Impact on Vulnerable Populations After Discontinuation of Continuous Glucose Monitoring in Patients With Type 2...

Continuous glucose monitoring (CGM) reinforces positive nonpharmacologic behaviors and optimizes pharmacotherapy. Long-term CGM may be financially unsustainable in vulnerable populations, but data on durability of benefits after short-term use are limited.

Building upon a prior study of a 3-month pharmacist-led CGM program, this study compared 1-year changes in glycemic management (glycated hemoglobin [A1c]) between patients who continued vs discontinued CGM.

This single-center pilot study, approved by University of Houston Institutional Review Board, was conducted at a federally qualified health center (FQHC). Patients in the initial program continued CGM if they were able to pay for CGM supplies via insurance or self-pay. All patients were followed for 12 months to assess changes in mean A1c and the proportion meeting A1c goals after 3 to 6 (early) and 9 to 12 (late) months.

Fifty-two patients were analyzed (continued CGM: n = 15; discontinued CGM: n = 37). Baseline A1c was similar between the groups. At early follow-up, mean A1c decreased slightly in the continued CGM group (-0.18 ± 1.0; P = .523) but increased significantly in the discontinued group (1.3 ± 1.6; P = .002). At late follow-up, A1c increased nonsignificantly with continued CGM (0.7 ± 1.4; P < .12) but significantly worsened with discontinuation (2.6 ± 1.9; P < .001). The proportion meeting A1c goals also significantly worsened in the discontinuation group.

Although differences existed between groups, this study supports uninterrupted access to CGM for patients with diabetes. Despite initial 3-month use, discontinuation was associated with significant A1c worsening within 1 year. Large-scale, randomized studies are needed to identify whether an optimal timing of personal CGM use exists to sustain glycemic management when consistent use is not feasible.