Glucose Monitors May Do More Than Track Blood Sugar

Continuous glucose monitors have changed diabetes care for many people by providing round-the-clock blood sugar readings.

New findings indicate these devices may also be associated with fewer deaths and fewer serious cardiovascular complications among people with type 2 diabetes who use long-acting insulin.

When blood sugar stays elevated over time, type 2 diabetes can gradually harm blood vessels. That can raise the chances of heart attack, stroke, heart failure, kidney disease, vision loss and other complications.

According to estimates cited by the researchers, about 7% of the world’s roughly 405 million people with type 2 diabetes require insulin. For these patients, maintaining glucose in a healthy range can be challenging.

CGM systems rely on a sensor worn on the skin that measures glucose repeatedly. Rather than isolated readings, users can follow patterns and receive information that may help them adjust food intake, physical activity or diabetes treatment.

To assess whether CGM use was linked to better long-term outcomes, the researchers analyzed electronic health records from the Truveta platform. They found 13,935 adults with type 2 diabetes taking basal insulin who started CGM and matched them with 13,935 similar patients who did not.

After 12 months, 1.16% of CGM users had died, compared with 2.09% of those who did not use the devices. After 24 months, the figures were 2.12% and 3.26%, respectively.

In relative terms, the risk of death was 44% lower after one year and 35% lower after two years among CGM users. The absolute differences were modest, but still meaningful in a group already at elevated risk for diabetes-related complications.

The team also looked at major cardiovascular events. CGM users showed a 26% lower relative risk of a first major heart or blood vessel event at one year and a 24% lower risk at two years.

Repeat cardiovascular events were less frequent as well, and hospital stays for heart failure were roughly half as common among CGM users. Similar patterns held in additional analyses, including one that excluded the COVID-19 period.

The study is scheduled to be presented at the annual meeting of the European Association for the Study of Diabetes in Milan, Italy.

Overall, the findings add to evidence that continuous monitoring may benefit people with type 2 diabetes who need basal insulin. Better visibility into glucose trends could help patients and clinicians respond sooner and avoid dangerous highs and lows.

Even so, the research does not prove that CGM caused the lower death and cardiovascular rates. Because it used existing health records instead of randomly assigning people to use the devices, unseen differences between the groups could have influenced the results.

The researchers also did not track every medication change or clinical measure during follow-up, and the patients may not reflect all people with insulin-treated type 2 diabetes. As a result, the findings are encouraging but not conclusive, and they will need confirmation in future prospective studies.

If future research confirms the association, the results could support wider access to CGM for people with type 2 diabetes who use basal insulin. They also suggest that technology designed to simplify daily glucose management may affect health far beyond the glucose reading itself.

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Source: University Hospital of Freiburg.