Continuous glucose monitoring in persons with type 2 diabetes not using insulin

ABSTRACT

Introduction

CGM is an evidence-based intervention to improve glycemic control in persons with T1D and T2D using insulin. Use of CGM in persons with T2D not using insulin is not well studied.

Areas covered

Existing clinical evidence for the use of CGM in persons with T2D is reviewed with a focus on persons with T2D not using insulin. Additional perspective and consideration are provided on the role and rationale for using CGM in persons with T2D not using insulin.

Expert opinion

On the basis of available evidence, persons with T2D not using insulin benefit clinically through reduction in HbA1c, and improvement in time in range. Additional benefits include improvement in behavior modification, satisfaction, quality of life, empowerment, and diabetes distress. Drivers of these benefits are independent of insulin use in persons with T2D and may include an improved understanding of how diet, lifestyle, and exercise impact diabetes through CGM use. Clinical benefits from CGM independent of medication use include ability to modify health behavior and subsequently improve self-management.

KEYWORDS:

• Continuous glucose monitoring
• flash glucose monitoring
• intermittent scanned continuous glucose monitoring
• type 2 diabetes
• diabetes mellitus
• diabetes technology

Article Highlights

• CGM can be used to monitor additional glycemic metrics beyond hemoglobin A1c (HbA1c) and traditional self-monitoring of blood glucose, which provide a more comprehensive assessment of glycemic control.

• High-quality evidence supports that CGM improves glycemic control, patient satisfaction, and reduces hypoglycemia in persons with T2D using intensive insulin therapy, though is less studied in persons with T2D not using insulin.

• Clinical benefits in persons with T2D not using insulin include reduction in HbA1c, improvement in time in range and improvement in behavior modification, satisfaction, quality of life, diabetes knowledge, and diabetes distress.

• In persons with T2D not using insulin, CGM presents an opportunity to: (i) facilitate or enhance shared decision-making between the PWD and clinician; (ii) lead to earlier treatment intensification and subsequently overcome clinical inertia; and (iii) improve understanding of lifestyle factors affecting glycemic control, and/or response to drug and/or lifestyle interventions.

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.