DISCUSSION
T1D, diabetes‐related complications, T2D, diabetes
REGRESSION, EVENTS, DIABETES
The ANSHIN study assessed the impact of non‐adjunctive Dexcom G6 use on glycaemic control and participant safety in people with suboptimal diabetes control (baseline mean HbA1c, 9.4%; mean TIR, 34%). In this study, significant improvements in HbA1c and CGM metrics and reduced SH events were observed following non‐adjunctive CGM use. Of note is that participants with T2D showed similar improvements in glycaemic outcomes as their counterparts with T1D. The results from the ANSHIN study will help inform regulatory agencies in Asian‐Pacific markets evaluating the safety and efficacy of this CGM system.CGM is increasingly used by people with T2D to manage their glucose levels. Results from the ANSHIN study further support the benefit of CGM in this population. In this study, participants with T2D experienced a mean HbA1c reduction of 1.0 percentage points and a significant 12‐percentage point increase in TIR which corresponds to an increase of 2.9 h per day (Older adults are at greater risk of developing diabetes‐related complications,Participants in the ANSHIN study had fewer episodes of SH while using the G6 compared to the baseline SMBG period. This observation aligns with the COACH study that reported non‐adjunctive Dexcom G5 use was associated with reductions in hypoglycaemic events for patients with insulin‐treated T1D or T2D.A strength of this analysis is the racial and ethnic diversity of the study population and the inclusion of 18 (23%) participants of Asian ancestry. The main limitation of the ANSHIN study is the lack of a non‐CGM control group during the intervention phases. Some of the reduction in HbA1c could be due to a study effect or regression to the mean phenomenon. However, there was a large mean (SD) HbA1c reduction of 1.1% (1.1%) achieved in a short period of time. Secondary CGM outcomes also provided additional evidence of a large improvement in glycaemia. A second limitation is that the study enrolled participants with suboptimal glycaemic control so findings are not generalizable to individuals with lower HbA1c levels. Third, while the total intervention duration was 28 weeks, this study only measured the change in glycaemic outcomes during phase one (16 weeks). Real‐world evidence suggests that glycaemic improvements are sustainableFinally, while participants experienced large glycaemic improvement, mean HbA1c remained above 8%, mean TIR was 47%, and mean TAR was 51% by end of study, falling short of the standard recommended glycaemic targets (HbA1c <7%, TIR >70%, TAR <25%).Non‐adjunctive Dexcom G6 use improved glycaemic control in adults managing their diabetes with IIT, regardless of age and diabetes type. Significant improvements in HbA1c and CGM‐based outcomes were observed for participants with T1D, with T2D, and those ≥65 years of age. Non‐adjunctive CGM use was safe and was associated with a decrease in the rate of severe hypoglycaemic events. Initiating this CGM system may help those with T1D or T2D make safe treatment decisions and move toward improved glycaemic outcomes.