Aurora – October 14, 2026 -- Adults with type 2 diabetes who do not take insulin spent about five more hours per day within their target blood sugar range when using continuous glucose monitors (CGMs) than patients receiving routine care, according to a randomized trial published in the New England Journal of Medicine.
Nearly twice as many CGM users reached an A1c below 7%, a common treatment goal. The A1c gap between the two groups was 0.9 percentage points, which the researchers say greatly exceeds the threshold generally considered clinically meaningful.
Trial enrolled 283 adults across 22 primary care practices
Participants were followed for 26 weeks. The University of Colorado Anschutz team describes the study as the first large-scale, multicenter randomized controlled trial to evaluate the effectiveness and safety of CGM in adults with type 2 diabetes who do not take insulin.
Unlike smaller earlier studies, the trial enrolled only patients receiving diabetes care in primary care practices, where most Americans with type 2 diabetes are treated. The authors say this makes the findings particularly relevant to everyday clinical care.
Evidence gap in ADA guidelines could narrow
The American Diabetes Association's Standards of Care currently cite Level A evidence, the highest rating, for CGM use in patients who take insulin. Recommendations for patients who do not take insulin rest on Level C evidence, reflecting more limited research.
The researchers hope the data will help close that gap. First author Tamara Oser, MD, a professor in the Department of Family Medicine at the University of Colorado Anschutz, said she hopes the research will strengthen national guidelines and expand insurance coverage.
About 20 million U.S. adults fall into the target population
Oser estimates that 20 million adults in the United States have type 2 diabetes and do not take insulin. Many of them still do not reach glycemic targets. Elevated blood sugar raises the risk of heart disease, kidney disease and vision loss.
CGMs use a small body-worn sensor to track glucose around the clock, showing patients how food and physical activity affect their levels. For now, the authors recommend that patients in this group discuss CGM use with their primary care providers.