A randomized clinical trial 1 studied the effect of continuous glucose monitoring (CGM) on HbA1C levels compared to patients using a blood glucose meter (BGM) for monitoring. Focused on adults with type 2 diabetes (T2D) who were treated with basal insulin without prandial insulin, the industry-funded Continuous Glucose MOnitoring in T2D Basal InsuLin UsErs (MOBILE) study involved 165 patients at 15 practice sites to understand the potential benefits of prescribing CGM earlier in the treatment algorithm.
Patients were randomized to CGM (continuous plus back-up BGM when needed) or usual care with BGM (fasting plus postprandial 1-3 times daily). The CGM and BGM results were reported to primary care providers (PCPs) who were able to make regimen changes when indicated. However, a limitation is that frequent reporting may have created more patient touchpoints with clinical teams than what is replicated in usual care settings.
Baseline mean HbA1C level, which was 9.1% in the CGM group and 9.0% in the BGM group, decreased to 8.0% and 8.4%, respectively (p=0.02). Additionally, a significantly greater percentage of time was spent in target glucose range (70-180 mg/dL) in the CGM group compared to the BGM group (59% vs. 43%, p<0.001), and significantly less time in hypoglycemia. The results support use of CGM in adults with type 2 diabetes, treated with basal-only regimens, to help reach glycemic targets with less hypoglycemia as part of a comprehensive care plan.
- Martens T, Beck RW, Bailey R, et al. Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes treated with basal insulin: a randomized clinical trial. JAMA. 2021;325(22):2262–2272. doi:10.1001/jama.2021.7444.