Glucose Sensors Help Type 2 Diabetes Even Without Insulin

Jeff's Daily Pick. Glucose sensors are usually for people on insulin. In a new NEJM trial, people with type 2 diabetes who don't take insulin cut their HbA1c almost a full point more with one.

In the United States, the CONNECT trial, published on October 14, 2026 in The New England Journal of Medicine, tested continuous glucose monitoring in adults with type 2 diabetes who do not use insulin. CGM is standard care for insulin users. Whether it helps people managed with pills or GLP-1 drugs had lacked a large randomized trial.

The trial

Researchers at 22 primary care practices screened 440 adults and randomized 283 with an HbA1c of 7.5% or higher to a Dexcom G7 sensor or to routine care with fingerstick meter testing, for 26 weeks. Visits occurred by video at weeks 1, 4, 8 and 19 and in clinic at weeks 13 and 26, where clinicians reviewed data and adjusted lifestyle advice or medicines. The study was funded by Dexcom and first presented at the American Diabetes Association meeting on June 6.

The results

HbA1c fell from 8.8% to 7.2% in the CGM group and from 8.7% to 8.0% with routine care. The adjusted difference was 0.9 percentage points (95% CI 0.6 to 1.1). An HbA1c below 7% was reached by 46% versus 24%. Time in the 70 to 180 mg/dL range was 62% against 42%, an adjusted gain of 21 points, about five hours a day. Mean glucose was 175 versus 207 mg/dL, and time above 250 mg/dL 7% versus 22%. Neither group had severe hypoglycemia, and time below 70 mg/dL stayed under 1%. Among participants on GLP-1 drugs, the additional reduction was also 0.9 points, Dexcom said.

A 0.9 point gap is about what an added diabetes drug delivers, which is why the authors at CU Anschutz described the effect as comparable to some medications. A 2026 meta analysis of 25 smaller trials found a more modest average of 0.34 points, so CONNECT sits at the high end. The policy question is coverage: Medicare coverage has centered on insulin users, and diabetes device makers expect CMS to widen it, MedTech Dive reported. Our piece on new diabetes devices covers the insulin side.