Loading ...

Continuous glucose monitoring (CGM) has transformed the management of type 1 diabetes and is now an integral part of routine care. Growing evidence suggests that CGM may also provide important benefits in type 2 diabetes (T2D), prompting questions about whether its use should be expanded. Several recent studies have offered insights into its potential role.

CGM is already used in some individuals with T2D, particularly in those receiving insulin therapy, and may be reimbursed in certain settings. However, most proposed applications in T2D involve temporary or intermittent use rather than continuous monitoring.

Short-term CGM use soon after a T2D diagnosis could help identify distinct disease subtypes and guide treatment decisions. In patients with T2D already receiving treatment, periodic use, such as a 15-day monitoring period twice a year, may improve disease management. Temporary CGM use has also been proposed as a tool for the earlier detection of prediabetes in individuals at increased risk.

A systematic review and meta-analysis from Singapore, published in January 2026 in Frontiers in Endocrinology, evaluated the effectiveness of real-time CGM (rtCGM) compared with self-monitoring of blood glucose using fingerstick testing in people with T2D. Primary outcomes included glycemic control, cardiometabolic measures, and patient-centered outcomes.

The analysis included 11 randomized controlled trials published between 2008 and 2023. Overall, 437 participants used rtCGM and 352 used self-monitoring via fingerstick testing. The mean age ranged from 53 to 70 years. Monitoring was continuous in six trials and intermittent in five, with intervention periods ranging from 12 to 56 weeks.

Compared with fingerstick testing, rtCGM was associated with significant reductions in A1c, improvements in time in range (TIR), and reductions in both time above range and time below range (TBR). rtCGM was also associated with lower glycemic variability and improved patient self-management.

CGM Plus Personalized Coaching

A prospective cohort study from South Korea, published in February 2026 in Primary Care Diabetes, evaluated the effects of rtCGM combined with personalized online coaching in individuals with T2D or prediabetes.

Although the study included only 110 participants and the intervention lasted only 8 weeks, improvements in glycemic control were seen in both groups. Reductions in A1c were greatest among participants with high glycemic variability, highlighting the potential value of monitoring this parameter. Access to real-time glucose data also appeared to increase patient engagement and awareness, encouraging healthier eating habits and greater physical activity.

CGM in Older Adults

A narrative review published in Diabetes Therapy in April 2025 examined studies comparing fingerstick glucose monitoring with CGM in adults older than 65 years with type 1 diabetes or T2D who were receiving insulin therapy.

The authors noted that relying solely on A1c in older adults may increase the risk for overtreatment. Instead, treatment goals should be individualized and include the prevention of hypoglycemia and its associated adverse effects.

By providing detailed information on glycemic patterns and variability, including TIR and TBR, CGM may help identify overtreatment and support individualized diabetes management in older adults.

This story was translated from MediQuality, part of the Medscape Professional Network.