Abstract
Aim
To determine whether the use of continuous glucose monitoring (CGM) aids in improving glycaemic control in Type 2 diabetes patients (T2DM) with foot ulcers and improve wound healing.
Methods
Retrospective study on patients attending the high-risk diabetes foot clinic for the management of complex diabetic foot ulcers were provided with Continuous Glucose Monitoring (CGM) devices (Freestyle Libre 2). Patients were reviewed in the foot clinic on a weekly to bi-weekly basis, depending on the severity of their foot ulcers and glycaemic control, which was reviewed at each visit. HbA1c was measured not more than 90 days prior to starting CGM and three months after the start of CGM. Wound size was measured at start and after 3 months of CGM use. Data of the eligible patients was reviewed from the medical records.
Results
22 patients with T2DM with active diabetic foot ulcers were included in this study. Mean age was 65.43 years (range 39–87). Mean HbA1c prior to providing CGM was 84.10 Mmol/mol (range 54–132). The mean HbA1c after three months of CGM use was 65.05 Mmol/mol (range 32–94). Mean reduction in HbA1c was 19.05 ± 22.07 mmol/mol (p = 0.0011) and the greatest improvements were noted in those who had higher HbA1c levels at baseline. Wound size at baseline was 1.53 (0.75–7.62) cm2 and after 3 months it was 0.42 (0.0–1.16) cm2 (p < 0.001); complete wound healing achieved in 3 patients.
Conclusion
This study showed a significant improvement in glycaemic control with the use of CGM and had a positive influence on wound healing. The utility of CGM in improving glycaemic control is well established and is currently widely used in type 1 diabetes mellitus and pregnancy but not directly recommended for patients with foot ulcers according to NICE guidelines. Further follow-up and larger-scale studies are needed to validate these findings and to observe the impact on wound healing.
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