ADA 2023 Poster: Examining Physician Case Studies on Success of Treatment Initiation in Patients with Type 2 Diabetes
Noa Kim, MSI
Informatics Design Lead
Noa is the Clinical Informatics Design Lead for the Michigan Collaborative for Type 2 Diabetes (MCT2D) and Healthy Behavior Optimization for Michigan (HBOM). They strive to design stories, services, and systems that make room for the humanity of health care experiences.
Presented at the 2023 American Diabetes Association (ADA) 83nd Scientific Sessions held June 23-26, 2023. The poster and presentation will be presented by MCT2D informatics design lead Noa Kim, MSI.
Introduction: The Michigan Collaborative for Type 2 Diabetes (MCT2D) is a state-wide quality initiative supported by Blue Cross Blue Shield of Michigan that aims to improve the treatment of diabetes through three initiatives-encouraging increased prescribing of continuous glucose monitoring (CGM), SGLT2i/GLP-1RA medications, and low carbohydrate diet (LCD), defined as 80-130 total grams of carbohydrates per day, with patients on an SGLT2i instructed to stay >100g among 264 primary care practices. The aim of this study was to evaluate physician experience prescribing LCD through case studies.
Methods: Each physician participating in MCT2D submitted a case study evaluating their experience implementing MCT2D initiatives. Close-ended questions were assessed using a 4-point scale (Yes, Somewhat, Too Early to Tell, No). Open-ended responses on intervention success were analyzed using a multi-step process of data immersion, generating initial codes, and reorganization.
Results: Physicians prescribed a LCD either alone or in combination with CGM and/or SGLT2i/GLP-1RA in 375 of 970 case studies. More than half (51.5%) reported that the intervention(s) achieved the target outcome. Case studies incorporating all three interventions were associated with greater physician satisfaction with results, as compared to diet alone (p<0.01). Five major themes regarding intervention effectiveness were: glycemic control, weight loss, patient motivation, simplification of medications, and combined benefit of multiple interventions. Improvement of blood glucose was reported in 45.9% of LCD alone cases and in 69.1% of cases that involved all three interventions. An increase in patient motivation to achieve improvement in health was most frequently discussed in cases where diet and CGM were combined (67.3%).
Conclusion: LCD may have a synergistic effect with the use of CGM and newer medications. These exploratory findings require confirmation through future investigations.
Tags: Created By MCT2D, Research