Continuous glucose monitoring for glycaemic control and cardiovascular risk reduction in patients with type 2 diabetes not on insulin therapy: A clinical trial

Abstract Aim To evaluate the impact of the Dexcom G6 continuous glucose monitoring (CGM) device on glycaemic control and cardiometabolic risk in patients with type 2 diabetes mellitus (T2DM) at high cardiovascular risk who are not on insulin therapy. Materials and Methods Adults with T2DM with glycated haemoglobin (HbA1c) >7% and body mass index (BMI) ≥30 kg/m 2 not using insulin were enrolled in a two‐phase cross‐over study. In phase 1, CGM data were blinded, and participants performed standard glucose self‐monitoring. In phase 2, the CGM data were unblinded, and CGM, demographic and cardiovascular risk factor data were collected through 90 days of follow‐up and compared using paired tests. Results Forty‐seven participants were included (44% women; 34% Black; mean age 63 years; BMI 37 kg/m 2 ; HbA1c 8.4%; 10‐year predicted atherosclerotic cardiovascular disease risk 24.0%). CGM use was associated with a reduction in average glucose (184.0 to 147.2 mg/dl, p < .001), an increase in time in range (57.8 to 82.8%, p < .001) and a trend towards lower glucose variability (26.2 to 23.8%). There were significant reductions in HbA1c, BMI, triglycerides, blood pressure, total cholesterol, diabetes distress and 10‐year predicted risk for atherosclerotic cardiovascular disease ( p < .05 for all) and an increase in prescriptions for sodium‐glucose cotransporter 2 inhibitors (36.2 to 83.0%) and glucagon‐like peptide‐1 receptor agonists (42.5 to 87.2%, p < .001 for both). Conclusions Dexcom G6 CGM was associated with improved glycaemic control and cardiometabolic risk in patients with T2DM who were not on insulin. CGM can be a safe and effective tool to improve diabetes management in patients at high risk for adverse cardiovascular outcomes.