We analyzed data from 2253 veterans with type 1 (34%) or type 2 (66%) diabetes who initiated Dexcom continuous glucose monitoring (CGM) between 2015 and 2022, all with ≥10 days of data over a 6-month landmark period. CGM data were merged with electronic health records (EHR). Diabetic retinopathy (DR) was defined from EHR diagnoses. Incident DR was assessed up to 4 years from CGM initiation. Cox models evaluated associations between CGM metrics (mean glucose MG, time in range TIR, time above range TAR, glycemia risk index GRI, coefficient of variation, and week-to-week average real variability ARV) and DR. There were 99 incident DR events. In separate multivariable models, higher MG, TAR, GRI, and ARV, and lower TIR were associated with DR risk; these associations (except ARV) remained significant after landmark HbA1c adjustment and were stronger than for landmark HbA1c itself, suggesting that CGM metrics provide more informative risk stratification than HbA1c alone.
Okuno et al. (Fri,) studied this question.