Results from a clinical study published in the New England Journal of Medicine showed that adults with type 2 diabetes who do not use insulin may benefit from wearing continuous glucose monitoring (CGM) devices. The publication followed the presentation of preliminary results by Dexcom during the American Diabetes Association’s scientific sessions this summer.
The study included 440 people at 22 primary care clinics in the United States, with participants randomly assigned to a group that used the Dexcom G7 or a group that received usual care. The device group included 145 participants, compared with 138 participants in the usual-care group, with follow-up lasting 26 weeks.
Improvement in HbA1c and Time in Range
Among CGM users, the average glycated hemoglobin HbA1c level fell from 8.8% to 7.2%, while it fell from 8.7% to 8% in the usual-care group. Device users also spent about five additional hours per day within the target blood glucose range of 70 to 180 milligrams per deciliter.
According to a Dexcom summary, the beneficial effect remained consistent across different groups, including age, sex, race, ethnicity, body mass index, duration of diabetes, income, education, health insurance, and use of other glucose-lowering medications. Additional analyses showed greater benefit among participants who started with higher HbA1c levels, along with the near elimination of prolonged periods of high blood sugar and increased escalation of drug treatment among CGM users.
Why Does This Matter?
The findings support expanding the discussion around CGM use to a stage before insulin treatment in type 2 diabetes. The fact that most participants continued using the device daily throughout the study period also suggests, according to Dr. Roy Beck, the study’s senior author and medical director at the JAEB Center for Health Research, that they were able to integrate it into their daily disease management.
However, the study was funded by Dexcom, so interpreting the findings within their funding context remains important when evaluating them. The results also measure the effect of use over 26 weeks and, on their own, do not settle longer-term outcomes or the effect of expanding use on costs and care management.
Next Step: Medicare Coverage
The publication of the peer-reviewed study coincides with diabetes technology companies awaiting a decision from the Centers for Medicare and Medicaid Services (CMS) on expanding coverage of CGM devices to people with type 2 diabetes who do not use insulin. Dexcom expects the decision before the end of 2026, with possible implementation in mid-2027, but the timing remains uncertain.
William Blair analysts wrote that publication in a prominent medical journal could support a CMS decision. The expansion could, according to Leerink Partners analyst Mike Kratky, double the number of people covered by Dexcom from approximately 15 million to 30 million. Abbott said the expanded coverage could add approximately 10 million Medicare beneficiaries, while William Blair analysts estimate the number of people with type 2 diabetes who do not use insulin in the United States at approximately 25 million.