Continuous Blood Glucose Monitoring Outcomes in Veterans With Type 2 Diabetes

Nearly 25% of patients served in the US Department of Veterans Affairs have been diagnosed with type 2 diabetes mellitus (T2DM). Patients with DM typically monitor their blood glucose using intermittent fingerstick self-testing. Continuous glucose monitoring (CGM) might offer improved disease management.

We conducted a retrospective of VA patient records using a pre-post model. Average hemoglobin A_1c (HbA_1c) values were calculated for the year before and the year after CGM initiation. Our primary objective was to determine change in HbA_1c from the year before CGM initiation to the year after. Secondary objectives included changes in blood pressure, weight, and DM-related hospital and clinic visits during the same time frame.

Both the total population and the adherent subgroup showed reduction in HbA_1c. The complete population showed a HbA_1c change of -0.3, and the adherent subgroup had a change of -1.3. The total population had a mean change in weight of -1.9 lb (-0.9 kg), and the adherent subgroup had an average change of -8.0 lb. Average systolic blood pressure changes were -0.1 mm Hg in the total population and +3.3 mm Hg in the adherent subgroup. A decrease in total encounters for DM complications was observed in the total population (-0.3 total encounters per patient) and the adherent subgroup (-0.6 total encounters per patient).

CGM did not correspond with clinically significant reductions in HbA_1c. However, veterans with increased health care engagement were likely to achieve clinically significant HbA_1c improvements. Adherent patients also had more reduction in weight and hospital or clinic visits with CGM compared with the total population.