CGM Linked to HbA1c Improvements in Patients with Type 2 Diabetes, Regardless of Insulin Use

Satish Garg, MD

Credit: University of Colorado School of Medicine

Findings from a recent study are calling attention to the significant impact of continuous glucose monitoring (CGM) on glucose control in patients with type 2 diabetes, highlighting its impact in this patient population across individuals on various therapeutic treatments.¹

The research was presented at the 84th American Diabetes Association (ADA) Scientific Sessions and found CGM use was associated with significant hemoglobin A1C (HbA1c) improvements in both non-insulin and insulin-treated patients with type 2 diabetes after 12 months.^1,2

"These results suggest that CGM can play a crucial role in enhancing health outcomes for all diabetes patients, regardless of their treatment regimen," lead study author Satish Garg, MD, professor and founder of the Barbara Davis Center for Diabetes at the University of Colorado Denver, said in a press release.¹ "The real-world analysis underscores the potential of CGM to not only improve glycemic outcomes but also reduce healthcare resource utilization and overall healthcare costs."

A wearable technology that tracks glucose levels over time, CGM is frequently used among patients with diabetes to monitor their blood sugar trends and improve their glycemic control.³ Although the benefits of CGM use in type 1 diabetes are well documented, its efficacy across the spectrum of patients with type 2 diabetes in real-world settings is not fully understood.

Investigators assessed the effects of CGM use in adults with type 2 diabetes through a retrospective, 12-month analysis using data from a large claims database that included >7.1 million patients with type 2 diabetes in the electronic medical records. Investigators considered the entire population across the treatment spectrum, including those on non-insulin therapies, basal insulin, and prandial insulin with/without non-insulin medications.^1,2

The study included a pair of observation periods relative to baseline, the date of the first CGM claim between December 27, 2019, and January 5, 2022. The first observation period was the pre-index period, defined as 360 days prior to patients' first CGM claim. The second was the post-index period, defined as 360 days after the first CGM claim. The primary outcome was change in HbA1c closest to 12 months after CGM acquisition.^1,2

In total, the analysis included 16,410 adults with type 2 diabetes. Among the cohort, the mean age was 59 years and the mean baseline HbA1c was 8.8%. Regarding treatment type, investigators noted 4659 patients were on non-insulin therapies, 6182 were on basal insulin, and 5569 were on prandial insulin.^1,2

At 12 months, the mean change in HbA1c was significant in all 3 subgroups compared with HbA1c levels in the pre-index period. In the non-insulin therapy group, HbA1c decreased from 8.63% during the pre-index period to 7.42% in the post-index period (-1.21%; 0.029%). In the basal insulin group, HbA1c decreased from 8.96% during the pre-index period to 7.91% in the post-index period (-1.06%; 0.026%). Finally, in the prandial insulin group, HbA1c decreased from 9.04% during the pre-index period to 7.97% in the post-index period (-1.07%; 0.027%).^1,2

Investigators highlighted the need for longer-term studies and randomized controlled trials to further validate their findings and explore the broader implications of CGM use in diabetes care, with future research focusing on confirming the sustained benefits of CGM and understanding its impact on various patient subgroups to tailor diabetes management strategies effectively.¹

References:

1. ^{Breakthrough Studies on Automated Insulin Delivery and CGM for Type 2 Diabetes Unveiled at ADA Scientific Sessions. June 24, 2024. Accessed June 24, 2024. https://www.prnewswire.com/news-releases/breakthrough-studies-on-automated-insulin-delivery-and-cgm-for-type-2-diabetes-unveiled-at-ada-scientific-sessions-302179064.html}
2. ^{Garg SK, Hirsch IB, Repetto E, et al. Glycemic Outcomes with CGM Use in Patients with Type 2 Diabetes—Real-World Analysis. Presented at: American Diabetes Association (ADA) 84th Scientific Sessions. June 21 - 24, 2024. Orlando, FL.}
3. ^{Cleveland Clinic. Continuous Glucose Monitoring (CGM). May 24, 2024. Accessed June 24, 2024. https://my.clevelandclinic.org/health/articles/continuous-glucose-monitoring-cgm}