Impact of Continuous Glucose Monitoring for American Indian/Alaska Native Adults With Type 2 Diabetes Mellitus Not Using Insulin.

BACKGROUND: American Indian and Alaskan Native (AI/AN) populations have the highest prevalence of type 2 diabetes mellitus (T2DM) in the United States. Continuous glucose monitors (CGMs) have revolutionized diabetes management, but their impact on AI/AN individuals with T2DM who are not insulin dependent remains understudied. METHODS: A retrospective observational study was conducted using deidentified electronic health records from an outpatient Indian Health Service clinic between 2019 and 2024. Ninety-three AI/AN patients with non-insulin-dependent T2DM who used CGMs for ≥ 1 year were included. Hemoglobin A1c (HbA1c), blood pressure (BP), weight, low-density lipoprotein cholesterol, and estimated glomerular filtration rate were compared at baseline and 1 year after CGM initiation without a control group. RESULTS: The mean age of participants was 55 years and 60% were female. Mean (SD) HbA1c significantly decreased from 9.5% (2.4%) at baseline to 7.6% (2.2%) at 1 year (95% CI, -2.35 to -1.37; P < .001, paired t test). Higher baseline HbA1c was associated with greater HbA1c reduction over 1 year (β = -0.576; P < .001, linear regression), explaining 34.6% of the variance in change. Mean (SD) systolic BP decreased by 4.9 (17) mm Hg (95% CI, -8.6 to -1.1; P = .01, paired t test), but diastolic BP and other variables showed no significant changes. CONCLUSIONS: CGM use in an AI/AN population was significantly associated with improved glycemic control in patients with non- insulin-dependent T2DM. The effect was more pronounced in patients with higher baseline HbA1c levels, suggesting CGMs could be beneficial for patients at greatest risk.