To estimate the association of initiating and maintaining real-time continuous glucose monitoring (rtCGM) with changes in HbA1c, urinary albumin-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) over 36 months.
Approach:
Design: Observational comparative-effectiveness study using target trial emulation and electronic health records from Kaiser Permanente Northern California.
Population: Adults with type 2 diabetes and no prior CGM use who met high-risk eligibility criteria: HbA1c greater than 8% in the prior year or a hypoglycemia-related emergency visit or hospital admission in the prior 36 months.
Comparison and follow-up: Monthly risk sets matched rtCGM initiators with CGM-naive controls. The per-protocol analysis followed participants for up to 36 months and censored follow-up after exposure changes or specified loss-to-follow-up events.
Outcomes: Outpatient HbA1c, UACR, and eGFR measurements from 12 months before baseline through censoring.
Interpretation:
The provided context describes the study rationale and methods but does not report results; effects on glycemic control or kidney outcomes cannot be summarized from this material.
Limitations:
The study is observational, so its estimates may be affected by limitations inherent to observational data.
The supplied context does not include the study’s results or detailed outcome-analysis methods.
Conclusion:
The investigators hypothesized that initiating and continuing rtCGM, compared with noninitiation, would be associated with improved glycemic control, less progression of kidney damage, and a smaller decline in kidney function.
