Continuous glucose monitors help type 2 diabetes patients spend 5 more hours a day in healthy blood sugar range

Continuous glucose monitors (CGMs) could transform diabetes management for millions of Americans with type 2 diabetes who don’t take insulin, according to findings published in the New England Journal of Medicine.

The clinical trial found that adults using CGMs spent approximately five additional hours each day within their target blood sugar range compared with those receiving routine care. Nearly twice as many CGM users also achieved an A1c level below 7%, a common treatment goal for people with diabetes.

CGMs use a small sensor worn on the body to continuously track glucose levels throughout the day and night. This allows patients to see how their blood sugar responds to food, physical activity and other daily habits, potentially helping them make more informed decisions about managing their diabetes.

“An estimated 20 million adults in the United States have type 2 diabetes and do not take insulin, and despite advances in treatment, many still do not reach glycemic targets,” said first author Tamara Oser, M.D., a professor in the University of Colorado Anschutz Department of Family Medicine.

“Over time, elevated blood sugar can increase the risk of serious health complications, including heart disease, kidney disease and vision loss, so it’s important we continue to improve care for everyone with diabetes.”

Oser and her co-authors also found that CGM users experienced significantly greater improvements in A1c, a measure of average blood sugar over approximately three months. The difference between the groups was 0.9 percentage points, exceeding the threshold generally considered clinically meaningful.

Largest clinical trial of its kind

The study included 283 adults across 22 U.S. primary care practices who were followed for 26 weeks. It’s the first large-scale, multicenter randomized controlled trial to evaluate the effectiveness and safety of CGM in adults with type 2 diabetes who do not take insulin.

Unlike smaller previous studies, this trial exclusively enrolled patients receiving diabetes care through primary care practices, where most Americans with type 2 diabetes are treated. This approach makes the findings particularly relevant to everyday clinical care.

Reshaping treatment recommendations

The findings provide some of the strongest evidence yet for this population, which has historically been underresearched.

Currently, the American Diabetes Association’s Standards of Care cite Level A evidence, the highest rating supported by rigorous clinical research, for CGM use in patients receiving insulin. However, recommendations for people with diabetes who don’t take insulin are supported by Level C evidence, reflecting more limited research.

The researchers hope these new findings could help close that gap by providing robust clinical evidence that CGMs improve blood sugar in this population.

“We hope this research will help strengthen national diabetes care guidelines and expand insurance coverage, making this technology more accessible to the millions of patients who could benefit from it,” said Oser, who is also founder and director of the Primary Care Diabetes Lab at CU Anschutz.

For now, the authors suggest people with type 2 diabetes who don’t take insulin should discuss the use of CGMs with their primary care providers as part of their diabetes management.

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Robert Egan

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