Continuous Glucose Monitoring in Non-Insulin-Treated Type 2 Diabetes
In brief
Glucose monitors lowered average A1C by 0.9 points in adults not using insulin
In a 26-week trial of 283 adults with type 2 diabetes, continuous glucose monitoring lowered glycated hemoglobin 0.9 percentage points more than routine care and increased time in the target glucose range by 21 percentage points. No severe low-glucose events were reported, but the trial does not establish whether these gains persist beyond six months.
- Journal
- The New England journal of medicine (Q1)
- Published
- 14 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Tamara K Oser, Thomas Martens, Katrina J Ruedy, Simon Bergford, Peter Calhoun, Ku-Lang Chang, et al.
- PMID
- 42878622
- DOI
- 10.1056/NEJMoa2608571
Why clinicians should know about it
- Picked for Family Practice (paper of the day, 16 October 2026): RCT showing CGM improves HbA1c in non‑insulin T2D
Abstract
BACKGROUND: Continuous glucose monitoring (CGM) has been shown to be beneficial in persons with type 1 diabetes and others with insulin-treated type 2 diabetes, but its role in the treatment of persons with type 2 diabetes not being treated with insulin has needed further study. METHODS: In a 26-week trial conducted at 22 primary care practices in the United States, we randomly assigned adults with type 2 diabetes who were not using insulin to either CGM or routine care (control). The primary outcome was the glycated hemoglobin level at 26 weeks. Key CGM-measured secondary outcomes were tested hierarchically to control the type I error rate. RESULTS: A total of 145 participants were assigned to the CGM group, and 138 to the routine-care group. Participants ranged in age from 21 to 84 years. The mean (±SD) glycated hemoglobin level decreased from 8.8±1.3% at baseline to 7.2±1.1% at 26 weeks in the CGM group and from 8.7±1.2% to 8.0±1.4% in the routine-care group (adjusted mean difference, -0.9 percentage points; 95% confidence interval [CI], -1.1 to -0.6; P<0.001). The mean percentage of time that the CGM-measured glucose level was in the glucose-level range of 70 to 180 mg per deciliter was 21 percentage points higher (95% CI, 16 to 26) with CGM than with routine care (P<0.001). The between-group difference in the percentage of time that the glucose level was below 54 mg per deciliter was -0.17 percentage points (95% CI, -0.27 to -0.11; P<0.001 for noninferiority); the difference in the percentage of time that the glucose level was below 70 mg per deciliter was -0.20 percentage points (95% CI, -0.43 to -0.09; P<0.001 for noninferiority; P = 0.004 for superiority). No severe hypoglycemia events were reported. CONCLUSIONS: Among adults with type 2 diabetes that was not being treated with insulin and was being managed in a primary care setting, the use of CGM led to a greater reduction in the glycated hemoglobin level and to a lower risk of hyperglycemia than routine care. (Funded by Dexcom; CONNECT ClinicalTrials.gov number, NCT06601166.).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.