title: Short- and long-term effects of real-time continuous glucose monitoring in patients with type 2 diabetes.
abstract: OBJECTIVE
  To determine whether short-time, real-time continuous glucose monitoring (RT-CGM) has long-term salutary glycemic effects in patients with type 2 diabetes who are not on prandial insulin.
  
  
  METHODS
  This was a randomized controlled trial of 100 adults with type 2 diabetes who were not on prandial insulin. This study compared the effects of 12 weeks of intermittent RT-CGM with self-monitoring of blood glucose (SMBG) on glycemic control over a 40-week follow-up period. Subjects received diabetes care from their regular provider without therapeutic intervention from the study team.
  
  
  RESULTS
  There was a significant difference in A1C at the end of the 3-month active intervention that was sustained during the follow-up period. The mean, unadjusted A1C decreased by 1.0, 1.2, 0.8, and 0.8% in the RT-CGM group vs. 0.5, 0.5, 0.5, and 0.2% in the SMBG group at 12, 24, 38, and 52 weeks, respectively (P = 0.04). There was a significantly greater decline in A1C over the course of the study for the RT-CGM group than for the SMBG group, after adjusting for covariates (P < 0.0001). The subjects who used RT-CGM per protocol (≥48 days) improved the most (P < 0.0001). The improvement in the RT-CGM group occurred without a greater intensification of medication compared with those in the SMBG group.
  
  
  CONCLUSIONS
  Subjects with type 2 diabetes not on prandial insulin who used RT-CGM intermittently for 12 weeks significantly improved glycemic control at 12 weeks and sustained the improvement without RT-CGM during the 40-week follow-up period, compared with those who used only SMBG.
authors.affiliation: Department of Endocrinology and Metabolism, Diabetes Institute, Walter Reed National Military Medical Center, Bethesda, Maryland, USA. robert.vigersky@us.army.mil
authors.forename: Robert A
authors.initials: RA
authors.lastname: Vigersky
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Fonda
authors.forename: Mary
authors.initials: M
authors.lastname: Chellappa
authors.forename: M Susan
authors.initials: MS
authors.lastname: Walker
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Ehrhardt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D003199:Computer Systems; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
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