Continuous monitoring showed a substantial daily difference
Continuous glucose monitors may improve blood-sugar management for adults with type 2 diabetes who do not take insulin, according to findings reported in the New England Journal of Medicine. In the clinical trial, participants using a continuous glucose monitor, or CGM, spent approximately five additional hours a day within their target glucose range compared with people receiving routine care.
The result addresses a large group of patients whose diabetes is generally managed outside specialist settings. The study authors estimate that 20 million adults in the United States have type 2 diabetes and do not take insulin. Despite advances in treatment, many do not reach glycemic targets.
For people with diabetes, persistently elevated blood sugar can raise the risk of serious complications, including heart disease, kidney disease and vision loss. The findings therefore focus on whether a monitoring tool can help people make practical day-to-day decisions that improve control before those long-term consequences develop.
What CGMs add to routine diabetes care
A CGM uses a small sensor worn on the body to track glucose continuously through the day and night. Rather than relying only on occasional measurements, users can see how glucose responds to meals, physical activity and other daily habits. That immediate feedback may give patients more information for managing their condition.
The trial found benefits on more than one measure. CGM users had significantly greater improvements in A1c, a measure of average blood sugar over roughly three months. The difference between the CGM and routine-care groups was 0.9 percentage points, which the report says exceeds the threshold generally considered clinically meaningful.
Nearly twice as many people using CGMs also reached an A1c level below 7%, a common treatment goal for people with diabetes. The combination of an improvement in A1c and more time in the target glucose range suggests that the effect was not limited to a single test result.
A primary-care trial at scale
The study enrolled 283 adults at 22 U.S. primary-care practices and followed them for 26 weeks. The researchers describe it as the first large-scale, multicenter randomized controlled trial to evaluate the effectiveness and safety of CGM use in adults with type 2 diabetes who do not take insulin.
Its setting is central to the result. Unlike smaller earlier studies, this trial exclusively enrolled patients receiving diabetes care through primary-care practices, where most Americans with type 2 diabetes receive care. That makes the findings particularly relevant to the places where broader use of CGMs would need to occur.
Tamara Oser, a professor in the University of Colorado Anschutz Department of Family Medicine and the study’s first author, said improving care remains important because many patients still do not meet glycemic targets. The trial indicates that continuous information about glucose patterns can be useful even for people whose treatment does not include insulin.
What the findings mean
The study does not make CGMs a substitute for clinical care, medication or the individual decisions patients make with their health professionals. It does show that, over 26 weeks, access to continuous glucose information was associated with more time in a healthy glucose range and a larger improvement in A1c than routine care.
For primary-care practices, the result raises the prospect that a tool once most closely associated with insulin treatment could have a wider role. The potential population is large, and the trial’s design directly examined people who do not use insulin rather than assuming evidence from insulin-treated patients would apply to them.
The central finding is also easy to understand in daily terms: participants using CGMs spent about five more hours each day in their target blood-sugar range. In a condition managed continuously between appointments, that added visibility into food, activity and glucose response may be a meaningful part of improving control.
This article is based on reporting by Medical Xpress. Read the original article.
Originally published on medicalxpress.com
