Primary Care–Initiated Continuous Glucose Monitoring Associated With Better Glycemic Outcomes

Primary care-initiated continuous glucose monitoring (CGM) was associated with greater reductions in hemoglobin A1c (HbA1c) and lower rates of recurrent hospitalizations and emergency department (ED) visits among adults with insulin-treated diabetes, according to a cohort study published in JAMA Network Open.

Investigators analyzed electronic health record data from 8,502 CGM-naive adults treated with insulin who received care at 18 primary care clinics within Montefiore Medical Center, health system in the Bronx, New York, between August 1, 2022, and August 1, 2025. Of these patients, 2,392 (28.1%) received their first CGM prescription from a primary care clinician.

At 12 months, estimated HbA1c decreased by 0.66 percentage points among CGM initiators and 0.17 percentage points among noninitiators. The adjusted between-group difference was −0.49 percentage points (95% CI, −0.62 to −0.35). The association persisted through 24 months, when the between-group difference was −0.54 percentage points (95% CI, −0.72 to −0.35).

During the 3-year study, the cohort experienced 8,448 acute care events, including 4,619 ED visits and 3,829 hospitalizations. CGM initiation was associated with a 13% lower risk of recurrent all-cause hospitalizations (hazard ratio [HR], 0.87; 95% CI, 0.77-0.98) and an 18% lower risk of recurrent ED visits (HR, 0.82; 95% CI, 0.74-0.91). Similar associations were observed among patients managed without endocrinology care.

The authors noted that CGM exposure was based on a prescription rather than confirmed device use and that residual confounding may remain despite statistical adjustment. Events outside the health system also may have been missed. They concluded that the findings support broader evaluation of CGM implementation in primary care, while prospective studies are needed to clarify optimal implementation, clinician training, and patient education.

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