CGM Tied to Better Glycemic Control in Insulin-Treated Diabetes

THURSDAY, June 3, 2021 (HealthDay News) — For insulin-treated patients with diabetes, real-time continuous glucose monitoring (CGM) is associated with improvements in hemoglobin A1c (HbA1c) and reductions in emergency department visits and hospitalizations for hypoglycemia, according to a study published online June 2 in the Journal of the American Medical Association.

Andrew J. Karter, Ph.D., from Kaiser Permanente in Oakland, California, and colleagues estimated clinical outcomes of real-time CGM initiation in a cohort of 41,753 participants with insulin-treated diabetes (5,673 with type 1 diabetes and 36,080 with type 2 diabetes). Ten end points were measured during the 12 months before and after baseline among 3,806 CGM initiators and 37,947 noninitiators.

The researchers found that mean HbA1c decreased from 8.17 to 7.76 percent among CGM initiators and from 8.28 to 8.19 percent among noninitiators (adjusted difference-in-differences estimate, −0.40 percent). Hypoglycemia (emergency department or hospital utilization) rates decreased among CGM initiators (5.1 to 3.0 percent) and increased among noninitiators (1.9 to 2.3 percent; difference-in-differences estimate, −2.7 percent). Statistically significant differences were observed in the adjusted net changes in the proportion of patients with HbA1c lower than 7 percent, lower than 8 percent, and higher than 9 percent (adjusted difference-in-differences estimates, 9.6, 13.1, and −7.1 percent, respectively); there were also statistically significant differences in the number of outpatient visits and telephone visits (adjusted difference-in-differences estimates, −0.4 and 1.1).

“In this observational study, patients selected by clinicians for real-time CGM initiation achieved improved glycemic control and lower hypoglycemia rates,” the authors write.

Several authors disclosed ties to Dexcom.

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