Introduction and Objective: CGM and GLP-1 receptor agonists (RA) are two distinct and increasingly used treatment strategies in T2D, each associated with meaningful improvements in clinical outcomes. However, there is little real-world evidence comparing their effectiveness in primary care or evaluating whether combined use offers added benefit in HbA1c and body weight (BW).Methods: We conducted a cohort study of adults with insulin-treated T2D (BMI ≥27 kg/m²) receiving primary care from 2020-2025 in a safety-net hospital system. Patients newly initiating CGM, GLP-1 RA, or both were followed while remaining on initial therapy. Inverse probability of treatment weighted mixed effects models were used to estimate longitudinal changes in HbA1c and BW.Results: Among 6,169 adults (mean age 58±14 y, 45% Hispanic, 29% CGM, 63% GLP-1 RA, 8% combination), both HbA1c and BW demonstrated a clear stepwise improvement favoring combination therapy. At 1 yr, HbA1c declined by 0.85 %pt [0.94, 0.75] with CGM, 1.16 %pt [1.24, 1.08] with GLP-1 RA, and 1.70 %pt [1.81, 1.61] with combination therapy, while 1-yr percent BW loss was 0.74% [1.02, 0.46], 2.80% [3.07, 2.54], and 3.24% [3.48, 2.99], respectively (Figure).Conclusion: Both CGM and GLP-1 RA were associated with meaningful improvements in HbA1c and weight, with the greatest benefit observed with combined use. These findings suggest complementary treatment effects and support a bundled, multimodal approach to T2D care in primary care settings.
J. Milosavljevic: None. L. Rasquin Leon: None. C. Schechter: None. S. Agarwal: None.
American Diabetes Association (7-25-JDFPC-0403)
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