title: The effect of real-time continuous glucose monitoring on glycemic control in patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  Real-time continuous glucose monitoring (RT-CGM) improves hemoglobin A1c (A1C) and hypoglycemia in people with type 1 diabetes mellitus and those with type 2 diabetes mellitus (T2DM) on prandial insulin; however, it has not been tested in people with T2DM not taking prandial insulin. We evaluated the utility of RT-CGM in people with T2DM on a variety of treatment modalities except prandial insulin.
  
  
  METHODS
  We conducted a prospective, 52-week, two-arm, randomized trial comparing RT-CGM (n = 50) versus self-monitoring of blood glucose (SMBG) (n = 50) in people with T2DM not taking prandial insulin. Real-time continuous glucose monitoring was used for four 2-week cycles (2 weeks on/1 week off). All patients were managed by their usual provider. This article reports on changes in A1C 0-12 weeks.
  
  
  RESULTS
  Mean (± standard deviation) decline in A1C at 12 weeks was 1.0% (± 1.1%) in the RT-CGM group and 0.5% (± 0.8%) in the SMBG group (p = .006). There were no group differences in the net change in number or dosage of hypoglycemic medications. Those who used the RT-CGM for ≥ 48 days (per protocol) reduced their A1C by 1.2% (± 1.1%) versus 0.6% (± 1.1%) in those who used it <48 days (p = .003). Multiple regression analyses statistically adjusting for baseline A1C, an indicator for usage, and known confounders confirmed the observed differences between treatment groups were robust (p = .009). There was no improvement in weight or blood pressure.
  
  
  CONCLUSIONS
  Real-time continuous glucose monitoring significantly improves A1C compared with SMBG in patients with T2DM not taking prandial insulin. This technology might benefit a wider population of people with diabetes than previously thought.
authors: Department of Endocrinology and Metabolism, Walter Reed Army Medical Center, Washington DC, USA.
authors: Nicole M
authors: NM
authors: Ehrhardt
authors: Mary
authors: M
authors: Chellappa
authors: M Susan
authors: MS
authors: Walker
authors: Stephanie J
authors: SJ
authors: Fonda
authors: Robert A
authors: RA
authors: Vigersky
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000737:chemistry; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy; D007328:Insulin / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human