Introduction and Objective: There are limited data evaluating both A1C and CGM metrics on a population level. This study assessed Dexcom CGM use on these measures in adults with T2D on non-insulin (NIT), non-intensive insulin (NIIT) and intensive insulin (IIT) therapies.Methods: Truveta EHR data linked at the individual level to Dexcom CGM data were analyzed for adults with T2D and baseline A1C >7% between 01/01/2018-06/30/2024. Outcomes were change in A1C from baseline to 3-12, 13-24 and >24 months and change in CGM metrics over 24 months using linear mixed-effect models.Results: A total of 7,153 adults with T2D (age 55.5 [SD 12.9] yrs, 47.4% female, 53.6% on an incretin mimetic) were included: n=1,250 NIT (17.5%), n=931 NIIT (13.0%), and n=4,972 IIT (69.5%). A1C decreased across all time periods in all cohorts (Table). For those with baseline TIR 70-180 mg/dL ≤70%, TIR increased significantly at 3 months with continued improvement over time. Incretin mimetic use was not associated with a significant difference in the change in A1C; change in TIR was significantly greater in the T2D IIT cohort only.Conclusion: In this large real-world analysis of over 7,000 adults with T2D, CGM use was associated with rapid, clinically meaningful improvements in A1C and TIR, with greatest improvement in non-insulin users, and benefits persisting over long-term follow-up. These findings underscore the importance of early CGM use to improve glycemic management in T2D.
M. Peng: Employee; Current; Dexcom, Inc. J. Layne: Employee; Current; Dexcom, Inc. G. Aleppo: Advisory Panel; Current; Medscape, Tandem Diabetes Care, Inc. Consultant; Current; Eli Lilly and Company, Dexcom, Inc., Insulet Corporation. Research Support; Current; AbbVie Inc., Bayer, Fractyl, Insulet Corporation, MannKind Corporation, Tandem Diabetes Care, Inc., Medtronic. V. Shah: Advisory Panel; Current; Abbott Diabetes, Dexcom, Inc. Advisory Panel; Ended; Medtronic. Advisory Panel; Current; Novo Nordisk, Eli Lilly and Company. Consultant; Current; Insulet Corporation, T1D Exchange. Advisory Panel; Current; Sanofi, Tandem Diabetes Care, Inc. Consultant; Ended; DreaMed Diabetes, Ltd. R.M. Bergenstal: Other – Advisory Panel, Consultant, Clinical Research Support; Current; Abbott Diabetes. Other – Consultant, Clinical Research Support; Current; Dexcom, Inc. Research Support; Current; Amgen Inc. Advisory Panel; Current; CeQur SA. Other – Advisory Panel, Consultant, Clinical Research Support; Current; Eli Lilly and Company. Research Support; Current; Insulet Corporation. Research Support; Ended; Luna. Research Support; Current; Medtronic. Other – Advisory Panel, Consultant, Clinical Research Support; Current; Novo Nordisk. Research Support; Current; Tandem Diabetes Care, Inc. Consultant; Current; Sanofi. Advisory Panel; Current; Vertex Pharmaceuticals Incorporated. Research Support; Current; Zealand Pharma A/S, Sequel, Embecta.
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