This trial found that continuous glucose monitors (CGMs) meaning small sensors worn on the body that track glucose all day and night, significantly improved blood sugar control in type 2 diabetes patients who do not use insulin.
What the study did:
- Largest trial of its kind for this population: 283 adults across 22 US primary care practices, followed for 26 weeks
- Published in the New England Journal of Medicine
- First large-scale, multicenter randomized controlled trial to focus only on patients treated in primary care, where most Americans with type 2 diabetes receive care
Key results:
- Time in range: CGM users spent about 5 more hours per day in their target blood sugar range compared with routine care
- A1c (a measure of average blood sugar over about 3 months): CGM group improved by 0.9 percentage points more than the control group. The authors note this greatly exceeds what is generally considered clinically meaningful
- A1c goal: Nearly twice as many CGM users reached an A1c below 7%, a common treatment goal
Why it matters:
An estimated 20 million US adults have type 2 diabetes and do not take insulin, and many do not reach glycemic targets, which over time raises risk for heart disease, kidney disease, and vision loss.
Currently, American Diabetes Association guidelines cite Level A evidence, the highest rating, for CGM use in people who use insulin, but only Level C evidence, reflecting limited research, for people who do not use insulin. The authors hope this trial provides robust evidence to strengthen guidelines and expand insurance coverage.
For now, they suggest people with type 2 diabetes not using insulin discuss CGM use with their primary care provider.