Continuous Glucose Monitoring in Working Adults with Type 1 Diabetes: A Twelve-Month Comparative Cohort: Glycaemic Control, Hypoglycaemia, Work Productivity and Patient-Reported Outcomes

Dr. Subhash Chandra Jha, Vaibhav, Manish Samyal

Type 1 Diabetes; Continuous Glucose Monitoring; CGM; Time in Range; Severe Hypoglycaemia; Insulin Pump; Work Productivity

Continuous glucose monitoring (CGM) has transformed type 1 diabetes (T1DM) care in many high-income settings, but real-world uptake and outcomes among working adults in middle-income settings remain incompletely characterised. We prospectively followed 248 working adults with T1DM at a tertiary diabetes service over 12 months, comparing 128 patients using real-time CGM with 120 patients using conventional self-monitoring of blood glucose (SMBG). Mean HbA1c fell from 8.6% to 7.1% in the CGM cohort and from 8.5% to 8.1% in the SMBG cohort over 12 months. Time in range (70-180 mg/dL) at 12 months was 68.4% in CGM users compared with 54.8% in SMBG users. Severe hypoglycaemia requiring assistance occurred in 14.1% of CGM users and 38.3% of SMBG users (HR 0.32, 95% CI 0.18-0.57). Strongest independent predictors of achieving time-in-range ≥70% included CGM use, insulin pump therapy, completion of diabetes education, and carbohydrate counting practice. The findings support broader CGM access for working adults with T1DM, with particular value in shift workers and those with hypoglycaemia unawareness

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