Continuous glucose monitoring (CGM) is widely used in the management of type 1 diabetes mellitus (T1DM), but its association with long-term complications and mortality remains under evaluation. Evidence from large population-based cohorts can provide insights into its impact on both acute and chronic outcomes.

A nationwide cohort study published in Diabetologia evaluated the association between CGM use and diabetes-related complications in adults with T1DM receiving intensive insulin therapy. The analysis included 17,018 individuals from the Korean National Health Insurance Service Cohort between 2016 and 2022, with 8509 CGM users matched to 8509 non-users. Primary outcomes included diabetic ketoacidosis (DKA), severe hypoglycaemia (SH), end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality. Between-group comparisons were assessed using Cox proportional hazards models, and within-group changes after CGM initiation were also analyzed.

CGM use was associated with lower rates of DKA (adjusted hazard ratio [aHR] 0.40; 95% confidence interval [CI] 0.33 to 0.48), ESKD (aHR 0.43; 95% CI 0.32 to 0.56), CVD (aHR 0.28; 95% CI 0.23 to 0.33), and all-cause mortality (aHR 0.38; 95% CI 0.32 to 0.46) compared with non-use. Rates of severe hypoglycaemia were comparable between groups (aHR 0.92; 95% CI 0.77 to 1.10). Among CGM users, the frequency of severe hypoglycaemia decreased by 61.5% after initiation, while DKA and CVD-related hospital or emergency visits decreased by 60.0% and 50.0%, respectively (p<0.001).

These findings show lower rates of acute and chronic diabetes-related complications and mortality among CGM users compared with non-users in adults with T1DM.