TL;DR
Get workout gear delivered free with Prime
- Fast, free delivery on millions of items
- Prime Video, Amazon Music and more included
- Member-only deals all year
In the 283-person CONNECT trial, adults with type 2 diabetes who were not using insulin and wore continuous glucose monitors had lower HbA1c and more time in target glucose range after 26 weeks than people receiving routine care. The study found high device use and no severe hypoglycemia or hyperglycemia-related serious adverse events, but whether the results persist in routine practice remains uncertain.
A 26-week randomized trial found that adults with type 2 diabetes who were not taking insulin had lower HbA1c and spent more time in the target glucose range when they used continuous glucose monitors (CGMs) than with routine care. The CONNECT study involved 283 patients at 22 U.S. primary care practices, adding evidence for a group for whom research on CGM has been more limited.
By week 26, mean HbA1c in the CGM group had fallen from 8.8% to 7.2%. In the routine-care group, it fell from 8.7% to 8.0%. The adjusted difference between groups was 0.9 percentage points in favor of CGM (95% confidence interval, 0.6 to 1.1 percentage points; P<0.001), according to results reported by Roy W. Beck, MD, PhD, of the Jaeb Center for Health Research in Tampa, Florida, and colleagues.
Participants assigned CGM spent 21 percentage points more time in the target range of 70 to 180 mg/dL than those receiving routine care, a difference the report equates to about five additional hours per day. Time in severe hyperglycemia, defined as above 250 mg/dL, was 15 percentage points lower in the CGM group. Time below 70 mg/dL and below 54 mg/dL was also lower by 0.20 and 0.17 percentage points, respectively.
Median CGM use was 97% of the time during the study. No severe hypoglycemia or hyperglycemia-related serious adverse events were observed. The report recorded 33 adverse events in the CGM group and 24 in routine care; three were sensor-related, including two cases of bleeding at the insertion site and one issue during sensor removal.
Evidence Beyond Insulin Users
The findings address an evidence gap in diabetes care. CGMs are recommended for people with type 1 diabetes and insulin-treated type 2 diabetes, while the evidence base for people with type 2 diabetes who do not use insulin has been more limited. The trial suggests that monitoring glucose continuously may support improved glucose measures in this population, including among patients receiving care in primary care settings.
The results do not show that the device alone caused every improvement or that every patient would see the same benefit. Medication changes occurred during the trial: glucose-lowering or insulin treatment was added for 31% of CGM participants and 17% of routine-care participants. The researchers said medication changes alone could not explain the observed improvement, and suggested that changes in behavior affecting glucose levels may have contributed.
The trial may inform discussions between patients and clinicians about monitoring options, particularly when HbA1c remains above the patient’s treatment target. It does not establish that CGM should replace medication, clinical follow-up or individualized treatment decisions.
Who Joined the CONNECT Trial
The study took place at 22 U.S. primary care practices, where many people with type 2 diabetes receive care. Participants were 21 to 84 years old, had been diagnosed for at least six months and had a baseline HbA1c of at least 7.5%. They had not used real-time CGM in the previous six months or insulin in the previous 12 months, and their non-insulin glucose-lowering or weight-loss medication had been stable for at least a month before enrollment.
At the start of the trial, 40% used GLP-1 receptor agonists, 37% used SGLT2 inhibitors and 18% used both medication classes. The researchers noted that the 2026 American Diabetes Association Standards of Care cited level A evidence for CGM use among people receiving insulin, but level C evidence for people with diabetes not treated with insulin. The CONNECT findings add randomized-trial data to that less established area.
“Results for glycated hemoglobin and time-in-range outcomes were similar across a wide range of participant characteristics.”
— Roy W. Beck, MD, PhD, and colleagues
How Durable Are the Results?
The trial followed participants for 26 weeks; it does not yet establish whether lower HbA1c and increased time in range will persist over longer periods. The report also cautions that participants received sensors and had trial visits, which may have helped maintain 97% median use. CGM adherence and benefit could be lower in routine practice.
The results do not determine which patients are most likely to benefit, how outcomes vary with different devices or levels of clinical support, or whether the observed glucose changes lead to fewer long-term complications. The study authors reported that outcomes were similar across a broad range of participant characteristics, but longer follow-up is still needed. The findings also do not separate the potential effects of glucose feedback on behavior from other aspects of care.
Extension Will Test Staying Power
A 26-week extension phase is underway to assess whether participants continue using CGMs and whether the effects on glucose measures last. Results from that follow-up should provide more information about sustained use beyond the initial trial period.
For now, the reported findings apply to adults who met the trial’s criteria, including an HbA1c of at least 7.5% and no recent insulin or real-time CGM use. Patients considering a monitor should discuss its potential role, costs, access and how results would fit into their treatment plan with their diabetes care team.
Key Questions
What did the CONNECT trial find?
After 26 weeks, participants using CGMs had a lower mean HbA1c and spent more time in the 70–180 mg/dL target range than participants receiving routine care. The adjusted HbA1c difference was 0.9 percentage points, and the time-in-range difference was 21 percentage points.
How many more hours were participants in the target range?
The study report describes the 21-percentage-point difference in time in range as about five more hours per day for the CGM group.
Did the study report serious safety problems?
No severe hypoglycemia or hyperglycemia-related serious adverse events were observed. Three sensor-related adverse events were reported in the CGM group: two involving insertion-site bleeding and one during sensor removal.
Do the results prove CGM benefits everyone with type 2 diabetes?
No. The trial studied adults with specified eligibility criteria, including HbA1c of at least 7.5% and no recent insulin use. Its results do not establish the same benefit for every person with type 2 diabetes or show that CGM replaces medication or clinical care.
What will researchers study next?
A 26-week extension is underway to examine continued CGM use and whether the glucose-related benefits seen in the initial study are sustained.
Source: rss
Fall Picks
fall essentials
As an affiliate, we earn on qualifying purchases.
