Continuous Glucose Monitoring and Mortality Risk Among US Veteran Dialysis Patients with Diabetes
Year: 2026
Type: other
Abstract: Objective: Dialysis patients with diabetes have a high burden of dysglycemia. While traditional glycemic markers have limited accuracy and convenience in dialysis, continuous glucose monitoring (CGM) provides automated, less invasive, and more comprehensive glycemic data than conventional measures. However, it remains unclear whether CGM is associated with improved clinical outcomes in dialysis patients. Research Design and Methods: We examined the association between CGM use vs. non-CGM use and survival among Veteran dialysis patients with diabetes using linked national Veterans Affairs, United States Renal Data System, and Medicare data. We examined Veteran dialysis patients with diabetes with incident CGM use (newly prescribed CGM) vs. non-CGM use over 1/2012-12/2023 matched by propensity scores (PS) to address confounding by indication, and who were followed for all-cause mortality events through 2/2025. Associations of CGM use vs. non-CGM use with mortality were evaluated using complete case analysis and multiple imputation. Results: Among 2008 patients in the complete case analysis cohort, CGM use was associated with lower mortality in PS-matched unadjusted and doubly-adjusted Cox models (ref: non-CGM use): HR (95%CI) 0.86 (0.76, 0.98) and 0.83 (0.75, 0.92), respectively. Among 3088 patients in the multiple imputation cohort, CGM use was also associated with greater survival in PS-matched unadjusted and doubly-adjusted Cox models: HR (95%CI) 0.88 (0.77, 0.99) and 0.84 (0.73, 0.96), respectively. Conclusions: In Veteran dialysis patients with diabetes, incident CGM use was associated with better survival vs. non-CGM use. Further studies are needed to determine underlying mechanisms, and the impact of CGM on other dialysis outcomes.
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W7162989598