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BACKGROUND Continuous glucose monitoring (CGM) might have beneficial effects on glycemic control and body-mass-index (BMI) in adults with type 1 (T1D) or type 2 diabetes (T2D). METHODS The diabetes prospective follow-up registry was used to identify individuals with T1D or T2D ≥18 years starting CGM management in 2015 or later and follow-up information available. HbA1c, BMI and event rates of severe hypoglycemia in the year prior to CGM start were compared to two follow-up periods: 1) CGM use for 3-6 months and 2) CGM use for >6 months. Repeated measurements linear and negative binomial regression were used (adjustment for sex, age at diabetes onset and baseline parameters) and stratified by diabetes type. RESULTS Mean follow-up time was 1.8 years in T1D (n=2,994) and 1.9 years in T2D (n=1,440). In T1D, adjusted mean HbA1c decreased significantly from 7.65% (95%-confidence interval: 7.62-7.68) at baseline to 7.54% (7.51-7.57) during follow-up. BMI increased slightly (baseline: 25.4 kg/m2 (25.3-25.5), follow-up >6 months: 25.8 kg/m2 (25.7-25.9)), whereas event rates of severe hypoglycemia were significantly lower after >6 months with CGM (9.0 events/100 PY (8.0-10.1)) compared to baseline (11.3 events/100 PY (10.4-12.2)) in adults with T1D. In T2D, HbA1c decreased from 7.21% (7.17-7.25) to 7.00% (6.95-7.04%) and BMI did not change after CGM initiation. CONCLUSION Our results provide real world evidence on CGM management in adult individuals with T1D or T2D. We suggest to strengthen patients' and physicians' readiness towards diabetes technology in T2D and more openness of health insurance to cover cost based on proven benefits.

Aims: The diabetic foot syndrome (DFS) is a serious complication in patients with diabetes increasing the risk for minor/major amputations. This analysis aimed to examine differences in diabetes patients with or without DFS stratified by type 1 (T1D) or type 2 diabetes (T2D). Material and Methods: Adult patients (���20y of age) with diabetes from the German/Austrian diabetes patients follow���up registry (DPV) were included. The cross���sectional study comprised 45 722 subjects with T1D (nDFS= 2966) and 313 264 with T2D (nDFS= 30 904). In DFS, minor/major amputations were analysed. To compare HbA1C, neuropathy, nephropathy, cardiovascular disease risk factors, and macrovascular complications between patients with or without DFS, regression models were conducted. Confounders: age, sex, diabetes duration. Results: In patients with DFS, a minor amputation was documented in 27.2% (T1D) and 25.9% (T2D), a major amputation in 10.2% (T1D) and 11.3% (T2D). Regression models revealed that neuropathy was more frequent in subjects with DFS compared with patients without DFS (T1D: 70.7 vs 29.8%; T2D: 59.4% vs 36.9%; both P< 0.0001). Hypertension, nephropathy, peripheral vascular disease, stroke, or myocardial infarction was more common compared with patients without DFS (all P< 0.0001). In T1D with DFS, a slightly higher HbA1C (8.11% vs 7.95%; P< 0.0001) and in T2D with DFS a lower HbA1C (7.49% vs 7.69%; P< 0.0001)was observed. Conclusions: One third of the patients with DFS had an amputation of the lower extremity. Especially neuropathy or peripheral vascular disease was more prevalent in patients with DFS. New concepts to prevent DFS���induced amputations and to reduce cardiovascular risk factors before the occurrence of DFS are necessary. �� In Copyright http://rightsstatements.org/vocab/InC/1.0/, acceptedVersion

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