Endocrine Abstracts

Aim: There is little real-world evidence comparing the effectiveness of real-time continuous glucose monitoring (rtCGM) and intermittently-scanned continuous glucose monitoring (isCGM) in glycemic control, with a large population and long-term follow-up. This study aimed to compare the association of rtCGM and isCGM with glycemic control in individuals with type 1 diabetes (T1D) in a real-world setting.

Methods: From the Korean National Health Insurance Service Cohort (2016–2022), individuals with T1D managed by intensive insulin therapy were followed up for 2 years at 3-month intervals since the initiation of CGM. The HbA1c and coefficient of variation (CV) of rtCGM and isCGM users were compared using an independent two-sample t-test and a linear mixed model.

Results: A total of 4,333 and 6,257 individuals were included in the HbA1c and CV analyses, respectively. Overall, a significant reduction in HbA1c levels was observed after 3 months of receiving CGM, and the effect remained durable for 2 years. A greater reduction in HbA1c levels was observed with rtCGM compared to isCGM (P for between-group difference <0.05 in both children and adults). The mean HbA1c level decreased from 8.9% at baseline to 7.1% at 24 months in rtCGM users, whereas it decreased from 8.6% to 7.5% in isCGM users. The greater reduction in HbA1c with rtCGM remained significant after adjusting for the baseline characteristics of users. CV also decreased more with rtCGM than with isCGM.

Conclusion: In this large nationwide cohort study, the use of rtCGM was associated with a greater improvement in glycemic control including HbA1c reduction than the use of isCGM in individuals with T1D.