A Korean study found that continuous glucose monitoring (CGM) may help reduce complications and the risk of death in patients with Type 1 diabetes, extending its benefits beyond blood sugar monitoring. While CGMs are already known to improve glucose control, evidence showing they reduce diabetes-related complications and mortality has been limited.
Samsung Medical Center said on the 29th that a research team led by endocrinology professors Kim Jae-hyun and Kim Ji-yoon, along with researcher Kim Seo-hyun of the Samsung Advanced Institute for Health Sciences & Technology, published the findings in the latest issue of Diabetologia, the official journal of the European Association for the Study of Diabetes.
Using National Health Insurance Service cohort data from 2016 to 2022, the researchers analyzed diabetes-related complications and mortality among 17,018 adults with Type 1 diabetes who received intensive insulin therapy with rapid-acting insulin at least three times daily between 2019 and 2022. The analysis compared outcomes between CGM users and non-users.
The study found that CGM users (8,509 patients) had a 60% lower risk of diabetic ketoacidosis, a 57% lower risk of end-stage kidney disease, and a 72% lower risk of cardiovascular disease than non-users (8,509 patients). Overall mortality risk was also 62% lower.
Although the risk of severe hypoglycemia did not differ significantly between the two groups, CGM users experienced a 61.5% reduction in severe hypoglycemia after adopting the device compared with before use. Hospitalizations and emergency room visits related to diabetic ketoacidosis and cardiovascular disease also declined by 60% and 50%, respectively.
Similar findings were observed among pediatric patients. The researchers also analyzed the risk of acute complications among 3,765 patients under age 19 with Type 1 diabetes who received rapid-acting insulin therapy between 2019 and 2022, comparing CGM users and non-users.
Among pediatric patients, CGM users (2,313 patients) had a 56% lower risk of diabetic ketoacidosis and a 52% lower risk of severe hypoglycemia than non-users (1,452 patients). As with adults, the incidence of diabetic ketoacidosis and severe hypoglycemia declined by 64% and 57%, respectively, after patients began using CGMs.
The pediatric study was published in the latest issue of Diabetes & Metabolism Journal, the official journal of the Korean Diabetes Association.
Based on the two studies, the researchers said they confirmed the clinical benefits of continuous glucose monitoring for both adults and children with Type 1 diabetes. They also noted that the findings suggest health insurance coverage for CGMs, combined with structured diabetes education programs, could improve real-world patient outcomes.
“Through this nationwide large-scale study, we confirmed that continuous glucose monitor use is associated not only with improved blood glucose control but also with lower risks of acute complications requiring emergency care, chronic complications such as end-stage kidney disease and cardiovascular disease, and death,” Kim Ji-yoon said. “These outcomes may reflect the combination of CGM use and structured education provided through the Type 1 diabetes home healthcare pilot program.”
Kim Jae-hyun added, “This study suggests that continuous glucose monitors are an important tool for reducing mortality risk and preventing complications in the management of Type 1 diabetes. Expanding national health insurance coverage alongside structured diabetes education could significantly improve long-term patient outcomes.”
Type 1 diabetes is a condition in which the pancreas does not produce insulin, requiring lifelong insulin therapy for survival. Beginning July 1, patients with Type 1 diabetes will become eligible to register as having a pancreatic disability under revisions to the Enforcement Decree of the Welfare of Persons with Disabilities Act.
