Study: Continuous Glucose Monitors Improve Blood Sugar Control in Insulin-Treated Patients

Patients with insulin-treated type 2 diabetes experienced improved blood sugar control and fewer visits to the emergency department (ED) for hypoglycemia when using continuous glucose monitors, according to a new study published in JAMA.

Patients with diabetes have traditionally used finger sticks to test their blood sugar levels. Since 2017, however, Medicare has covered the cost of continuous glucose monitors for patients with diabetes who met certain qualifications. The monitor’s sensor transmits blood sugar readings every 5 minutes to a receiver or smartphone, the study noted.

To qualify under Medicare guidelines, a patient generally must give themselves 3 or more shots of insulin daily or use an insulin pump, perform blood glucose testing 4 or more times a day, and consistently communicate with a diabetes care team every 3 to 6 months.

The new retrospective, comparative efficacy study included 5673 patients with type 1 diabetes and 36,080 patients with type 2 diabetes treated with insulin who were self-monitoring their blood glucose. Between January 2015 and December 2019, 3462 patients with type 1 diabetes and 344 with type 2 diabetes began using continuous glucose monitors.

The researchers then evaluated results from before and after the intervention, compared to results among patients who did not use the monitors. The analyses found that continuous glucose monitors were associated with a decline in levels of HbA1c, and also found that the monitors reduced ED visits and hospitalizations for hypoglycemia.

“The improvement in blood sugar control was comparable to what a patient might experience after starting a new diabetes medication,” said lead author Andrew J. Karter, PhD, a senior research scientist with the Kaiser Permanente Northern California Division of Research, in a press release.

Continuous glucose monitors are now considered the standard of care for patients with type 2 diabetes, according to the study. Earlier research has shown that the monitors improve glucose control for patients with type 1 diabetes, as well.

“Selective prescribing of continuous glucose monitors may partially explain the benefits we saw in these patients with type 2 diabetes,” Karter said in the press release. “Doctors appeared to have preferentially prescribed monitors to patients with a history of hypoglycemia or at high risk of hypoglycemia.”

The researchers said the next step is to determine whether there are other patients whose blood sugar would be better controlled with continuous glucose monitors, including patients who may not meet all of the Medicare criteria.

REFERENCE

Continuous glucose monitors help manage type 2 diabetes [news release]. Kaiser Permanente; June 2, 2021. Accessed June 10, 2021. https://about.kaiserpermanente.org/our-story/health-research/news/continuous-glucose-monitors-help-manage-type-2-diabetes