2 diabetes 20 years ago. He was prescribed a combination of insulin and OHAs (oral hypoglycemic agents) to keep his blood sugar levels within the normal range by his treating physician. He also had a history of hypertension and dyslipidemia. He was also prescribed anti-anxiety medication.

There was no significant family history of diabetes and hypertension.

The patient was enrolled in an integrated CGMS-based lifestyle management wellness program by Fitterfly - DiabeflyTM program.

Problem areas identified with its solution:

Here is a short summary of the problem areas identified by our expert Team of Diabefly along with their solutions.

  1. Hypoglycemia during the day

    The episodes of hypoglycaemia occurred primarily during daytime wherein the patient experienced sweat, tremble, felt hungry, anxious, had difficulty in walking and extreme weakness.

    The patient was advised to improve on meal timings, i.e. smaller, more frequent meals.

  2. Hypoglycemia at midnight and early morning

    Alarming low blood sugars were observed during midnight and early morning. To overcome this potentially fatal state, a bedtime snack was added.

  3. Carbohydrate and Fat overload

    The patient was taking more than the recommended daily allowance (RDA) of carbs and fat in his diet.

    Diabefly coach advised improving on the quality of carbohydrates sources and their combinations. He was recommended to introduce other millets instead such as ragi.

    Fats were reduced by controlling the intake of total oil & switching to skimmed milk.

  4. Lack of interest in physical activity

    Since the patient experienced tiredness throughout the day, he was less motivated to work out.

    He was motivated for a regular walk for 20 mins a day for at least 5 days a week. To overcome post-workout fatigue, pre and post-workout snacks were added to the diet.

  5. Poor intake of Protein and Fiber

    The patient was not meeting his daily requirement of protein and fibre.

    He was advised to include salads in every meal to increase the fibre intake. He was given multiple options for food sources to increase protein in his diet.

Results from the DiabeflyTM program:

Changes in blood sugar levels while on the CGMS device in the first 14 days of the program:

  • Reduction in calorie consumption from 1773 kcal to 1540 kcal.
  • 8% reduction in Average Blood Sugar readings from 159mg/dl to 147mg/dl.
  • Daily Time-in-Range (TIR) increased from 56% to 68%.
  • Time-below-Range (TBR) decreased from 6% to 4%.
  • Time-above-Range (TAR) decreased from 38% to 29%.

Results at the end of 3 months:

  • The patient lost 11.3 kgs in 3 months.
  • BMI reduced from 28.9 to 25.2 kg/m2.
  • HbA1c reduced from 7.4% to 6.2%.
  • Insulin dosage was reduced by 8 units in total from 20 U to 16 U (in the morning) and from 8 U to 4 U (at night) by his treating physician.

Summary

This study provides preliminary evidence that CGMS based lifestyle modification plan may be used to identify, intervene and prevent the unwarranted onset of hyper and hypoglycemic events.

The findings provide a basis for more comprehensive, larger-scale study to assess better the potency of CGMS device, revised diet plans and lifestyle modification plans in regulating diabetes and its complications.

Patient ‘s Testimonial

‘Thank you very much, team fitterfly. This has been a great learning experience which has holistically changed the way I live now. Wish your team all the very best.’

Watch him speak about his journey here.

https://youtu.be/9WQYhp4XjGc