People with type 2 diabetes (T2D) who use basal insulin may have a significantly lower risk of death and cardiovascular complications when they use a continuous glucose monitor (CGM), according to new research presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Milan, Italy.
The study found that people with T2D who started using CGM had a 44% lower risk of death from any cause after one year compared with those who did not use CGM. After two years, their risk of death remained 35% lower, reports News Medical.
Researchers say this is the first study to show an association between modern CGM technology and a reduced risk of death in people with T2D treated with basal insulin, either alone or alongside non-insulin diabetes medications. The study also found that CGM users had fewer major cardiovascular events.
Around 7% of the estimated 405 million people living with T2D worldwide – nearly 30 million people – require insulin therapy. Maintaining healthy blood glucose levels can be challenging, and prolonged high blood sugar can increase the risk of serious complications such as heart disease, stroke, and vision loss.
CGM devices use a small sensor worn on the skin to continuously measure glucose levels. The readings are transmitted to a smartphone, dedicated reader, or insulin delivery system, allowing users to monitor glucose throughout the day and make informed decisions about diet, physical activity, and insulin treatment.
While CGM has already been shown to improve blood glucose control and reduce episodes of hypoglycemia, its potential impact on long-term complications and survival among people with T2D has been less clear.
What the Study Found
Researchers from Abbott and collaborating institutions analyzed anonymized electronic health records from the Truveta platform, which contains data from more than 140 million Americans.
The study included 27,870 adults with T2D receiving basal insulin between January 2017 and March 2024. Researchers compared 13,935 people who began using CGM with an equal number of people who did not use CGM.
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The two groups were carefully matched using 29 characteristics, including age, sex, ethnicity, diabetes duration, HbA1c levels, diabetes complications, other medical conditions, medications, healthcare use, and blood glucose monitoring.
At 12 months, death from any cause occurred in 1.16% of CGM users, compared with 2.09% of non-users, representing a 44% lower risk. At 24 months, mortality was 2.12% among CGM users versus 3.26% among non-users, a 35% lower risk.
CGM users also experienced fewer major cardiovascular events, including heart attack, heart failure, stroke, transient ischemic attack, and peripheral artery disease. The risk was 26% lower after one year and 24% lower after two years.
The most notable finding involved heart failure hospitalizations. These were 54% lower after one year and 47% lower after two years among CGM users. Recurrent major cardiovascular events were also 35% lower at one year and 36% lower at two years.
Study lead Professor Jochen Seufert of University Hospital of Freiburg said the findings suggest CGM could make a meaningful difference to the long-term health of people with insulin-treated T2D and may help reduce the risk of premature death.
However, the researchers caution that the study was observational and cannot prove that CGM directly caused the lower risk of death or cardiovascular events. Although the participants were matched across 29 factors, other unmeasured differences may have influenced the results.
The researchers also noted that the findings may not apply to every person with T2D using basal insulin. Larger prospective studies will be needed to confirm these results.
If confirmed, the findings could strengthen the case for expanding access to CGM technology among people with type 2 diabetes who use basal insulin.
