Primary care–led glucose monitoring improves outcomes for insulin-treated diabetes

A new cohort study suggests that when primary care clinicians—rather than specialists—start patients on continuous glucose monitoring (CGM), the benefits are substantial and measurable.

Published in JAMA Network Open, the study examined adults with insulin-treated diabetes and found that CGM initiation in primary care settings was associated with clinically meaningful improvements in HbA1c, a key marker of long-term blood sugar control. Just as notably, patients experienced significant reductions in recurrent hospitalizations and emergency department visits—two costly and disruptive markers of poorly managed diabetes.

The findings carry particular weight for underserved populations, who often face barriers to specialist care. Because primary care is typically the first and most accessible point of contact in the health system, equipping these clinicians to prescribe and support CGM could extend the technology’s reach far beyond the specialist’s office.

The authors frame primary care–initiated CGM as a scalable strategy: one that could improve diabetes outcomes while easing pressure on acute care services. Rather than treating CGM as a tool reserved for endocrinology clinics, the study makes the case for embedding it into routine primary care management.

For a condition as widespread as diabetes, the practical implication is significant. Expanding where and by whom CGM is prescribed may be one of the more achievable ways to close persistent gaps in diabetes care.

The study, led by corresponding author Jovan Milosavljevic, MD, MS, of Montefiore, is available open access through JAMA Network Open.