Rebecca – T2D on basal insulin

Patient background

dexcom medicare

Rebecca is a 67-year-old female who was diagnosed with T2D 12 years ago.

Current treatment: Metformin 1000 mg BID, Sitagliptin 100 mg QD, Glimepiride 4 mg BID, basal insulin (glargine) 36 units QPM

Current A1C: 9.8%

Scenario

Rebecca is motivated to manage diabetes but struggles with eating lower carbohydrate foods consistently. She’s busy with volunteering activities and her new post-retirement social life. When Rebecca was working, she kept her blood glucose meter at her desk and would check her glucose 1-3 times daily. Nowadays, she often forgets to bring the meter with her when she’s out and about.

Why Dexcom G7 was prescribed

Rebecca’s primary care provider (PCP) recognizes her desire to better manage her diabetes and wants to provide a tool that shows her glucose patterns and trends. Her PCP believes Rebecca can use that information to adjust her medications and improve overall glycemic management. In addition, expanded Medicare coverage criteria* includes anyone with diabetes treated with any type of insulin.

How Dexcom CGM helped

Glucose patterns and trends shown on Dexcom Clarity reports allowed Rebecca’s PCP to see what areas to improve and made medication adjustments to address her persistent evening and overnight hyperglycemia.^# Her new medication plan included changing glimepiride to dapagliflozin (SGLT-2i), changing sitagliptin to semaglutide (GLP-1 RA) 0.25 mg titrated up to 1 mg weekly, continue on Dexcom G7, and follow up in 3 months.

At 3-month office visit, Rebecca’s A1C had decreased to 7.2% with improved postprandial hyperglycemia. Her Dexcom Clarity reports showed overnight hypoglycemia and glycemic variability. Her PCP recommended reducing her basal insulin to 18 units QPM and continuing with lifestyle modifications. Rebecca is now using Dexcom G7 to guide meal choices and thanks to Dexcom G7 alerts, she can intervene earlier to prevent or minimize hypoglycemia episodes.

dexcom clarity agp report

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