Background: CGMs are used to guide lifestyle modifications, prevent hypoglycemia, and inform therapies. This study aimed to evaluate whether CGM, alongside various classes of anti-diabetes medications, is associated with lower A1c in PWT2D NIT.

Materials and Methods: A retrospective analysis of deidentified Optum Clinformatics® US healthcare claims data was conducted. CGM naïve, PWT2D NIT, ≥ 30 years and A1c ≥ 8.0% who initiated a CGM between 01/2019 through 12/2022 (index date = start of CGM) were included. A control group consisted of CGM nonusers assigned a random index date. Continuous health plan coverage was required 6 months pre- (baseline) and post- (follow-up) index date. One A1c laboratory value at baseline and follow-up was required to calculate A1c change. In multivariate linear regression models A1c change was regressed on CGM use and its combined effect with five anti-diabetes medication classes (metformin, sulfonylurea, glucagon-like peptide-1 receptor agonists (GLP-1RA), sodium-glucose cotransporter-2 inhibitors, and dipeptidyl peptidase-4 (DPP-4) inhibitors). Covariates included age, gender, race, insurance type, Charlson comorbidity score, baseline A1c and diabetes medications.

Results: A total of 52,394 PWT2D NIT (CGM users = 4,086) were identified. The CGM cohort was 67 years of age, 52% male, 69.3% non-Hispanic white, and 85% Medicare insured. Overall, CGM was associated with an adjusted A1c change of -0.26 to -0.27 in all models (p<0.0001). The joint effect of CGM when combined with either a GLP-1RA, sulfonylurea, or DPP-4 inhibitors resulted in additional A1c reductions (-0.13 to -0.26; p<0.05).

Conclusions: The findings suggest that, for people with T2D not using insulin, CGM use is associated with improvement in A1c independent of anti-diabetes medication use. Furthermore, there may be additional benefits of CGM when used in combination with therapies such as GLP-1RA and DPP-4 inhibitors.

Disclosure

P. Nemlekar: Employee; Dexcom, Inc. K. Hannah: Employee; Dexcom, Inc. G.J. Norman: Employee; Dexcom, Inc.

© 2024 by the American Diabetes Association
2024
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