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Dysglycemic Events after Initiation of Intermittently Scanned Continuous Glucose Monitoring in Patients with

Lisa K Gilliam1, Melissa M Parker2, Andrew J Karter2,3,4

  • 1South San Francisco Medical Center, The Permanente Medical Group (TPMG) Diabetes Population Care, TPMG Regional Endocrinology, Kaiser Permanente, South San Francisco Medical Center, South San Francisco, California, USA.

Diabetes Technology & Therapeutics
|April 16, 2025
PubMed

Insights

Intermittently scanned continuous glucose monitors (isCGM) improve blood sugar control in type 2 diabetes but do not reduce acute hypoglycemia or hyperglycemia events. This large study offers insights into isCGM benefits for insulin-treated patients.

Area of Science:

  • Endocrinology
  • Diabetes Management
  • Medical Technology

Background:

  • Insulin-treated type 2 diabetes (T2D) management often involves monitoring blood glucose.
  • Intermittently scanned continuous glucose monitors (isCGM) are increasingly used, showing potential for improving glycemic control.
  • The impact of isCGM on acute dysglycemic events (hypoglycemia and hyperglycemia) requires further investigation.

Purpose of the Study:

  • To compare the effectiveness of isCGM versus self-monitoring of blood glucose (SMBG) in patients with insulin-treated T2D.
  • To evaluate the impact of isCGM initiation on glycemic control, specifically hemoglobin A1c (A1c).
  • To assess whether isCGM reduces the incidence of acute hypoglycemic and hyperglycemic events.

Main Methods:

  • Observational, comparative effectiveness analysis.
  • Utilized a difference-in-differences framework with overlap weighting based on propensity scores.
  • Employed rigorous causal analysis and machine learning techniques to address confounding.

Main Results:

  • Initiation of isCGM was associated with improved glycemic control, evidenced by reduced A1c levels.
  • A higher proportion of patients using isCGM achieved target A1c levels (<8% and <9%).
  • No significant reduction in the incidence of acute hypoglycemic or hyperglycemic events was observed with isCGM initiation.

Conclusions:

  • isCGM initiation improves glycemic control (A1c) in patients with insulin-treated T2D.
  • isCGM does not appear to reduce the frequency of acute dysglycemic events in this population.
  • This study, one of the largest of its kind, provides valuable data on isCGM utility in T2D management.
Keywords:
continuous glucose monitoremergency roomhospital admissionshyperglycemiahypoglycemia

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