Change in Glycated Hemoglobin and Associated Factors in Diabetic Patients Using Flash Glucose Monitoring in a Colombian Institution: A Retrospective Cohort Study

Abstract

Introduction: Diabetes mellitus (DM) is one of the leading causes of morbidity and mortality worldwide. Flash glucose monitoring (FGM) has been shown to improve metabolic control and reduce hypoglycemic events.

Objective: To analyze changes in glycated hemoglobin (HbA1c) and associated factors in adult patients with type 1 and 2 DM who initiated FGM use at a specialized IPS in Medellín, Colombia, between 2023 and 2024.

Materials and Methods: A retrospective, analytical cohort study with secondary data sources was included. 126 adult patients with DM who previously used capillary glucose monitoring and subsequently initiated FGM use were included. Baseline HbA1c values ​​were compared with those obtained after ≥6 months of use. Descriptive analyses, the Wilcoxon test, bivariate analysis (chi-square, simple logistic regression), and multivariate analysis using Poisson regression with robust variance were applied.

Results: The median age was 41 years; 60% were women, and 67% had type 1 DM. HbA1c decreased significantly from 8.4% to 7.7% (median difference = 0.75; 95% CI: 0.55–0.94; p < 0.001). In the bivariate analysis, dyslipidemia and kidney disease were associated with a lower likelihood of HbA1c reduction, while health education was positively associated with changes in glycemic control. In the multivariate model, education (adjusted RR = 0.53; 95% CI: 0.27–0.93; p = 0.041) and kidney disease (adjusted RR = 0.63; 95% CI: 0.39–0.97; p = 0.046) remained significant factors.

Conclusions: Flash glucose monitoring significantly reduced HbA1c in patients with diabetes, with greater benefit in those who received health education. Kidney disease modified this association, requiring cautious interpretation of the results in this subgroup. Education and multidisciplinary support are consolidated as key factors for optimizing metabolic control.