Continuous Glucose Monitoring Frequency and Glycemic Control in People With Type 2 Diabetes

Area of Science:

• Endocrinology and Metabolism
• Diabetes Management
• Health Informatics

Background:

• The impact of continuous glucose monitoring (CGM) frequency on glycemic control in type 2 diabetes (T2D) remains understudied.
• Understanding this association is crucial for optimizing diabetes management strategies.
• Existing research has not fully elucidated the dose-response relationship between CGM usage and glycemic outcomes.

Purpose of the Study:

• To evaluate the association between the frequency of continuous glucose monitoring (CGM) use and glycemic status over 12 months.
• To compare glycemic control in T2D patients with varying CGM usage frequencies against those with no CGM use.
• To identify optimal CGM usage patterns for improved hemoglobin A1C (HbA1C) levels.

Main Methods:

• Retrospective, propensity score-matched, cross-sectional study utilizing Optum deidentified Market Clarity Data (2019-2023).
• Included 9258 adult patients with T2D and baseline HbA1C between 7.0%-15.0%.
• Categorized CGM use into four frequencies (≥1 to ≤90 days, >90 to ≤180 days, 180 to ≤270 days, >270 days) and a control group (no CGM use) over 12 months postindex.
• Primary outcome: change in HbA1C using mixed-model analysis.

Main Results:

• High CGM use (>270 days, frequency 4) was associated with the greatest HbA1C reduction (-1.52 percentage points) at 12 months compared to no CGM use (-0.63 percentage points).
• Significant HbA1C reductions were observed across all CGM frequency groups within 3 months, with sustained improvements noted for frequency 1 and 4 groups throughout the study period.
• The addition of glucagon-like peptide-1 receptor agonists in the high CGM use group further enhanced HbA1C reduction (-1.13 percentage points difference vs. controls).

Conclusions:

• Frequent CGM use (>75% sensor wear) is significantly associated with improved glycemic control in patients with type 2 diabetes.
• Clinicians should monitor CGM adherence at 6 months, address potential barriers, and encourage consistent CGM utilization for sustained glycemic benefits.
• Findings support the integration of frequent CGM use into T2D management protocols to enhance patient outcomes.