TL;DR
The CONNECT randomized trial found that adults with type 2 diabetes who were not using insulin had lower HbA1c and spent more time in target glucose range with continuous glucose monitoring (CGM) than with routine care over 26 weeks. The researchers reported high device use and no severe hypoglycemia or hyperglycemia-related serious adverse events, but longer-term effects and real-world adherence remain uncertain.
A 26-week randomized trial found that continuous glucose monitoring (CGM) improved blood sugar measures in adults with type 2 diabetes not treated with insulin, compared with routine care. The CONNECT study reported a larger drop in HbA1c and about five additional hours per day in target glucose range for participants assigned to CGM, adding trial evidence for a group with less-established guidance on device use.
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The trial included 283 adults treated at 22 U.S. primary care practices. Participants had type 2 diabetes for at least six months and 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. By week 26, mean HbA1c fell from 8.8% to 7.2% in the CGM group and from 8.7% to 8.0% in the routine-care group. The adjusted difference between groups was 0.9 percentage points in favor of CGM.
Participants using CGM spent 21 percentage points more time in the target glucose range of 70 to 180 mg/dL than those receiving routine care, equivalent to about five hours a day. Time spent above 250 mg/dL was also lower in the CGM group. The researchers reported lower time in hypoglycemia as well, and no cases of severe hypoglycemia or serious adverse events related to hyperglycemia were observed.
Device use was high: CGM participants used their sensors for a median of 97% of the study period. The study report, published in the New England Journal of Medicine and covered by MedPage Today, was led by Roy W. Beck, MD, PhD, of the Jaeb Center for Health Research in Tampa, Florida. The researchers also reported that glucose-lowering or weight-loss medications were added for 31% of the CGM group and 17% of the routine-care group during the trial.
Evidence for CGM Without Insulin
The findings address an evidence gap for people with type 2 diabetes who do not use insulin. CGM is recommended for people with type 1 diabetes and for many people with insulin-treated type 2 diabetes, while the evidence base for use without insulin has been more limited. A randomized comparison in primary care settings gives clinicians and patients additional data when considering glucose-monitoring options for people whose HbA1c remains elevated.
The observed differences could matter in daily management because glucose readings can show patterns over time rather than only a periodic HbA1c result. However, the trial measured glucose outcomes over 26 weeks; it does not establish whether CGM use will produce lasting benefits, improve long-term complications, or be practical and affordable for every patient. The results support considering the device as an option, not a guarantee of a particular outcome.
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How CONNECT Tested CGM
CONNECT was conducted at 22 primary care practices, where much type 2 diabetes care takes place. Participants were 21 to 84 years old, with a mean age of about 59 to 60. Their non-insulin glucose-lowering or weight-loss medications had to be stable for the month before enrollment. At baseline, 40% were taking a GLP-1 receptor agonist, 37% an SGLT2 inhibitor, and 18% both drug classes.
In the 2026 American Diabetes Association Standards of Care, the evidence cited for CGM use is stronger for people receiving insulin than for those with diabetes not treated with insulin. The CONNECT investigators said prior trials had established benefits in type 1 and insulin-treated type 2 diabetes, while evidence for the non-insulin-treated group was less developed. The trial was designed to assess CGM in that population against routine care.
“Results for glycated hemoglobin and time-in-range outcomes were similar across a wide range of participant characteristics.”
— Roy W. Beck and colleagues, reporting the CONNECT trial
Durability and Daily Use
The trial followed participants for 26 weeks, so it does not yet show whether the improvements persist over a longer period or affect complications and other long-term health outcomes. It also does not establish how results would translate to routine use outside the study. The researchers said sensor provision and study visits may have helped produce the high adherence rate, which could be lower in everyday care.
Medication changes complicate interpretation, though the investigators said those changes alone could not explain the observed improvement because they occurred for only a minority of participants. The study also does not show that every person with non-insulin-treated type 2 diabetes would benefit to the same degree. Cost, access, patient preference, and how clinicians act on the readings were not resolved by the reported results.
Extension Will Test Lasting Effects
A 26-week extension phase is underway to examine whether participants continue using CGM and whether the glucose benefits persist. Those results may clarify durability beyond the initial trial period. Until then, the findings provide evidence about short-term glucose measures, while longer-term outcomes and adherence in routine practice remain open questions.
Key Questions
What did the CONNECT trial find?
Over 26 weeks, adults with non-insulin-treated type 2 diabetes assigned to CGM had a larger average HbA1c reduction and spent more time in the 70-to-180 mg/dL target range than participants receiving routine care.
How much more time did CGM users spend in target range?
The CGM group spent 21 percentage points more time in the target range, equivalent to about five additional hours per day compared with routine care.
Were serious safety problems reported?
The trial reported no cases of severe hypoglycemia or serious adverse events related to hyperglycemia. Three sensor-related adverse events were reported in the CGM group: two involving bleeding at the insertion site and one during sensor removal.
Does the study prove CGM works equally well in everyday care?
No. Sensor use was high in the trial, but the investigators said study-provided sensors and visit frequency may have supported adherence. Use and benefit could be lower in routine practice.
What happens after the 26-week trial?
A 26-week extension is underway to assess continued CGM use and whether the effects last. The initial findings do not establish longer-term health outcomes.
Source: rss
