Initiation of Continuous Glucose Monitoring Is Linked to Improved Glycemic Control and Fewer Clinical Events in Type 1 and Type 2 Diabetes in the Veterans Health Administration
Authors' conclusion
In a large national cohort, initiation of CGM was associated with sustained improvement in HbA1c in patients with later-onset T1D and patients with T2D using insulin. This was accompanied by a clear pattern of reduced risk of admission to an emergency room or hospital for hypoglycemia or hyperglycemia and of all-cause hospitalization.
Study context
- Population
- Adults with adult-onset T1D or T2D receiving insulin, Veterans Affairs Health Care System, 1 January 2015 to 31 December 2020T1D 5,015
- Exposure
- Continuous glucose monitoring (CGM) initiation vs no CGM in insulin-treated T1D and T2D
- Outcome
- Change in HbA1c (glucose control); hypoglycemia- or hyperglycemia-related ED or hospital admission; all-cause hospitalization
- Follow-up
- 12 months
Methodological detailspropensity score overlap weighted
- Propensity score overlap weighted
Main finding
As reported in the abstract
Decline in HbA1c, CGM users vs nonusers
Each group vs nonusersEstimate (95% CI)
CGM users
difference in HbA1c decline (T1D) −0.26 %(−0.33 to −0.19)
CGM users
difference in HbA1c decline (T2D) −0.35 %(−0.40 to −0.31)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Hypoglycemia-related ED or hospital admission, T1D · 12 monthsCGM initiation | 0.69 (0.48–0.98) | |
| All-cause hospitalization, T1D · 12 monthsCGM initiation | 0.75 (0.63–0.90) | |
| Hyperglycemia-related ED or hospital admission, T2D · 12 monthsCGM users | 0.87 (0.77–0.99) | |
| All-cause hospitalization, T2D · 12 monthsCGM users | 0.89 (0.83–0.97) | |
| 0.512Hazard ratio (log scale) |
HbA1c <8 and <9% · 12 months
- Percentages achieving HbA1c <8 and <9% were greater in CGM users
Subgroups (baseline age, HbA1c, hypoglycemic risk, follow-up CGM use)
- Several subgroups had even greater responses
Original publication
Initiation of Continuous Glucose Monitoring Is Linked to Improved Glycemic Control and Fewer Clinical Events in Type 1 and Type 2 Diabetes in the Veterans Health Administration. Diabetes Care. Published 17 February 2023. doi:10.
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