Virtual Weight Management and Continuous Glucose Monitoring in Patients With Type 2 Diabetes: A Randomized Controlled Trial

OBJECTIVE: This study examined the effectiveness of behavioral weight management integrated with continuous glucose monitoring (CGM) among adults with overweight or obesity and type 2 diabetes. METHODS: This was a two-arm, parallel, randomized clinical trial. Participants (n = 151) were randomly assigned to intervention (INT; n = 75) or usual care (UC; N = 76). INT participants received a behavioral weight management program tailored for type 2 diabetes and CGM. UC participants received a session with a dietitian and educational materials. The primary outcome was 6-month change in HbA1c%. Additional outcomes included changes in weight, waist circumference, blood pressure, CGM metrics, diabetes stress, and treatment satisfaction. RESULTS: INT reduced HbA1c% (-0.87%; 95% CI: -1.17%, -0.57%) more than UC (-0.41%; -0.72%, -0.10%) (difference: -0.46%; -0.89%, -0.03%; p = 0.037). INT had greater reductions in percent body weight compared to UC (difference: -3.2%; -4.9%, -1.5%; p < 0.001). Several CGM metrics improved significantly more in INT than UC, and INT had significantly greater improvements in diabetes treatment satisfaction and regimen-related diabetes stress relative to UC. CONCLUSIONS: Integrating CGM with a digital weight management program produced significantly greater improvements in HbA1c%, body weight, and other glucose metrics compared to UC among adults with overweight or obesity and type 2 diabetes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05935514.