A Multi-Site Prospective Review of the Use of Continuous Glucose Monitoring in People with HIV and Diabetes

People with HIV (PWH) have an increased risk of diabetes, and glycemic markers may underestimate glycemic burden in this population. This study prospectively evaluated the accuracy of continuous glucose monitor (CGM) derived Glucose Management Indicator (GMI) compared with A1C and fructosamine in PWH with type 2 diabetes and assessed patient satisfaction with CGM use. In this prospective observational study conducted between September 2024 and September 2025, adults with HIV and type 2 diabetes were recruited from two outpatient clinics in New York City and followed for 12 weeks using a Dexcom G7 CGM. Participants were required to maintain ≥70% CGM active time. A1C and fructosamine were obtained at study completion. Agreement between GMI, A1C, and fructosamine-derived A1C was assessed using correlation analyses and Bland-Altman plots. Patient satisfaction was evaluated using a Likert-scale survey. Forty-eight participants completed the study. GMI demonstrated strong correlation with A1C (r = 0.84, p < 0.001) and moderate correlation with fructosamine-derived A1C (r = 0.77, p < 0.001). Bland-Altman analysis showed minimal bias between GMI and A1C (MD = -0.07%), but greater systematic and proportional bias between GMI and fructosamine (MD = 0.70%). CGM utilization was high, and most participants reported improved understanding of glucose patterns and increased confidence in diabetes self-management. In PWH and type 2 diabetes, CGM-derived GMI demonstrates strong agreement with A1C and less agreement with fructosamine. CGM use was feasible and well accepted, providing important insights into glycemic patterns. These findings support CGM as a valuable adjunct to traditional glycemic markers in PWH.