Reduced rates of diabetic retinopathy complications with use of continuous glucose monitoring

Amer F Alsoudi; Karen M Wai; Euna Koo; Eubee Koo; Prithvi Mruthyunjaya; Ehsan Rahimy

doi:10.1038/s41598-025-08971-7

Reduced rates of diabetic retinopathy complications with use of continuous glucose monitoring

Sci Rep. 2025 Jul 12;15(1):25215. doi: 10.1038/s41598-025-08971-7.

Authors

Amer F Alsoudi¹, Karen M Wai², Euna Koo², Eubee Koo², Prithvi Mruthyunjaya², Ehsan Rahimy^{3

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Affiliations

¹ Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA.
² Horngren Family Vitreoretinal Center, Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
³ Horngren Family Vitreoretinal Center, Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA. rahimye@stanford.edu.
⁴ Department of Ophthalmology, Palo Alto Medical Foundation, Palo Alto, CA, USA. rahimye@stanford.edu.
⁵ Department of Ophthalmology, Byers Eye Institute at Stanford University, 2452 Watson Court, Palo Alto, CA, 94303, USA. rahimye@stanford.edu.

PMID: 40652066
DOI: 10.1038/s41598-025-08971-7

Abstract

Elucidating the outcomes of patients using continuous glucose monitoring (continuous glucose monitoring) in day-to-day clinical practice could help expand optimal practice guidelines in prevention and mitigation of diabetic retinopathy (DR). Retrospective cohort study. Subjects, Participants, and/or Controls: 13,302 patients with NPDR initiated on continuous glucose monitoring, compared with 179,079 patients with NPDR not initiated on continuous glucose monitoring before propensity score matching (propensity score matching) at one year. TriNetX (Cambridge, MA, USA), was used to identify patients diagnosed with NPDR stratified by initiation of continuous glucose monitoring or not with at least six months of follow-up. propensity score matching controlled for baseline demographics and medical comorbidities. After propensity score matching, 12,730 patients were subsequently analyzed in each cohort. Use of continuous glucose monitoring was associated with lower risk of vision threatening complications (DME: hazards ratio [HR], 0.87, 95% CI, 0.82-0.93; P < .001; PDR: HR, 0.74, 95% CI, 0.66-0.82; P < .001; VH: HR, 0.55, 95% CI, 0.47-0.66; P < .001; TRD: HR, 0.42, 95% CI, 0.27-0.68; P = .027), and need for ocular intervention (anti-VEGF injection: HR, 0.72, 95% CI, 0.65-0.80; P < .001; PRP: HR, 0.53, 95% CI, 0.44-0.64; P < .001; PPV: HR, 0.37, 95% CI, 0.26-0.51; P < .001) among patients with NPDR when compared with matched patients not using continuous glucose monitoring at 1 year. Similar associations at two years were found. continuous glucose monitoring use in patients with NPDR without prior ocular therapy was associated with lower risk of progression to vision threatening complications as well as need for ocular intervention at one year and two years, highlighting that glycemic variability and time in range are important factors influencing the risk of complications from diabetic eye disease.

Keywords: Continuous glucose monitoring; Diabetic macular edema; Panretinal photocoagulation; Pars plan vitrectomy; Proliferative diabetic retinopathy; Vascular endothelial growth factor.

MeSH terms

Aged
Blood Glucose Self-Monitoring* / methods
Blood Glucose* / analysis
Continuous Glucose Monitoring
Diabetic Retinopathy* / blood
Diabetic Retinopathy* / epidemiology
Diabetic Retinopathy* / prevention & control
Female
Humans
Male
Middle Aged
Propensity Score
Retrospective Studies

Substances

Blood Glucose