The effect of initiating and subsequently intermittent use of CGM/FGM technology on glycaemic control in patients with type 1 diabetes: a retrospective study from 4 centres

Czech version

Authors: Peter Novodvorský ^1,2,3; Na A Jelínková ¹; Ingrid Bugáňová ⁴; Radovan Plášil ⁵; Eva Žákovičová ⁶; Marta Korecová ¹; Kristína Kadlecová ¹; Zbynek Schroner ⁷; Miloš Mráz ³; Michal Dubský ³; Martin Haluzík ³
Authors‘ workplace: metabolické centrum s. r. o., Trenčín ¹; I. interná klinika JLF UK a UNM, Martin ²; Centrum diabetologie IKEM, Praha ³; Poliklinika MEDIVASA, Žilina ⁴; IRIDIA s. r. o, Vrútky ⁵; Diacrin, Bratislava ⁶; Lekárska fakulta, Univerzita Pavla Jozefa Šafárika v Košiciach ⁷
Published in: Forum Diab 2026; 15(1): 45-51
Category:

Overview

Background and aims: The reimbursement of CGM/FGM technology for people with type 1 diabetes (PwT1D) has become widely available in Slovakia from January 2022. In January 2023, reimbursement regulations changed from a fixed allowance of sensors per year to a budget system. Consequently, PwT1D were started on various types of CGM/FGM sensors and used them intermittently and for a variable amount of time. We investigated the glycaemic effects of such CGM/FGM use after 12 months (Y1) from their initiation. Methods: All PwT1D who were initiated on CGM/FGM at four diabetology centres in Slovakia between January and August 2022 were included in the analysis. PwT1D using CGM as part of AHCL systems were not enrolled in the study. We analysed two 14day CGM/FGM periods in the form of AGP reports –⁠ at baseline and one year after (Y1). Results: A total of 92 PwT1D were included; 47/92 (51.1 %) were women, with a mean ± SD (range) age of 42.7 ± 13.6 (20–74) years and T1D duration of 22.5 ± 12.3 (3–51) years. Overall, 68/92 (73.9 %) PwT1D were initiated on CGM and 24/92 (26.1 %) on FGM. Mean HbA_1c at initiation of 8.0 ± 1.1 % decreased over 1 year to 7.5 ± 1.1 % (mean paired difference 0.59 %, 95% CI 0.47–0.72 %, p < 0.001). No statistically significant differences in CGM metrics were observed. The duration of CGM/FGM use was 26 ± 12 (4–52) weeks. The duration of CGM/FGM use correlated positively with TIR at Y1 (Pearson’s r = 0.323, p = 0.002), and negatively with mean glucose at Y1 (r = −0.538, p < 0.001) and HbA_1c at Y1 (r = −0.429, p < 0.001). Interestingly, the duration of CGM/FGM use also correlated positively with TIR (r = 0.301, p = 0.004) and negatively with HbA_1c (r = −0.365, p < 0.001) at the time of CGM/FGM initiation. Conclusion: Initiation and subsequent intermittent use of CGM/FGM in PwT1D led after 12 months to a clinically meaningful reduction in HbA_1c. The duration of CGM/FGM use correlated positively with the extent of improvement in glycaemic control over the observation period. Patients with better baseline glycaemic control (HbA_1c and TIR) tended to use CGM/FGM more intensively. Alongside the improvement of CGM reimbursement it is necessary to actively motivate PsT1D with poorer glycaemic control to use CGM so that they can fully benefit from this technology.

Keywords:

type 1 diabetes (T1D) – continuous glucose monitoring/flash glucose monitoring (CGM/FGM) – Time in range (TIR)

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