A new CGM type 2 diabetes readout from the CONNECT trial shows continuous glucose monitoring cuts A1c more than standard care in non-insulin T2D adults.

Coauthor Thomas W. Martens, MD, presented at the American Diabetes Association (ADA) 2026 Scientific Sessions in New Orleans. Martens is with the International Diabetes Center at HealthPartners Institute in Minneapolis.

Why the CGM type 2 diabetes question matters

CGM remains the established standard of care for type 1 diabetes and insulin-treated T2D. Evidence for non-insulin T2D has been thin. Many patients run A1c levels above target even on SGLT2 inhibitors or GLP-1 receptor agonists (RAs). The question: would wearing a CGM itself drive better outcomes.

How the CONNECT trial was set up

Martens and colleagues enrolled 283 adults with T2D not taking insulin from 22 primary care practices across the US.

Patients were randomized 1:1.

• CGM arm (n = 145): Dexcom G7 device.

• Standard care arm (n = 138): routine blood glucose meter testing.

Both arms continued pre-study medications and received diet and exercise education and check-ins.

Mean age was 60, with median T2D duration 10 years (range 1-37). Mean A1c sat high at 8.8%, with 31% at or above 9%. Mean BMI reached 33 kg/m2. Some 13% had used insulin but had stopped over a year before enrollment.

Regarding background medications, 37% were on an SGLT2 inhibitor and 40% on an incretin-based agent like a GLP-1 RA.

The A1c numbers were striking

Completion rates in the CGM type 2 diabetes trial were 97% in the CGM arm and 90% in standard care at 26 weeks.

The headline A1c outcome favored CGM by a wide margin.

• CGM arm: 1.6% A1c reduction at 26 weeks.

• Standard care arm: 0.7% A1c reduction.

• Between-arm difference: 0.9% (P < .001).

The CGM type 2 diabetes treatment effect tracked with starting A1c levels. Patients with baseline A1c under 8% dropped 0.6% on CGM vs 0.4% on standard care. Those at or above 10% baseline dropped 3.1% on CGM vs 1.2% on standard care.

Bigger response rates and target attainment

The share hitting clinically meaningful A1c gains in the CGM type 2 diabetes data shifted toward CGM.

• A1c reduction ≥ 0.5%: 82% in the CGM arm vs 56% in standard care (P < .001).

• A1c below 8.0%: 84% in the CGM arm vs 56% in standard care (P < .001).

A1c reductions held across drug regimens, with patients responding on SGLT2 inhibitors, GLP-1 RAs, and other agents.

Time in range also moved

The target was 70-180 mg/dL. CGM users gained 5 hours per day in target over standard care patients. Time in target climbed from 29% at baseline to 62% across weeks 13 and 26 in the CGM arm. Standard care moved from 31% to 42% (P < .001).

"The greatest improvement was seen in participants with the highest baseline A1c and lowest time in range, who have the highest risk for vascular complications," Martens said.

"And the benefit was observed in both users and nonusers of GLP-1 RA and SGLT2 inhibitor medications," he added.

Severe hypoglycemia did not occur in either arm. Other serious adverse events unrelated to CGM ran at similar rates between groups. CGM users reported greater satisfaction and lower diabetes-related distress.

What outside experts said

The data carries weight for coverage policy. Beck, an outside expert, said earlier small studies had hinted at gains but a large randomized trial was missing.

"Consequently, CGM is not covered by Medicare or most commercial insurers for patients with [T2D] not using insulin, which represents about 75% of adults in the US with [T2D], or about 20 million patients," Beck said.

Josh Neumiller, PharmD, of Washington State University in Spokane, said the trial helps answer a long-running question. Neumiller is the Allen I. White Distinguished Professor at the College of Pharmacy.

"This study really helps us answer that question, [showing] that just having that CGM on board can, in and of itself, lower A1c, nearing 1% in the trial," Neumiller said.

He added that diabetes is largely self-managed: patients who observe their own glucose response to food, activity, and medications often achieve better management. The CGM type 2 diabetes trial supports that view.

Dexcom funded the trial. Coverage on Medigear.uk shows why primary care and endocrinology teams must track CGM results for type 2 diabetes.

Source: Originating coverage based on Medscape Medical News reporting on the CONNECT trial presented at the American Diabetes Association (ADA) 2026 Scientific Sessions in New Orleans. Coauthor Thomas W. Martens, MD, International Diabetes Centre, HealthPartners Institute, Minneapolis, Minnesota. Outside commentary from Josh Neumiller, PharmD, Washington State University, Spokane. Funded by Dexcom.