INTRODUCTION: To evaluate the effect of adding flash glucose monitoring (Flash GM) to glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy on glycemic and metabolic outcomes in people with type 2 diabetes (PwT2D) who failed to achieve target HbA1c levels.
METHODS: A prospective cohort study enrolled 264 PwT2D who were on stable GLP-1RA therapy and had failed to reach an HbA1c target of ≤ 7.0% at our institution. Participants were assigned to Flash GM + GLP-1RA or GLP-1RA alone, matched by age and baseline HbA1c using a nearest-neighbor approach, and followed for 12 months. Changes in HbA1c, body weight, lipid profile, and continuous glucose monitoring (CGM) metrics were assessed.
RESULTS: After 12 months, the Flash GM group achieved a mean HbA1c reduction of - 0.58% (from 8.24 to 7.66%) versus - 0.35% (from 8.32 to 7.97%) in the GLP-1RA-only group (p < 0.001). Weight decreased by - 4.03 kg (from 83.97 to 79.95 kg) with Flash GM, significantly more than the - 2.29 kg reduction (from 84.75 to 82.50 kg) in the GLP-1RA alone group (p < 0.001). Total cholesterol and triglyceride levels decreased significantly in the Flash GM group, while HDL cholesterol levels increased, compared to minimal changes in the controls. LDL levels decreased within the Flash GM group; however, the between-group change did not reach statistical significance. Mean time-in-range was 69.6%, with low hypoglycemia exposure and no signal for increased severe events or diabetes-related emergencies.
CONCLUSION: Adding Flash GM to GLP-1RA therapy significantly improved glycemic control, weight, and lipid parameters without added risk. This supports the consideration of integrating Flash GM into routine GLP-1RA-based management to optimize outcomes in PwT2D.
