Effectiveness of Continuous Glucose Monitoring on Glycemic and Metabolic Outcomes in Type 2 Diabetes: A Two-Year...

To evaluate whether sustained use of continuous glucose monitoring (CGM) is associated with long-term patterns in glycemic control, safety indicators, and health care utilization among adults with type 2 diabetes (T2D) in routine clinical care.

A two-year retrospective chart review was conducted at a tertiary care center in Saudi Arabia. Adults with T2D who initiated second-generation CGM (FreeStyle Libre 2) and maintained use for 24 months were included. Glycemic, metabolic, and clinical outcomes were assessed at baseline, 12 months (T12), and 24 months (T24).

Among 222 adults (mean age 48.7 years; 48.2% female), sustained CGM use was associated with improvements across multiple glycemic parameters. Glycated hemoglobin (HbA1c) declined from 8.2% at baseline to 7.8% at T24, accompanied by reductions in mean glucose, self-monitoring of blood glucose frequency, glycemia risk indices, and glucose variability. %TIR_70-180 increased, time spent in hyperglycemia decreased, and time below range remained low throughout follow-up. Directionally similar glycemic improvements were observed across subgroups, including individuals with obesity, those treated with oral agents only, and those receiving insulin-based regimens. Beyond glycemic outcomes, body weight decreased by approximately 2 kg over 24 months. Diabetes-related emergency department visits declined from five participants (2.3%) at T0 to two (0.9%) at T12 and one (0.5%) at T24.

Two-year use of CGM in routine care was associated with favorable trends in glycemic control, glycemic stability, self-monitoring behavior, and health care utilization. Long-term CGM integration may be feasible and potentially beneficial across diverse T2D populations, although prospective studies are needed to clarify the causal effects.