{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T15:48:56Z","timestamp":1788191336368,"version":"build-2803163510"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Most diabetes care is managed in primary care settings, which represent a critical yet underutilized site for continuous glucose monitoring (CGM) adoption. Whether CGM initiation by primary care clinicians improves glycemic outcomes and reduces acute health care utilization remains understudied.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n To evaluate the association of primary care\u2013initiated CGM with changes in hemoglobin A\n 1c<\/jats:sub>\n (HbA\n 1c<\/jats:sub>\n ) levels and rates of hospitalizations and emergency department (ED) visits among adults with insulin-treated diabetes.\n <\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study was performed at 18 primary care clinics within Montefiore Medical Center, a large safety-net health system in the Bronx, New York. Adults 18 years or older with any insulin-treated diabetes who had at least 1 primary care visit between August 1, 2022, and August 1, 2025, were included. Patients were excluded if they were uninsured, if they had a CGM prescription in the prior 2 years, or if their first CGM during follow-up was prescribed outside primary care.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n First CGM prescription by a primary care clinician.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n The primary outcomes were HbA\n 1c<\/jats:sub>\n level trajectories, which were analyzed using mixed-effects models, and hospitalizations and ED visits, which were analyzed using recurrent event frailty models.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The study included 8502 insulin-treated CGM-naive adult patients with diabetes (mean [SD] age, 62.3\u2009[14.6] years; 4764 [56.0%] female; 3618 [42.6%] with Medicare and 2854 [33.6%] with Medicaid coverage). Of these, 2392 patients (28.1%) were prescribed CGM by primary care clinicians. Patients who initiated CGM were younger, more often English-speaking and commercially insured, and had higher baseline HbA\n 1c<\/jats:sub>\n levels and more microvascular complications. At 12 months, HbA\n 1c<\/jats:sub>\n levels decreased by 0.66 (95% CI, 0.57-0.75) percentage points (pp) in patients who initiated CGM vs 0.17 (95% CI, 0.08-0.27) pp in those who did not, with a between-group difference of \u22120.49 (95% CI \u22120.62 to \u22120.35) pp. CGM initiation was associated with lower risk of recurrent hospitalizations (hazard ratio, 0.87 [95% CI, 0.77-0.98]) and ED visits (hazard ratio, 0.82 [95% CI, 0.74-0.91]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n \n In this cohort study of adults with insulin-treated diabetes, initiation of CGM by primary care clinicians was associated with clinically meaningful improvements in HbA\n 1c<\/jats:sub>\n and significant reductions in recurrent hospitalizations and ED visits. These findings support expanding CGM implementation in primary care settings as a scalable strategy to improve diabetes outcomes and reduce acute care utilization, particularly in underserved populations.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.21713","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T15:01:36Z","timestamp":1783350096000},"page":"e2621713","source":"Crossref","is-referenced-by-count":1,"title":["Primary Care\u2013Initiated Continuous Glucose Monitoring in Adults With Insulin-Treated Diabetes"],"prefix":"10.1001","volume":"9","author":[{"given":"Jovan","family":"Milosavljevic","sequence":"first","affiliation":[{"name":"Fleischer Institute for Diabetes and Metabolism, Division of Endocrinology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena Rasquin","family":"Leon","sequence":"additional","affiliation":[{"name":"Fleischer Institute for Diabetes and Metabolism, Division of Endocrinology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Rikin","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clyde","family":"Schechter","sequence":"additional","affiliation":[{"name":"Department of Family and Social Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sybil","family":"Hodgson","sequence":"additional","affiliation":[{"name":"Department of Family and Social Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York"},{"name":"Montefiore Medical Group, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivani","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Fleischer Institute for Diabetes and Metabolism, Division of Endocrinology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York"},{"name":"Community Healthcare Improvement and Strategy, Network Performance Group, Montefiore Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"zoi260604r1","doi-asserted-by":"publisher","first-page":"S150","DOI":"10.2337\/dc26-S007","article-title":"7. 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