Continuous glucose monitoring among adults with type 2 diabetes receiving noninsulin or basal insulin therapy in primary care

Abstract Rates of type 2 diabetes (T2D) continue to rise in the United States, with many patients failing to achieve glycemic targets. Primary care providers often serve as the sole clinician managing diabetes. Continuous glucose monitors (CGMs) have shown promise in diabetes management, yet their a...

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Main Authors: Stephen Shields, Roy Thomas, Joy Durham, Joseph Moran, Jake Clary, Elizabeth L. Ciemins
Format: Article
Language:English
Published: Nature Portfolio 2024-12-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-83548-4
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author Stephen Shields
Roy Thomas
Joy Durham
Joseph Moran
Jake Clary
Elizabeth L. Ciemins
author_facet Stephen Shields
Roy Thomas
Joy Durham
Joseph Moran
Jake Clary
Elizabeth L. Ciemins
author_sort Stephen Shields
collection DOAJ
description Abstract Rates of type 2 diabetes (T2D) continue to rise in the United States, with many patients failing to achieve glycemic targets. Primary care providers often serve as the sole clinician managing diabetes. Continuous glucose monitors (CGMs) have shown promise in diabetes management, yet their adoption in primary care settings, especially among patients with T2D not using intensive insulin therapy, remains limited. We sought to evaluate the impact of CGM use on glycemic control in patients with T2D not using insulin and those using basal but not bolus insulin in a primary care setting. CGM use was associated with a significantly greater reduction in HbA1c (-0.62%, p < 0.01) compared with matched controls at 3 months (n = 182). Patients showed improvements in time in range (39.7–61.9%, p < 0.0001), time > 180 mg/dL (60.1–37.9%, p < 0.001), time > 250 mg/dL (27.6–8.5%, p < 0.001), mean estimated glucose value (212 mg/dL to 173 mg/dL, p < 0.001) and glucose management indicator (8.39–7.46%, p < 0.001). CGM use in a primary care setting compared to usual care significantly improved glycemic control in T2D patients not on bolus insulin, irrespective of treatment with non-insulin or basal insulin. This suggests potential for broader CGM integration in primary care.
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spelling doaj-art-2046023bfe3f49f9af562aac5a56b82f2025-01-05T12:27:57ZengNature PortfolioScientific Reports2045-23222024-12-0114111210.1038/s41598-024-83548-4Continuous glucose monitoring among adults with type 2 diabetes receiving noninsulin or basal insulin therapy in primary careStephen Shields0Roy Thomas1Joy Durham2Joseph Moran3Jake Clary4Elizabeth L. Ciemins5Research & Analytics Department of AMGA (American Medical Group Association)Dexcom, IncPiedmont HealthCarePiedmont HealthCarePiedmont HealthCareResearch & Analytics Department of AMGA (American Medical Group Association)Abstract Rates of type 2 diabetes (T2D) continue to rise in the United States, with many patients failing to achieve glycemic targets. Primary care providers often serve as the sole clinician managing diabetes. Continuous glucose monitors (CGMs) have shown promise in diabetes management, yet their adoption in primary care settings, especially among patients with T2D not using intensive insulin therapy, remains limited. We sought to evaluate the impact of CGM use on glycemic control in patients with T2D not using insulin and those using basal but not bolus insulin in a primary care setting. CGM use was associated with a significantly greater reduction in HbA1c (-0.62%, p < 0.01) compared with matched controls at 3 months (n = 182). Patients showed improvements in time in range (39.7–61.9%, p < 0.0001), time > 180 mg/dL (60.1–37.9%, p < 0.001), time > 250 mg/dL (27.6–8.5%, p < 0.001), mean estimated glucose value (212 mg/dL to 173 mg/dL, p < 0.001) and glucose management indicator (8.39–7.46%, p < 0.001). CGM use in a primary care setting compared to usual care significantly improved glycemic control in T2D patients not on bolus insulin, irrespective of treatment with non-insulin or basal insulin. This suggests potential for broader CGM integration in primary care.https://doi.org/10.1038/s41598-024-83548-4Continuous glucose monitors (CGMs)Primary careType 2 diabetesInsulinGlycemic controlNoninsulin
spellingShingle Stephen Shields
Roy Thomas
Joy Durham
Joseph Moran
Jake Clary
Elizabeth L. Ciemins
Continuous glucose monitoring among adults with type 2 diabetes receiving noninsulin or basal insulin therapy in primary care
Scientific Reports
Continuous glucose monitors (CGMs)
Primary care
Type 2 diabetes
Insulin
Glycemic control
Noninsulin
title Continuous glucose monitoring among adults with type 2 diabetes receiving noninsulin or basal insulin therapy in primary care
title_full Continuous glucose monitoring among adults with type 2 diabetes receiving noninsulin or basal insulin therapy in primary care
title_fullStr Continuous glucose monitoring among adults with type 2 diabetes receiving noninsulin or basal insulin therapy in primary care
title_full_unstemmed Continuous glucose monitoring among adults with type 2 diabetes receiving noninsulin or basal insulin therapy in primary care
title_short Continuous glucose monitoring among adults with type 2 diabetes receiving noninsulin or basal insulin therapy in primary care
title_sort continuous glucose monitoring among adults with type 2 diabetes receiving noninsulin or basal insulin therapy in primary care
topic Continuous glucose monitors (CGMs)
Primary care
Type 2 diabetes
Insulin
Glycemic control
Noninsulin
url https://doi.org/10.1038/s41598-024-83548-4
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