Introduction and Objective: People with T2D are at high risk for cardiovascular disease (CVD) and risk increases with poor glycemic control. This study evaluated the association between CGM use and the risk of major adverse cardiovascular events (MACE) among adults with T2D using real-world evidence.Methods: This retrospective study analyzed Truveta EHR data for people with T2D on intensive insulin treatment (IIT), with or without a history of CVD, linked to Dexcom CGM data. Index dates were first CGM data upload or a randomly selected insulin prescription date for non-CGM users between 01/01/2018 and 06/30/2024. Primary outcomes were time to first non-fatal myocardial infarction (MI), stroke or cardiovascular-related death. Secondary outcomes were hospitalization for heart failure (HF) or any cause, all-cause death and change in A1C. Propensity score matching was performed to balance demographics, comorbidities and medication use and Cox regression analysis compared the risk of outcomes between the matched cohortsResults: The study included 48,317 CGM users and 961,430 non-CGM users with a median follow-up of 2.1 years. CGM users were younger, had higher A1C and fewer comorbidities prior to matching. After matching, CGM use was associated with significantly lower risk of MI (HR:0.95, 95% CI:0.92, 0.99), stroke (HR:0.95, CI:0.93, 0.98), cardiovascular-related death (HR:0.77, CI:0.72, 0.83), hospitalization for HF (HR:0.84, CI:0.80, 0.88), any hospitalization (HR:0.89, CI:0.87, 0.92), and all-cause death (HR:0.77, CI:0.73, 0.81). Results were similar for those without established CVD (primary prevention) and after matching on A1C. CGM use was associated with 0.4% greater reduction in A1C compared to non-CGM users.Conclusion: Dexcom CGM use was associated with a significant reduction in A1C and risks of MACE, hospitalizations and death in people with T2D IIT. These results highlight the potential benefit of CGM use in primary and secondary CVD prevention to improve long-term cardiovascular outcomes in this high-risk population.
I. Neeland: Speaker’s Bureau; Current; Boehringer Ingelheim International GmbH, Eli Lilly and Company, Bayer AG. Research Support; Current; American Heart Association, National Heart, Lung, and Blood Institute. Advisory Panel; Current; MJH Life Sciences. M. Peng: Employee; Current; Dexcom, Inc. J. Layne: Employee; Current; Dexcom, Inc. K. Hannah: Employee; Current; Dexcom, Inc. G. Norman: Employee; Current; Dexcom, Inc. Stock/Shareholder; Current; Dexcom, Inc. J. Castle: Employee; Current; Dexcom, Inc. Stock/Shareholder; Current; Dexcom, Inc.
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