CGM can support improved diabetes management.In an observational study, the rates of hospitalizations for acute diabetes events (ADEs) decreased following the initiation of the FreeStyle Libre (FSL) continuous glucose monitoring (CGM) system in adults with type 2 diabetes (T2D).
“[This study showed] notable reductions in hospitalizations for ADEs in the year following FSL initiation, irrespective of diabetes therapy type,” said Dr Bruno Guerci from Université de Lorraine, Vandœuvre-Lès-Nancy, France, during his presentation at EASD 2026.
The study included 253,845 adults with T2D from the French national claims database SNDS* who had a first reimbursement claim for the FSL CGM system between 2018 and 2022. The three diabetes therapy types were multiple daily injections (MDI; n=179,142), basal insulin (n=46,061), and noninsulin therapy (NIT: n=28,642). NIT was further stratified into monotherapy (n=8,399), dual therapy (n=9,701), and triple therapy (n=10,542).
Overall, approximately 60 percent of the participants were men, and the mean age was 64 years. The mean duration since the first T2D diagnosis was longer in the MDI and basal insulin groups than the NIT group (15 years and 12.3 years vs 8.6 years). [EASD 2026, abstract LBA 110]
The incidence of ADE hospitalizations decreased from 1 year before to 1 year after FSL CGM initiation across all study groups: from 2.7 to 1.2 percent in the MDI group (–56 percent; p<0.001), from 1.7 to 0.9 percent in the basal insulin group (–47 percent; p<0.001), and from 4.2 to 0.8 percent in the NIT group (–81 percent; p<0.001).
Similarly, significant reductions in incidence rates per 1,000 person years were observed across all diabetes therapy types a year following FSL initiation: from 33.8 to 15.2 in the MDI group, from 22.3 to 10.3 in the basal insulin group, and from 52.9 to 10.2 in the NIT group.
In a sensitivity analysis evaluating NIT participants who remained on NIT for 6 months after CGM initiation, the proportion of ADEs decreased from 0.9 to 0.3 percent, representing a 67-percent reduction (p<0.001).
ADE by type
The ADE reductions were primarily driven by the reductions in diabetic ketoacidosis rates from 1 year before to 1 year after FSL initiation across study groups: from 1.5 to 0.6 percent (–60 percent), from 1.1 to 0.4 percent (–64 percent), and from 3.4 to 0.4 percent (–88 percent) in the respective MDI, basal insulin, and NIT groups.
There were also notable reductions in hyperglycaemia rates between the two timepoints across all diabetes therapy types (–50, –50, and –75 percent in the MDI, basal insulin, and NIT groups, respectively).
For hypoglycaemia events, the MDI group had a reduction from 1 year prior to 1 year after FSL initiation (–38 percent), but the incidence increased by 33 percent in the basal insulin group and remained stable in the NIT group.
The incidence of diabetic coma decreased by 67 percent in both MDI and NIT groups, but there was no change in the basal insulin group between the two timepoints.
Robust findings
Guerci underscored the robustness of the findings despite the observational nature of the study and the lack of comparator. “This is a nationwide, generalizable, real-world analysis with sizeable study populations and robust secondary and sensitivity analyses.”
“The results suggest that CGM can support improved diabetes management, particularly in patients with complex NIT regimens, such as those on triple therapy,” he added.
Guerci noted that the study team plans to evaluate complementary CGM metrics (eg, time in range, time below range) in future studies, as well as noninsulin users to ascertain which of these patients would benefit the most from CGM access.