Continuous Glucose Monitoring shown to improve glucose control and results in fewer clinical events in people with Type 1 and Type 2 Diabetes in the Veterans Health Administration

Abstract

Continuous Glucose Monitoring (CGM) technology has been increasingly used to replace pin-prick of blood sugar in order to monitor glucose control, helps meal planning and reduce risk of hypoglycaemia. Using this technology, assessment of “Time in Range”, “Time below range”, glucose trends as well as alerting patients to low glucose levels have become possible. While this has tremendously improved patients quality of life, long-term impact on clinical outcomes is still limited, especially in people with Type 2 Diabetes and in real life setting. An observational retrospective study was therefore undertaken within the Veteran Affairs Health Care system to determine the benefit of starting CGM in adult-onset type 1 Diabetes (T1D) and type 2 Diabetes (T2D) with regard to longer-term glucose control and serious clinical events. Using health care records, investigators, compare glucose control and hypoglycemia- or hyperglycemia-related admission to an emergency room or hospital and all-cause hospitalization and matched them by statistical methods to CGM nonusers over 12 months. The study included 5,015 people with T1D and 15,706 with T2D who are on insulin and receving CGM, with similar numbers of nonusers. These individuals identified from January 1, 2015 to December 31, 2020. The analysis showed that reduction in HbA1c levels were significantly greater in CGM users with T1D (−0.26%; 95% CI −0.33, −0.19%) and T2D (−0.35%; 95% CI −0.40, −0.31%) than in nonusers at 12 months. Percentages of patients achieving HbA1c <8 and <9% after 12 months were also greater in CGM users. Importantly also, in people with T1D, CGM significantly reduced risk of hypoglycaemia by about 31% and all-cause hospitalization by about 25%. Similarly among people with T2D, CGM users showed a significant 13% reduction in the risk of hyperglycemia and a significant 11% reduction in all-cause hospitalization. This study, which was derived from a large national cohort in the US showed further evidence to support the increase use of CGM to not only improve glucose control but to reduce risk of hypo-, hyperglycaema and all-cause hospitalization.