Poorva M. Nemlekar, Katia L. Hannah, Courtney R. Green, Gregory J. Norman
{"title":"探索连续血糖监测和抗糖尿病药物联合应用于不使用胰岛素的2型糖尿病患者的血糖控制","authors":"Poorva M. Nemlekar, Katia L. Hannah, Courtney R. Green, Gregory J. Norman","doi":"10.1002/edm2.70089","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Continuous glucose monitoring (CGM) offers a detailed view of glycaemic management, potentially enhancing the effectiveness of non-insulin, anti-diabetes medications. This study aimed to evaluate whether CGM use in combination with anti-diabetes medications is associated with changes in A1c among people with type 2 diabetes not using insulin.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>This was a retrospective, observational analysis of administrative claims and linked laboratory data from Optum's Clinformatics Data Mart database. The study observation period covered 01/07/2018 through 30/06/2023 with 6-month baseline and follow-up periods. CGM use in conjunction with ≥ 1 of five anti-diabetes medication classes: metformin, sulfonylureas, sodium-glucose cotransporter-2 (SGLT2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors and/or glucagon-like peptide-1 receptor agonists (GLP-1 RAs) was required. The primary outcome was change in A1c from baseline. Linear regression models tested the main and interaction effects of CGM and each anti-diabetes medication.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Overall, 52,394 CGM-naïve adults with non-insulin-treated type 2 diabetes using anti-diabetes medications were identified (4086 CGM users; 48,308 CGM non-users). CGM use was associated with a –0.45% greater A1c change among CGM users compared to CGM non-users (<i>p</i> < 0.0001). After adjusting for covariates, CGM users experienced greater A1c reductions vs. CGM non-users with all medications, but statistically significant interactions showed that for DPP-4 inhibitors, GLP-1 RAs and sulfonylureas, there were greater decreases in A1c for CGM users vs. CGM non-users who were taking the medication compared to CGM users vs. CGM non-users who were not taking the medication. A1c change between CGM users vs. CGM non-users did not vary by metformin or SGLT2 inhibitor use.</p>\n </section>\n \n <section>\n \n <h3> Discussion</h3>\n \n <p>The findings suggest that CGM use could augment the glycaemic benefits of anti-diabetes medications in people with non-insulin treated type 2 diabetes. These results support broader adoption of CGM.</p>\n </section>\n </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"8 5","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70089","citationCount":"0","resultStr":"{\"title\":\"Exploring Combined Use of Continuous Glucose Monitoring and Anti-Diabetes Medications on Glycaemic Control for People With Type 2 Diabetes Not Using Insulin\",\"authors\":\"Poorva M. Nemlekar, Katia L. Hannah, Courtney R. Green, Gregory J. Norman\",\"doi\":\"10.1002/edm2.70089\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Continuous glucose monitoring (CGM) offers a detailed view of glycaemic management, potentially enhancing the effectiveness of non-insulin, anti-diabetes medications. This study aimed to evaluate whether CGM use in combination with anti-diabetes medications is associated with changes in A1c among people with type 2 diabetes not using insulin.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Materials and Methods</h3>\\n \\n <p>This was a retrospective, observational analysis of administrative claims and linked laboratory data from Optum's Clinformatics Data Mart database. The study observation period covered 01/07/2018 through 30/06/2023 with 6-month baseline and follow-up periods. CGM use in conjunction with ≥ 1 of five anti-diabetes medication classes: metformin, sulfonylureas, sodium-glucose cotransporter-2 (SGLT2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors and/or glucagon-like peptide-1 receptor agonists (GLP-1 RAs) was required. The primary outcome was change in A1c from baseline. Linear regression models tested the main and interaction effects of CGM and each anti-diabetes medication.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Overall, 52,394 CGM-naïve adults with non-insulin-treated type 2 diabetes using anti-diabetes medications were identified (4086 CGM users; 48,308 CGM non-users). CGM use was associated with a –0.45% greater A1c change among CGM users compared to CGM non-users (<i>p</i> < 0.0001). After adjusting for covariates, CGM users experienced greater A1c reductions vs. CGM non-users with all medications, but statistically significant interactions showed that for DPP-4 inhibitors, GLP-1 RAs and sulfonylureas, there were greater decreases in A1c for CGM users vs. CGM non-users who were taking the medication compared to CGM users vs. CGM non-users who were not taking the medication. A1c change between CGM users vs. CGM non-users did not vary by metformin or SGLT2 inhibitor use.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Discussion</h3>\\n \\n <p>The findings suggest that CGM use could augment the glycaemic benefits of anti-diabetes medications in people with non-insulin treated type 2 diabetes. 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Exploring Combined Use of Continuous Glucose Monitoring and Anti-Diabetes Medications on Glycaemic Control for People With Type 2 Diabetes Not Using Insulin
Introduction
Continuous glucose monitoring (CGM) offers a detailed view of glycaemic management, potentially enhancing the effectiveness of non-insulin, anti-diabetes medications. This study aimed to evaluate whether CGM use in combination with anti-diabetes medications is associated with changes in A1c among people with type 2 diabetes not using insulin.
Materials and Methods
This was a retrospective, observational analysis of administrative claims and linked laboratory data from Optum's Clinformatics Data Mart database. The study observation period covered 01/07/2018 through 30/06/2023 with 6-month baseline and follow-up periods. CGM use in conjunction with ≥ 1 of five anti-diabetes medication classes: metformin, sulfonylureas, sodium-glucose cotransporter-2 (SGLT2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors and/or glucagon-like peptide-1 receptor agonists (GLP-1 RAs) was required. The primary outcome was change in A1c from baseline. Linear regression models tested the main and interaction effects of CGM and each anti-diabetes medication.
Results
Overall, 52,394 CGM-naïve adults with non-insulin-treated type 2 diabetes using anti-diabetes medications were identified (4086 CGM users; 48,308 CGM non-users). CGM use was associated with a –0.45% greater A1c change among CGM users compared to CGM non-users (p < 0.0001). After adjusting for covariates, CGM users experienced greater A1c reductions vs. CGM non-users with all medications, but statistically significant interactions showed that for DPP-4 inhibitors, GLP-1 RAs and sulfonylureas, there were greater decreases in A1c for CGM users vs. CGM non-users who were taking the medication compared to CGM users vs. CGM non-users who were not taking the medication. A1c change between CGM users vs. CGM non-users did not vary by metformin or SGLT2 inhibitor use.
Discussion
The findings suggest that CGM use could augment the glycaemic benefits of anti-diabetes medications in people with non-insulin treated type 2 diabetes. These results support broader adoption of CGM.