January 02, 2026
3 min read
Key takeaways:
Among adults with diabetes using rapid- or short-acting insulin, 83% did not have evidence of CGM use during the study period.
CGM users had lower total health care costs over a 1-year period vs. nonusers.
Adults with type 1 or type 2 diabetes who used a continuous glucose monitor experienced fewer emergency department and inpatient days related to hypoglycemia or hyperglycemia than non-CGM users, according to study findings.
In a retrospective cohort study of approximately 960,000 adults aged 18 years and older diagnosed with either type 1 or type 2 diabetes with claims data available in the Mariner Commercial Claims Database, researchers found 17% of the study group used CGM, with device use tied to higher odds for glycemic control and lower health care spending. The study was published in Diabetes Technology & Therapeutics.
Most adults with type 1 or type 2 diabetes who use a CGM spend fewer days in the emergency department or inpatient hospital care due to to hypoglycemia or hyperglycemia. Image: Adobe Stock
“Together, these findings highlight both the urgency of improving CGM adoption and the value of CGM when it is used to mitigate the long-term trajectory of diabetes-related complications,” Consuela Dennis, DNP, RN, NE-BC, Chief Clinical Officer for CCS Medical, told Healio.
Consuela Dennis
All patients had at least one claim for rapid or short-acting insulin during the first 3 months of 2021 and were followed for 1 year. The study cohort was divided into two groups based on whether they had a documented claim for using a CGM. Total health care costs included inpatient care, outpatient care, ED visits and pharmacy claims. Participants were deemed to not have glycemic control if they had at least two codes indicating an HbA1c of more than 9% during follow-up.
CGM uptake low
Of the study group, 83% of adults eligible for a CGM did not have evidence for CGM use during the study period. Dennis said the large proportion of adults with diabetes not using CGM in the study was noteworthy.
“CGM adoption remains low, even among people who meet clinical eligibility,” Dennis said. “At the same time, the newly released 2026 American Diabetes Association Standards of Care calls for earlier CGM use in targeted populations. That means that the gap between guideline recommendations and real-world use is likely going to widen unless we focus on adoption support for providers, for general referral workflows and for patients themselves.”
Victoria E. Bouhairie, MD, DipABLM, DABOM, an endocrinologist and founder and CEO of Parry’s Wellness and Diabetes Center in Charlotte, said one reason CGM uptake remains low may be the need for better support around CGM initiation in primary care settings, where most diabetes care occurs.
“Because the majority of people with diabetes are cared for in primary care, improving CGM uptake requires looking closely at how these tools fit into real-world primary care workflows,” Bouhairie told Healio. “Barriers may include limited time, competing priorities, data overload and the need for practical support in interpreting CGM reports.”
CGM tied to lower health care costs
For the cost and health care utilization analysis, researchers matched 469,370 CGM users with 469,370 adults who did not use CGM. Over the course of 1 year, CGM users had lower total health care costs vs. nonusers (mean costs, $6,245 vs. $7,786; P < .001).
Victoria E. Bouhairie
Adults using CGM spent fewer days admitted to inpatient care or the ED over the course of follow-up than nonusers. At 1 year, the CGM group spent a mean 2.14 days in the ED or inpatient care vs. 2.78 days for adults not using a CGM (P < .001). A smaller proportion of CGM users had fewer ED or inpatient visits due to hypoglycemia or diabetic ketoacidosis than those not using a CGM (4.44% vs. 5.42%; P < .001).
CGM users were more likely to achieve an HbA1c of less than 9% vs. adults who did not use a CGM (OR = 1.19; P < .001).
Bouhairie said the data point to the need for research on how CGM eligibility can more consistently translate into device initiation, while Dennis added that more studies are needed to examine ways to support sustained CGM use for patients.
“The downstream effect is seen afterwards,” Bouhairie said. “If we can get more people using CGM and more people staying on CGM, we will see reductions in total cost of care, hospitalizations and diabetes-related complications.”
For more information:
Victoria E. Bouhairie, MD, DipABLM, DABOM, can be reached at bouhairiemd@parryswellness.com; or on LinkedIn @VictoriaBouhairie.
Consuela Dennis, DNP, RN, NE-BC, can be reached at coni.dennis@ccsmed.com; or on LinkedIn @ConiDennis.