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In the 283-person CONNECT randomized trial, adults with type 2 diabetes who were not treated with insulin and used continuous glucose monitors had a larger HbA1c reduction and spent more time in the target glucose range than participants receiving routine care. The study lasted 26 weeks; whether the benefits persist and match routine real-world use remains under study.
Adults with type 2 diabetes not treated with insulin had lower HbA1c levels and spent more time in their target glucose range when using continuous glucose monitors, compared with routine care, in the 26-week CONNECT randomized trial. The findings add trial evidence for CGM use in a group for whom guidance has had less evidence than for people using insulin.
The trial included 283 adults treated at 22 U.S. primary care practices. By week 26, average HbA1c fell from 8.8% to 7.2% among participants assigned to CGM, compared with a reduction from 8.7% to 8.0% with routine care. The adjusted difference between groups was 0.9 percentage points in favor of CGM (95% confidence interval, 0.6 to 1.1 points; P<0.001), according to the study report in the New England Journal of Medicine.
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, a difference equivalent to about five additional hours per day. Time spent above 250 mg/dL was also 15 percentage points lower in the CGM group. The report said time spent below 70 mg/dL and below 54 mg/dL was slightly lower with CGM.
Median CGM use was 97% of the time during the study. No severe hypoglycemia or hyperglycemia-related serious adverse events were reported. Three sensor-related adverse events occurred in the CGM group: two involving bleeding at the insertion site and one during sensor removal. The study also reported 33 adverse events in that group and 24 in the routine-care group.
Evidence for CGM Beyond Insulin Use
The results address a gap in evidence for CGM among people with type 2 diabetes who are not using insulin. The report said the 2026 American Diabetes Association Standards of Care cited level A evidence for CGM in people receiving insulin, but level C evidence for people with diabetes not treated with insulin. The CONNECT results may inform future discussions about CGM in this population, though the trial alone does not establish how guidance or coverage policies will change.
The findings matter for patients whose glucose remains above target despite non-insulin treatment. CGM provides ongoing glucose readings that can help users see patterns over time. The study authors said the observed improvement could reflect changes in behavior, such as habits that affect glucose, as well as the monitor’s feedback. The trial did not establish which specific behavioral changes occurred or how much they contributed.
continuous glucose monitor for adults with type 2 diabetes
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How CONNECT Tested CGM
CONNECT enrolled adults aged 21 to 84 who had type 2 diabetes for at least six months and a baseline HbA1c of at least 7.5%. Participants had not used real-time CGM in the previous six months or insulin in the previous 12 months. Their non-insulin glucose-lowering or weight-loss medicines had to be stable for at least one month before enrollment.
The trial took place in primary care practices, where most people with type 2 diabetes receive care, according to the investigators. At baseline, 40% of participants used a GLP-1 receptor agonist, 37% used an SGLT2 inhibitor, and 18% used both. During the trial, insulin or other glucose-lowering medicines were added for 31% of the CGM group and 17% of the routine-care group.
Because only a minority had medicines added, the investigators said medication changes alone could not explain the improvement. They also cautioned that the study supplied sensors and included scheduled visits, which may have supported high device use. Previous trials had established CGM benefits for type 1 diabetes and insulin-treated type 2 diabetes, while evidence for non-insulin-treated type 2 diabetes had been more limited.
“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, in the CONNECT report
CGM device non-insulin dependent diabetes
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Durability and Everyday Use Remain Open
The trial reports outcomes at 26 weeks; it does not yet show whether the glucose improvements continue over a longer period. A 26-week extension is underway to examine sustained CGM use and how durable the effects are.
It is also not clear whether adherence and benefits will be as high outside the trial, where participants may not receive the same sensor provision or visit schedule. The study report does not establish which patients would benefit most, the cost-effectiveness of CGM for this group, or how the results will affect insurance coverage and clinical recommendations.
glucose monitoring system for type 2 diabetes
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Extension Study Will Track Longer-Term Effects
The CONNECT extension will follow participants for an additional 26 weeks to assess whether people continue using CGM and whether the observed glucose changes persist. Those results should help clarify durability, but they will not by themselves answer every question about access, cost, or outcomes in routine practice.
For now, the reported evidence is from a six-month randomized trial in adults with elevated baseline HbA1c who were not using insulin. Further follow-up and real-world evidence will be needed to show how broadly the findings apply beyond the study conditions.
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Key Questions
What did the CONNECT trial find?
In the 26-week trial, adults with type 2 diabetes not using insulin who were assigned to CGM had a greater average HbA1c reduction and spent more time in the 70–180 mg/dL target range than those receiving routine care.
How much did HbA1c change?
Average HbA1c fell from 8.8% to 7.2% in the CGM group and from 8.7% to 8.0% in the routine-care group by week 26. The adjusted difference between groups was 0.9 percentage points in favor of CGM.
Did the trial report serious safety events?
No cases of severe hypoglycemia or hyperglycemia-related serious adverse events were observed during the trial. Three sensor-related events were reported in the CGM group, including two cases of insertion-site bleeding and one event during sensor removal.
Are the benefits known to last beyond six months?
That remains unclear. A 26-week extension is underway to assess continued CGM use and whether the glucose benefits persist.
Does this trial mean CGM is now recommended for everyone with type 2 diabetes?
No. The study provides evidence for adults matching its eligibility criteria, including elevated baseline HbA1c and no recent insulin use. It does not establish a universal recommendation or determine how clinical guidance and coverage policies will change.
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