Diabetes Self-Management
Diabetes Self-Management
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December 19, 2022
Using a continuous glucose monitoring (CGM) system is linked to a lower risk for hospitalization in people with type 1 or type 2 diabetes, according to a new study presented at the World Congress on Insulin Resistance, Diabetes & Cardiovascular Disease and described in an article at Healio.
Continuous glucose monitoring involves wearing a sensor that extends under your skin (or is implanted under your skin) — usually on your upper arm — that sends glucose readings to a compatible device at predetermined intervals, such as every minute or every five minutes. These readings are now so accurate that most CGM systems are approved for use without confirmation by traditional (finger-stick) glucose meter readings in most situations. Continuous glucose monitoring has been shown to help improve glucose control in both young people and older adults with type 1 diabetes and has become increasingly commonplace among young people with type 1 in particular. Studies have shown that people with type 2 diabetes who use CGM systems are at lower risk for severe hypoglycemia (low blood glucose) as well.
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For the latest study, researchers looked at records from Veterans Affairs (VA) clinics for 54,151 adult patients with type 1 or type 2 diabetes. All participants had at least one clinic visit for primary care or endocrinology in the last year and had at least two years of overall health data available. New CGM system users were identified by a sensor prescription with a first fill date between 2015 and 2020. Non-CGM system users were identified by not having sensor prescriptions, while having glucose test strip prescriptions. The researchers were interested in comparing various outcomes after CGM system users had been using their system for 12 months — including changes in A1C (a measure of long-term blood glucose control), hospitalizations related to high or low blood glucose, and hospitalization for any reason. The participants included 5,015 people with type 1 diabetes who used a CGM system, 3,518 people with type 1 who did not, 15,706 people with type 2 diabetes who used a CGM system, and 29,912 people with type 2 who did not.
After 12 months, people with type 1 diabetes who used a CGM system had a greater decline in A1C by an average of 0.26%. For people with type 2 diabetes, there was an even greater difference in A1C reduction, 0.39%, among CGM system users. But the most dramatic differences were related to hospitalization. Among people with type 1 diabetes, those who used a CGM system were 31% less likely to be hospitalized for events related to low blood glucose and 25% less likely to be hospitalized for any reason. Among people with type 2 diabetes, those who used a CGM system were 13% less likely to be hospitalized for events related to high blood glucose and 11% less likely to be hospitalized for any reason. There was no significant difference between CGM users and non-users when it came to hospitalization for high blood glucose in type 1 diabetes, or hospitalization for low blood glucose in type 2 diabetes.
In a preliminary analysis of death risk after 18 months — not a very long follow-up time for an outcome as infrequent as death in this group of participants — the researchers found that after adjusting for factors that might affect both death risk and use of CGM systems (such as certain illnesses), the risk of dying among CGM system users with type 1 diabetes was 62% lower, while for CGM system users with type 2 diabetes it was 21% lower compared with non-users. More data over time is needed to confirm the validity of these results on death, the researchers emphasized — but they do point to a very important outcome to consider in future research on the benefits of continuous glucose monitoring.
Want to learn more about CGM? Read “CGM for Diabetes Management” and “How to Pick an Insulin Pump or CGM.”
Disclaimer of Medical Advice: Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information, which comes from qualified medical writers, does not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs.
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