Initiation of CGM in Primary Care Enhances Glycemic Control and Reduces Hospital Utilization: JAMA

A new study published in the Journal of American Medical Association showed that patients with insulin-treated diabetes who started continuous glucose monitoring (CGM) in primary care had improved glycemic control and fewer hospital stays.

The recommended standard of treatment for diabetes controlled with insulin is continuous glucose monitoring, or CGM. It has been shown to enhance quality of life, cut HbA1c levels, and decrease hospitalizations. CGM adoption is still low in primary care, where the majority of patients receive treatment, despite these advantages.

The majority of current research focuses on adoption hurdles rather than the therapeutic results of CGM started in primary care. This cohort research assesses if starting CGM in general care lowers hospitalizations or emergency department (ED) visits and improves HbA1c levels to close this gap. Notably, the study concentrates on Black and Hispanic patients, two groups that have previously been underrepresented in the therapeutic usage of CGM.

In the Bronx, New York's Montefiore Medical Center, a sizable safety net health system, eighteen primary care clinics participated in this cohort research. Included were anyone 18 years of age or older with any kind of insulin-treated diabetes who saw a primary care physician at least once between August 1, 2022, and August 1, 2025.

Patients who were uninsured, received a CGM prescription within the previous two years, or had their first CGM prescribed outside of primary care were all excluded. The main results were hospitalizations and ED visits, which were examined using recurrent event frailty models, and HbA1c level trajectories, which were examined using mixed-effects models.

8502 adult patients with diabetes who were insulin-treated and CGM-naive were included in the research. 

Among these, primary care physicians prescribed CGM to 2392 patients (28.1%). Patients who started CGM were younger, more likely to speak English, have commercial insurance, have higher baseline HbA1c levels, and experience more microvascular problems. 

CGM initiation was linked to a lower risk of recurrent hospitalizations (hazard ratio, 0.87 [95% CI, 0.77-0.98]) and ED visits (hazard ratio, 0.82 [95% CI, 0.74-0.91]). 

At 12 months, HbA1c levels decreased by 0.66 (95% CI, 0.57-0.75) percentage points (pp) in patients who started CGM.

Overall, similar to the advantages shown in clinical trials and specialist care settings, primary care-initiated CGM was linked to significant reductions in HbA1c levels and fewer acute health care events. These findings highlight the necessity of incorporating CGM into standard primary care procedures, particularly in underserved and racially and ethnically diverse populations.

Reference:

Milosavljevic, J., Leon, L. R., Rikin, S., Schechter, C., Hodgson, S., & Agarwal, S. (2026). Primary care-initiated continuous glucose monitoring in adults with insulin-treated diabetes. JAMA Network Open, 9(7), e2621713. https://doi.org/10.1001/jamanetworkopen.2026.21713