Sustained reduction in HbA1c for adults with type 2 diabetes after starting CGM
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Key takeaways:
- Adults with type 2 diabetes have a reduction in HbA1c 3 months after starting CGM that is maintained at 12 months.
- The HbA1c decrease was observed for all adults, regardless of insulin therapy.
ORLANDO — Adults with type 2 diabetes experienced a reduction in HbA1c within 3 months of starting continuous glucose monitoring, regardless of insulin therapy, a presenter reported at the American Diabetes Association Scientific Sessions.
In findings from a retrospective analysis of data from the Optum Market Clarity database, adults with type 2 diabetes had improvements in HbA1c after initiating CGM that were sustained for up to 1 year. Satish K. Garg, MD, professor of medicine and pediatrics at the Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, said the findings revealed how CGM can benefit all adults with type 2 diabetes.
“It’s important to note, especially in the noninsulin group, we did not expect this large of a drop,” Garg said during a presentation. “Obviously, this is related to the behavioral change, but we were pleased to note that irrespective of [insulin] therapy, people had a significant drop in HbA1c.”
Researchers conducted a retrospective study of adults aged 18 years and older with type 2 diabetes who initiated CGM from June 30, 2019, to Jan. 5, 2022. Data were obtained from electronic medical records. Adults were included if they had a baseline HbA1c between 7% and 15% and they did not use a CGM in the 6 months before their first claim. HbA1c values were obtained for 6,030 adults who had values available before using CGM and during CGM use. Low-frequency CGM use was defined as using a CGM less than 90 days in a 12-month period, and high-frequency use was use of a CGM for more than 180 days.
Of the study group, 3,122 were on prandial insulin therapy (mean age, 61 years; 52% women), 1,375 used basal insulin therapy (mean age, 59.6 years; 48% women) and 1,533 did not use insulin (mean age, 57.2 years; 46% women).
All three insulin therapy groups had HbA1c reductions at 3 months that were sustained at 6 and 12 months. Adults on basal insulin therapy had an HbA1c reduction from 9% at baseline to 8.1% at 3 months and 8% at 12 months. The prandial insulin group had an HbA1c decline from 8.9% at baseline to 8.1% at 3 months and 7.9% at 12 months. Adults not receiving insulin had an HbA1c reduction from 8.6% at baseline to 7.7% at 3 months and 7.5% at 12 months (P < .001 for all).
Garg said the findings help establish the glycemic benefits of CGM. He emphasized the importance of the findings, especially for adults who may discontinue or choose not to use a GLP-1 receptor agonist.
“Every patient, whether it is type 1 or type 2 [diabetes], they may give up their [tirzepatide] or semaglutide,” Garg said. “But in my own impressions from patients, they never want to give up the CGM. So it’s important to see that CGM really helps people with diabetes.”
Garg said randomized controlled trials should be conducted to confirm the study’s findings.
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Garg SK, et al. 355-OR. Presented at: American Diabetes Association Scientific Sessions; June 21-24, 2024; Orlando.
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