Achieving HbA1c Reduction in Diabetes Management : A Retrospective Comparison of Glucose Monitoring Methods.
- 1Bayhealth Family Medicine.
- 2Bayhealth Endocrinology.
Abstract
Objective
To evaluate the effectiveness of continuous glucose monitoring (CGM) compared to point-of-care (POC) glucose testing in reducing HbA1c among adults with diabetes.Methods
This single-center, retrospective cohort study included adult patients with type 1 or type 2 diabetes attending Bayhealth Sussex Endocrinology Clinic between January 1, 2023 and December 31, 2024. Controls were POC testers, while the intervention group was CGM users. Data was extracted from Epic electronic medical records via SlicerDicer and chart review. Exclusion criteria included pregnancy, terminal illnesses (i.e. end-stage renal disease, cancer), and medications affecting CGM accuracy (i.e. hydroxyurea, ascorbic acid). The primary endpoint was change in HbA1c from baseline to 3- and 6-month follow-ups. Secondary endpoints included estimated average glucose (eAG) and CGM metrics (time sensor active, time in range (TIR), time above range (TAR)).Results
Of 90 patients, 63 used CGM and 27 were POC testers. Baseline characteristics were similar between the groups, though CGM patients had higher comorbidity burden and insulin use. CGM users achieved significantly greater HbA1c reduction than POC testers (-1.8% vs. -1%; p < 0.001). Improvements were most pronounced among patients with baseline HbA1c ≥9% (time sensor active of -2 with p = 0.227, TIR 13.4 with p = 0.43, high TAR -8.7 with p = 0.344, very high TAR 1.9 with p = 0.455) but significant among baseline HbA1c 7-9% (time sensor active of -1.5, TIR -3.6, high TAR 1.9, very high TAR -1, with p < 0.001 for all metrics). CGM compliance maintained high (81.9% at 3 months vs. 75.4% at 6 months, p = 0.021) with notable improvement of time-in-range (TIR) (1.8, p = 0.002).Conclusion
CGM use significantly improves glycemic outcomes for patients at-risk of developing HbA1c >9%, which supports broader CGM access for all patients with diabetes.
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BibTeX
@article{sharmin2026achieving,
title = {{Achieving HbA1c Reduction in Diabetes Management : A Retrospective Comparison of Glucose Monitoring Methods.}},
author = {Eshita Sharmin and Cameron Golden and Ejaz Mahmood},
journal = {Delaware journal of public health},
year = {2026},
month = oct,
doi = {10.32481/djph.2026.10.08},
url = {https://europepmc.org/article/MED/42948824},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Achieving HbA1c Reduction in Diabetes Management : A Retrospective Comparison of Glucose Monitoring Methods.
AU - Eshita Sharmin
AU - Cameron Golden
AU - Ejaz Mahmood
PY - 2026
DA - 2026/10/26
JO - Delaware journal of public health
DO - 10.32481/djph.2026.10.08
UR - https://europepmc.org/article/MED/42948824
AB - Objective To evaluate the effectiveness of continuous glucose monitoring (CGM) compared to point-of-care (POC) glucose testing in reducing HbA1c among adults with diabetes.Methods This single-center, retrospective cohort study included adult patients with type 1 or type 2 diabetes attending Bayhealth Sussex Endocrinology Clinic between January 1, 2023 and December 31, 2024. Controls were POC testers, while the intervention group was CGM users. Data was extracted from Epic electronic medical records via SlicerDicer and chart review. Exclusion criteria included pregnancy, terminal illnesses (i.e. end-stage renal disease, cancer), and medications affecting CGM accuracy (i.e. hydroxyurea, ascorbic acid). The primary endpoint was change in HbA1c from baseline to 3- and 6-month follow-ups. Secondary endpoints included estimated average glucose (eAG) and CGM metrics (time sensor active, time in range (TIR), time above range (TAR)).Results Of 90 patients, 63 used CGM and 27 were POC testers. Baseline characteristics were similar between the groups, though CGM patients had higher comorbidity burden and insulin use. CGM users achieved significantly greater HbA1c reduction than POC testers (-1.8% vs. -1%; p < 0.001). Improvements were most pronounced among patients with baseline HbA1c ≥9% (time sensor active of -2 with p = 0.227, TIR 13.4 with p = 0.43, high TAR -8.7 with p = 0.344, very high TAR 1.9 with p = 0.455) but significant among baseline HbA1c 7-9% (time sensor active of -1.5, TIR -3.6, high TAR 1.9, very high TAR -1, with p < 0.001 for all metrics). CGM compliance maintained high (81.9% at 3 months vs. 75.4% at 6 months, p = 0.021) with notable improvement of time-in-range (TIR) (1.8, p = 0.002).Conclusion CGM use significantly improves glycemic outcomes for patients at-risk of developing HbA1c >9%, which supports broader CGM access for all patients with diabetes.
SN - 2639-6378
ER -