Continuous glucose monitoring and risks of acute and chronic diabetes-related complications and mortality in adults with type 1 diabetes: a nationwide cohort study
Authors' conclusion
In this nationwide cohort study of adults with type 1 diabetes, CGM users had lower rates of both acute and chronic diabetes-related complications and all-cause mortality compared with non-users.
Study context
- Population
- Adults with T1D receiving intensive insulin therapy, Korean National Health Insurance Service Cohort (2016–2022)
- Participants
- 17,018 adults
- Exposure
- Continuous glucose monitoring (CGM) users vs non-users
- CGM usersn = 8,509
- Non-usersn = 8,509reference
- Outcome
- DKA, severe hypoglycaemia (SH), end-stage kidney disease (ESKD), CVD and all-cause mortality
Methodological detailsKorean National Health Insurance Service Cohort (2016-2022), Cox proportional hazards regression, within-group before/after CGM initiation analysis (paired t tests)
- Korean National Health Insurance Service Cohort (2016-2022)
- Cox proportional hazards regression
- Within-group before/after CGM initiation analysis (paired t tests)
Main finding
As reported in the abstract
Primary outcomes:
- DKA
- ESKD
- CVD
- All-cause mortality
- SH
CGM users vs Non-usersEstimate (95% CI)
Primary outcomes (DKA, ESKD, CVD, all-cause mortality, SH)
aHR (DKA) 0.40(0.33–0.48)
Primary outcomes (DKA, ESKD, CVD, all-cause mortality, SH)
aHR (ESKD) 0.43(0.32–0.56)
Primary outcomes (DKA, ESKD, CVD, all-cause mortality, SH)
aHR (CVD) 0.28(0.23–0.33)
Primary outcomes (DKA, ESKD, CVD, all-cause mortality, SH)
aHR (all-cause mortality) 0.38(0.32–0.46)
Comparable between the two groups
aHR (SH) 0.92(0.77–1.10)
Observational data: associations, not effects.
Further findings
Within-group change in frequency after CGM initiation, CGM users · before vs after CGM initiation
- Mean frequency of severe hypoglycaemia (SH) decreased (p<0.001)
- 61.5%
- Frequency of diabetic ketoacidosis (DKA) decreased (p<0.001)
- 60.0%
- Frequency of cardiovascular disease (CVD)-related hospitalisation or ED visits decreased (p<0.001)
- 50.0%
- Paired t tests
Original publication
Continuous glucose monitoring and risks of acute and chronic diabetes-related complications and mortality in adults with type 1 diabetes: a nationwide cohort study. Diabetologia. Published 21 March 2026. doi:10.
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