# Use of continuous glucose monitoring and long-term diabetes outcomes within the Veteran Affairs Health Care System

> **NIH VA I01** · PHOENIX VA HEALTH CARE SYSTEM · 2024 · —

## Abstract

Summary: Continuous glucose monitoring (CGM) is increasing rapidly in the Veterans Administration Health
Care System (VAHCS). Experience with CGM is greatly modifying our concepts of glucose control and our
understanding of how to define and achieve optimal glucose goals. Most available data on CGM has been
derived from short-term small trials or observational studies conducted in classic early onset T1D patients and
have illustrated the value of CGM in these patients with respect to glucose lowering and reduced hypoglycemia.
However, much less is known about benefits of CGM in T1D that develops later in life nor in the far more frequent
setting of T2D. There is also very little known about CGM related effects on the many serious, debilitating and
costly diabetes complications that are so prevalent in both T1D and T2D. Because use of CGM has substantial
financial costs and requires extensive time on the part of patients, physicians, nurses and other staff participating
in diabetes care to implement and sustain CGM, we need to better understand how to best use CGM and what
is gained from it. Our preliminary data demonstrate we can extract clinical and demographic information for
T1D and T2D patients and evaluate the benefits of CGM initiation on short-term glucose control and several
adverse outcomes. There is also a striking signal of potential benefits on major comorbidities such as renal
disease, cardiovascular disease and even mortality. Now we propose to expand the years of data collection and
follow-up time to directly focus on the benefits of CGM initiation on long-term clinically important outcomes. There
will be three main aims for this project. In Aim 1, we will assess in T1D and T2D within the VAHCS the effect of
CGM initiation (compared with matched nonCGM users) on the occurrence of ER or hospital admissions for
hypoglycemia and hyperglycemia and all-cause hospital admissions over 4 years. In all three aims we will use
overlap propensity score weighting to balance CGM users and nonusers and will conduct multiple sensitivity
analyses to assess and adjust for potential bias in matching. As a secondary analyses we will compare the
effects in T1D and T2D of initiating CGM on long-term glucose control. We will also examine baseline features,
such as age, racial/ethnic identity, glycemic control, hypoglycemic risk, complication status, CGM type as well
as patterns of CGM use to identify subgroups with differential long-term benefits of CGM on these outcomes. In
Aim 2, we will assess in T1D and T2D the effects of CGM on development of renal disease and diabetes
complications. To achieve this aim, we will compare the effects in T1D and T2D of initiating CGM (vs. nonCGM
users) on development of a composite outcome indicating severe renal disease and assess change in a validated
diabetes complication index score. As in Aim 1, we will also attempt to identify subgroups with differential benefits
of CGM on these outcomes. We will also explore the...

## Key facts

- **NIH application ID:** 10702210
- **Project number:** 1I01BX006126-01A1
- **Recipient organization:** PHOENIX VA HEALTH CARE SYSTEM
- **Principal Investigator:** Peter D Reaven
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2023-10-01 → 2027-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10702210

## Citation

> US National Institutes of Health, RePORTER application 10702210, Use of continuous glucose monitoring and long-term diabetes outcomes within the Veteran Affairs Health Care System (1I01BX006126-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10702210. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*