NEW YORK, Oct 16: Wearable continuous glucose monitoring devices may offer meaningful benefits to people with type 2 diabetes who do not use insulin, according to a new clinical study that could influence how doctors approach long-term blood sugar management.
The study, reported by Reuters on Friday, found that adults who used the Dexcom G7 continuous glucose monitoring system experienced a greater reduction in average blood sugar levels than patients receiving routine care over six months.
The findings could broaden the potential role of wearable monitoring technology, which has traditionally been associated with people who require insulin to manage their diabetes. Researchers said the results support considering these devices earlier in treatment for selected patients with type 2 diabetes.
The trial involved 283 adults who were not using insulin. Participants were assigned either to continuous glucose monitoring or to routine diabetes care, allowing researchers to compare changes in blood sugar control over the study period.
The research was sponsored by Dexcom, the manufacturer of the monitoring device. The findings were reported in The New England Journal of Medicine.
Study records greater improvement in blood sugar levels
The researchers assessed changes in glycated haemoglobin, commonly known as HbA1c, which provides an estimate of a person’s average blood glucose levels over approximately two to three months.
Among participants using the Dexcom G7 system, average HbA1c declined from 8.8 per cent at the beginning of the study to 7.2 per cent after six months.
In the routine-care group, the average fell from 8.7 per cent to 8.0 per cent during the same period.
After accounting for individual risk factors, the researchers reported that participants using the wearable monitoring system achieved an approximately one-percentage-point greater reduction in HbA1c compared with those receiving standard care.
The results indicate that continuous glucose monitoring may help some patients improve their understanding of how everyday activities and treatment decisions affect blood sugar levels.
However, the findings should not be interpreted as proof that every person with type 2 diabetes needs a wearable monitor. Treatment decisions depend on individual medical circumstances, glucose levels, existing medication, affordability and a healthcare professional’s assessment.
How continuous glucose monitoring works
Continuous glucose monitoring systems use a small sensor placed on the body to measure glucose levels in the fluid beneath the skin. The device sends readings to a compatible receiver or smartphone, allowing users to observe changes throughout the day and night.
Unlike conventional finger-prick testing, which measures glucose at a particular moment, these systems provide repeated readings and can display trends over time.
Users may be able to identify patterns associated with meals, physical activity, sleep, stress and medication. Depending on the device and its settings, alerts can also warn users when glucose levels move beyond specified thresholds.
The Dexcom G7 system used in the study employs a small wearable sensor attached to the upper arm. Its readings can help users and healthcare professionals understand how glucose levels change during ordinary daily routines.
For someone managing type 2 diabetes without insulin, these patterns may provide additional information about the effects of food choices, exercise and prescribed medication.
For example, monitoring data may help a patient recognise that certain meals are consistently followed by substantial glucose increases. A doctor or diabetes educator can then use that information to discuss practical adjustments to diet, activity or treatment.
The device does not independently cure diabetes or eliminate the need for medical supervision. Its value depends on whether the information helps patients and clinicians make appropriate decisions.
Participants spent more time within the target range
In addition to the improvement in HbA1c, the study found that participants using continuous glucose monitoring spent approximately five additional hours each day within the target glucose range of 70 to 180 milligrams per decilitre compared with those receiving routine care.
Time in range is an increasingly used measure of diabetes management because it shows how long glucose levels remain within a specified interval rather than relying exclusively on an average.
Two people can have similar HbA1c readings but different daily glucose patterns. One may experience frequent rises and falls, while the other maintains more stable levels. Continuous monitoring can help reveal these differences.
The additional time spent within the target range suggests that the devices may provide useful information for managing daily glucose fluctuations.
Nevertheless, target ranges should be individualised where appropriate, particularly for older adults and people who have other health conditions or face an increased risk of low blood sugar.
Researchers also reported that the benefits were observed across different participant groups, including variations in age, sex, race and ethnicity, body mass index, income, education, insurance status and glucose-lowering medication use.
At the end of the six-month trial, approximately 97 per cent of participants were still using their monitors, with most continuing daily use. This level of continued use suggests that the participants generally found the technology practical enough to incorporate into their routines during the study.
Longer-term research will be needed to establish whether the improvements persist over several years and whether they lead to fewer diabetes complications.
Why the findings matter for type 2 diabetes care
Type 2 diabetes is a chronic condition in which the body does not use insulin effectively or cannot produce enough insulin to maintain normal blood glucose levels. Poorly controlled diabetes can increase the risk of cardiovascular disease, kidney damage, vision problems, nerve injury and other complications.
Management commonly involves a combination of prescribed medication, balanced nutrition, physical activity, weight management where appropriate and regular medical monitoring.
