Continuous Glucose Monitoring in Non-Insulin-Treated Type 2 Diabetes

Key numbers

• 1.3% at baseline to 7.2
• 1.1% at 26 weeks in
• 1.2% to 8.0

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.).

Tamara K Oser, Thomas Martens, Katrina J Ruedy, Simon Bergford, Peter Calhoun, Ku-Lang Chang, Erik S Kramer, Beth A Klug, R Lacy Anderson, Benjamin R Cook, David Pickering, Martin Ortega, Bryce Peterson, Lisa Davidson, Rita Schmid, Nitinchandra D Desai, Edwin Burkett, Jamie L Haynes, Amir Herman, Shehzad M Topiwala, Ryan Bailey, Sean M Oser, Nelly N Cadet, Matthew L Johnson, Karen E Elkind-Hirsch, Stayce E Beck, Jessica R Castle, Roy W Beck, CONNECT Study Group

Leverage2 / 5

Reusable within one subfield (a technique, dataset, or protocol a few groups will adopt).

10% of this desk’s rubric

Magnitude3 / 5

Large gain: roughly 2x, or a clear new state of the art on a hard, unsaturated problem.

20% of this desk’s rubric

Evidence4 / 5

Strong: large scale, preregistered, independently replicated, or a well-powered randomized trial.

32% of this desk’s rubric

Novelty3 / 5

A genuinely new approach to an open problem.

8% of this desk’s rubric

Trajectory2 / 5

Some room to improve with obvious engineering.

5% of this desk’s rubric

Stakes3 / 5

Meaningful benefit to many people within a few years.

25% of this desk’s rubric

• Citations0 (reference 20, via openalex, Oct 20, 2026, 06:17 UTC)

• Reviewed by heuristic-v7 on Oct 20, 2026, 06:17 UTC. Paper type: clinical.
• Categories: Journal Article
• BRIEF, No.2 in the Medicine edition of October 20, 2026.