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Open Access 26-10-2024 | Type 2 Diabetes | Article

Intermittently scanned continuous glucose monitoring compared with blood glucose monitoring is associated with lower HbA1c and a reduced risk of hospitalisation for diabetes-related complications in adults with type 2 diabetes on insulin therapies

Authors: David Nathanson, Katarina Eeg-Olofsson, Tim Spelman, Erik Bülow, Mattias Kyhlstedt, Fleur Levrat-Guillen, Jan Bolinder

Published in: Diabetologia

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Abstract

Aims/hypothesis

We assessed the impact of initiating intermittently scanned continuous glucose monitoring (isCGM) compared with capillary blood glucose monitoring (BGM) on HbA1c levels and hospitalisations for diabetes-related complications in adults with insulin-treated type 2 diabetes in Sweden.

Methods

This retrospective comparative cohort study included adults with type 2 diabetes who had a National Diabetes Register initiation date for isCGM after 1 June 2017. Prescribed Drug Register records identified subgroups treated with multiple daily insulin injections (T2D-MDI) or basal insulin (T2D-B), with or without other glucose-lowering drugs. The National Patient Register provided data on hospitalisation rates.

Results

We identified 2876 adults in the T2D-MDI group and 2292 in the T2D-B group with an isCGM index date after 1 June 2017, matched with 33,584 and 43,424 BGM control participants, respectively. The baseline-adjusted difference in the change in mean HbA1c for isCGM users vs BGM control participants in the T2D-MDI cohort was −3.7 mmol/mol (−0.34%) at 6 months, and this was maintained at 24 months. The baseline-adjusted difference in the change in HbA1c for isCGM users vs BGM control participants in the T2D-B cohort was −3.5 mmol/mol (−0.32%) at 6 months, and this was also maintained at 24 months. Compared with BGM control participants, isCGM users in the T2D-MDI cohort had a significantly lower RR of admission for severe hypoglycaemia (0.51; 95% CI 0.27, 0.95), stroke (0.54; 95% CI 0.39, 0.73), acute non-fatal myocardial infarction (0.75; 95% CI 0.57, 0.99) or hospitalisation for any reason (0.84; 95% CI 0.77, 0.90). isCGM users in the T2D-B cohort had a lower RR of admission for heart failure (0.63; 95% CI 0.46, 0.87) or hospitalisation for any reason (0.76; 95% CI 0.69, 0.84).

Conclusions/interpretation

This study shows that Swedish adults with type 2 diabetes on insulin who are using isCGM have a significantly reduced HbA1c and fewer hospital admissions for diabetes-related complications compared with BGM control participants.

Graphical Abstract

Appendix
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Literature
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Metadata
Title
Intermittently scanned continuous glucose monitoring compared with blood glucose monitoring is associated with lower HbA1c and a reduced risk of hospitalisation for diabetes-related complications in adults with type 2 diabetes on insulin therapies
Authors
David Nathanson
Katarina Eeg-Olofsson
Tim Spelman
Erik Bülow
Mattias Kyhlstedt
Fleur Levrat-Guillen
Jan Bolinder
Publication date
26-10-2024
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-024-06289-z

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