For some patients who do not use insulin, glucose testing may be less frequent than it is for people whose treatment requires close monitoring. As a result, patients may have limited information about how their blood sugar responds to everyday habits.
Continuous glucose monitoring could help address that information gap by showing glucose patterns that occasional measurements may miss.
The data may also make consultations more specific. Rather than relying entirely on a patient’s recollection of meals, symptoms or medication routines, healthcare professionals can examine recorded patterns and discuss possible changes.
Researchers suggested that the consistency of the observed benefits supports considering monitoring technology earlier in the management of type 2 diabetes, before insulin becomes necessary.
Such an approach could be particularly relevant for patients who struggle to achieve their treatment targets or need more detailed feedback to understand their glucose fluctuations.
However, the study does not establish that continuous monitoring should replace conventional testing or become mandatory for all patients. Its appropriate use will depend on clinical guidelines, individual needs and the resources available within different healthcare systems.
Cost and access remain important considerations
Despite the potential clinical benefits, affordability remains a major issue in determining how widely continuous glucose monitoring can be used.
Wearable sensors may involve recurring expenses because they need to be replaced according to the manufacturer’s instructions. Patients may also need compatible smartphones or receivers and access to technical support.
Insurance coverage and reimbursement policies vary across healthcare systems. In places where patients must pay out of pocket, the cost may discourage regular use, particularly among people who already face substantial expenses for consultations, medicines and laboratory tests.
The trial’s results therefore raise an important question for health policymakers: how can the potential benefits of monitoring technology be made available to patients who are most likely to benefit without creating an unsustainable financial burden?
Further economic evaluations could help determine whether the improvements in glucose control justify the cost for different patient groups.
Healthcare providers will also need to consider whether patients can interpret the information correctly. Continuous monitoring produces substantial amounts of data, and readings may cause unnecessary anxiety if users do not understand how to respond.
Education and professional guidance are important to ensure that patients use the information constructively instead of making abrupt medication or dietary changes without medical advice.
Limitations of the research
The findings are encouraging, but several considerations are important when interpreting the results.
First, the trial lasted six months. Although this period was sufficient to identify differences in HbA1c and time spent within the target glucose range, it cannot establish whether the benefits will continue over many years.
Second, the study was sponsored by Dexcom, the company that manufactures the monitoring system. Industry-sponsored trials can provide valuable evidence, but independent research is important to confirm findings and evaluate the performance of different devices.
Third, the reported improvements concern measures of glucose control rather than direct evidence that the devices prevent heart attacks, kidney failure, blindness or other long-term complications. Studies involving longer follow-up would be needed to establish whether improved monitoring translates into better health outcomes over time.
Researchers and healthcare professionals must also consider differences between patients. Some may benefit substantially from detailed glucose information, while others may achieve adequate control through their existing treatment plans.
The findings should therefore inform discussions between patients and clinicians rather than serve as a universal recommendation.
Implications for healthcare systems
The study highlights the growing role of digital tools in the management of chronic diseases. Wearable sensors, mobile applications and remote monitoring platforms are increasingly being explored as ways to supplement conventional healthcare.
For diabetes services, these technologies may create opportunities to identify problematic glucose patterns earlier and support more personalised treatment.
They could also help healthcare professionals provide more focused advice during consultations. However, this potential depends on the availability of trained staff, reliable technology, appropriate data protection and systems that allow clinicians to use monitoring information efficiently.
In healthcare settings with limited resources, policymakers will need to balance investment in digital devices against other essential priorities, including access to medicines, routine testing, primary care and diabetes education.
The technology is likely to be most useful when integrated into a broader treatment plan rather than offered as a stand-alone solution.
Patients still require regular medical reviews, appropriate screening for complications and guidance on nutrition, physical activity and medication. Monitoring devices can add information to that process, but they cannot replace professional care.
A possible shift towards earlier monitoring
The six-month findings provide evidence that continuous glucose monitoring may benefit some adults with type 2 diabetes even before they begin insulin treatment.
The reduction in HbA1c and increase in time spent within the target range suggest that wearable technology can provide actionable information for daily diabetes management.
The next steps will include determining which patients benefit most, assessing long-term outcomes, examining cost-effectiveness and establishing how these devices should be incorporated into clinical practice.
For patients, the central message is that better glucose information may support better decisions, but monitoring technology works best when combined with an appropriate treatment plan and regular professional guidance.
As research continues, continuous glucose monitoring could become a more widely considered option for managing type 2 diabetes. Its ultimate contribution will depend on whether improved measurements translate into lasting health benefits and whether patients can access the technology at a reasonable cost.