European study reassures that continuous glucose monitoring does not lead to significant weight gain in adults with type 1 diabetes

A large European retrospective study finds that adults with type 1 diabetes using continuous glucose monitoring experience modest weight changes and generally improved glucose control, with early warning signs identified for those at risk of substantial weight gain.

A large European study is offering some reassurance to adults with type 1 diabetes who worry that starting continuous glucose monitoring might improve glucose control at the cost of substantial weight gain. In matched comparisons from the DPV registry, people who began CGM were markedly less likely than non-users to fall into the least favourable pattern: notable weight gain without any real HbA1c improvement. The analysis covered 4,178 adults starting CGM, including 2,104 in the DPV registry and 2,074 in a pooled Belgian cohort, with the DPV users matched against 2,104 controls who did not start the technology. (sciencedirect.com)

The headline averages were modest rather than dramatic. Over 24 months, mean weight rose by 1.8kg in the DPV CGM cohort and 1.0kg in the Belgian cohort, while HbA1c fell by 0.2 percentage points and 0.1 percentage points respectively. The matched DPV controls also put on weight, gaining 1.2kg on average, while showing only a very small HbA1c reduction of 0.06 percentage points. A Russian clinician-facing summary published on 17 August presented the same topline numbers, underlining how quickly the results were taken up beyond the journal itself. (sciencedirect.com)

What makes the paper more useful clinically is that it moves past those averages and separates patients into three distinct patterns. According to the journal abstract and publisher summary, the biggest group in every cohort showed little movement in either weight or HbA1c: 83.2% of DPV CGM users and 69.8% of Belgian users fell into that stable category. A smaller group saw HbA1c improve with only limited weight gain, while the least favourable group accounted for 9.9% of DPV CGM users and 10.4% of Belgian users, compared with 20.5% of matched DPV controls. The publisher’s table summary adds that, after two years, the favourable subgroup in DPV had gained 3.8kg while cutting HbA1c by 2.3 percentage points, whereas the unfavourable subgroup had gained 11.1kg with essentially no HbA1c change; in Belgium, the equivalent figures were 1.3kg and a 1.1-point HbA1c fall for the favourable group, versus 8.2kg with virtually no HbA1c shift in the unfavourable one. (sciencedirect.com)

The study also suggests that the warning signs appear early. In the table data surfaced on the publisher page, the high-risk subgroup had already gained roughly 4.5kg to 4.7kg by six months, far ahead of the rest of the cohort. By contrast, the stable groups were close to flat at that point, and the favourable groups had much smaller gains alongside sharper HbA1c improvements. That pattern matters because it implies that clinicians may not need to wait two years to spot who is drifting into trouble after CGM initiation. (sciencedirect.com)

Methodologically, the paper is a retrospective cohort study rather than a randomised trial, but it is broader than many earlier reports. The ScienceDirect record says the researchers limited inclusion to adults aged 18 or over with at least six months’ duration of type 1 diabetes who were newly starting CGM on either a pump or multiple daily injections, and who had at least two years of follow-up. In the paper’s “research in context” section, the authors said they screened 6,873 articles published between 1 January 2000 and 31 March 2026 before setting out their own analysis, positioning the work as an attempt to answer a long-running concern with larger real-world datasets. As a matched retrospective study, it cannot eliminate every unmeasured difference between people who chose CGM and those who did not, but the control comparison strengthens the argument that CGM itself is not driving widespread excess weight gain. (sciencedirect.com)

The publication trail also helps place the study. PubMed lists the article date as 8 August 2026 and records it in the October 2026 issue of The Lancet Regional Health – Europe, volume 69, article 101806, with open-access availability in PubMed Central under PMCID PMC13476762. The Maastricht University repository confirms the same citation and shows the multinational author group spans institutions including KU Leuven, Vrije Universiteit Brussel, Ulm University and Maastricht University, among others. PubMed also records funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No. 875534. (pubmed.ncbi.nlm.nih.gov)

The paper has already travelled widely through secondary medical coverage, though not always perfectly. Internist.ru summarised the study for Russian clinicians in mid-August, again stressing the modest average weight change and the lower share of CGM users in the worst trajectory. A Georgian medical site published its own account on 1 September and highlighted the same 9.9% versus 20.5% contrast, but identified the journal as The Lancet eBioMedicine. PubMed and Maastricht University’s record show that the paper in fact belongs to The Lancet Regional Health – Europe. That may seem minor, but it is a useful reminder that the strongest reading of the work still comes from the journal and registry records themselves: for most adults in this study, CGM was linked to better glucose control without a major weight penalty, and the minority who did gain large amounts of weight were visible well before the two-year mark. (internist.ru)