Benefits and Barriers to Use of Continuous Glucose Monitoring 24 Weeks Following Hospital Discharge

Continuous glucose monitoring (CGM) improves glycemic control in patients with type 2 diabetes, but real-world sustainability following hospital discharge remains unclear. We evaluated factors associated with CGM continuation after transitioning from structured study support to routine care.

This 12-week observational follow-up study included hospitalized patients with insulin-requiring type 2 diabetes (HbA1c > 8.0%) who had received study-provided CGM for 12 weeks postdischarge. After the intervention, participants could continue CGM through usual care if desired. Primary outcomes included CGM continuation, glycemic parameters, health care utilization, and patient-reported barriers.

Of 108 participants, 66 completed 12 week assessments and 59 were using CGM. At 24 weeks, data were available for 57 participants, 17 of whom maintained CGM use. Median HbA1c improved from baseline to 24 weeks (11.6% [IQR 10.0 to 13.4] to 7.4% [IQR 6.7 to 9.5], 103 to 57 mmol/mol, P < .0001), with similar reductions among users and nonusers. Among CGM users, median time in range (70 to 180 mg/dL) increased from 43% at 12 weeks to 62% at 24 weeks (P = .66), while time above range (> 180 mg/dL) decreased from 57% to 37% (P = .67). Cost and insurance barriers were the most reported challenges (46%), occurring more often among those who discontinued versus continued CGM (75% vs 32%, P = .007).

HbA1c improved from baseline to 24 weeks among participants, regardless of continued CGM use. However, discontinuation was common, with financial barriers representing the predominant obstacle, underscoring the need for improved coverage and support.