ROLE OF CONTINUOUS GLUCOSE MONITORING IN MANAGING DIABETIC PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION

Abstract

Background: Diabetes mellitus is a chronic condition characterized by persistent hyperglycemia, significantly increasing cardiovascular disease risks, including coronary artery disease. Percutaneous coronary intervention (PCI) is commonly performed to manage coronary artery disease. However, diabetic patients undergoing PCI face heightened risks of complications due to poor glycemic control. Traditional glucose monitoring methods, like intermittent finger-stick testing, often fail to provide comprehensive glucose data, leading to suboptimal diabetes management during critical periods. Continuous glucose monitoring (CGM) offers a promising alternative by providing real-time dynamic glucose measurements, enabling better glycemic control and potentially reducing complications. This study evaluates the role of CGM in managing diabetic patients undergoing PCI.

Objective: The primary objective of this study was to assess the effectiveness of CGM in maintaining optimal blood glucose levels, measured by the time in range (TIR) of 70-180 mg/dL. Secondary objectives included evaluating the incidence of hypoglycemic and hyperglycemic events, hospital readmissions due to cardiovascular events, and patient-reported outcomes related to quality of life and satisfaction with CGM.

Methods: This prospective observational study was conducted at Hayatabad Medical Complex, Peshawar from January 2023 to December 2023. It included 200 adult diabetic patients scheduled for PCI. Patients were fitted with CGM devices prior to the procedure, which continuously monitored their glucose levels for 30 days post-PCI. Standard diabetic management protocols were followed alongside CGM, and therapy adjustments were made based on CGM readings. Data were collected using CGM devices and additional information through patient interviews and medical record reviews. Statistical analysis was conducted using SPSS version 25.0.

Results: The mean TIR increased significantly from 58.3% ± 12.4% pre-intervention to 72.6% ± 10.1% post-intervention (p < 0.001). The incidence of hypoglycemic events decreased from 5.6 ± 2.3 to 2.1 ± 1.4 per patient (p < 0.001), and hyperglycemic events decreased from 8.4 ± 3.1 to 3.7 ± 2.0 per patient (p < 0.001). Hospital readmissions due to cardiovascular events were lower in the CGM group (5%) compared to historical controls (15%) (p = 0.01). High patient satisfaction was reported, with 85% of patients noting improved quality of life.

Conclusion: CGM significantly improves glycemic control and reduces adverse events in diabetic patients undergoing PCI. These findings support the broader implementation of CGM in clinical practice for this patient population, potentially enhancing patient outcomes and satisfaction.