CONNECT trial: CGM raised time in range by 21 points in type 2 diabetes without insulin

The randomized controlled CONNECT trial, published in October 2026 in the New England Journal of Medicine, examined continuous glucose monitoring (CGM) in adults with type 2 diabetes who were not yet injecting insulin, according to ad-hoc-news.de. ad-hoc-news.dead-hoc-news.dead-hoc-news.deOpen source ↗ The study, conducted by Oser and colleagues, enrolled 283 adults aged 21 to 84 with a baseline HbA1c of at least 7.5%. Participants were recruited at 22 primary care practices in the United States.

Design and HbA1c results

Participants were followed for 26 weeks. A total of 145 used continuous glucose monitoring, and 138 received conventional standard care. At the end of the period, mean HbA1c in the sensor group fell to 7.2%, while in the standard care group it remained at 8.0%. The adjusted mean difference was -0.9 percentage points (95% confidence interval -1.1 to -0.6, p<0.001).

The analyses indicate that the glycemic benefit did not depend on the initial HbA1c value, concomitant medication or demographic factors.

Time in range and hypoglycemia

Beyond HbA1c, the trial recorded parameters of daily glucose stability. Time in the 70 to 180 mg/dL range averaged 62% in patients with a CGM system, compared with 42% in the control group. ad-hoc-news.dead-hoc-news.dead-hoc-news.deOpen source ↗ This corresponds to an increase of 21 percentage points (95% CI 16 to 26).

No severe hypoglycemia occurred. Time below 70 mg/dL decreased slightly (adjusted mean difference -0.20 points), as did time below 54 mg/dL (adjusted mean difference -0.17 points).

Earlier data and the author's view

Study author Roy W. Beck argued that CGM should be considered earlier in the course of the disease, before insulin therapy becomes necessary.

The controlled data agree with larger care analyses. A three-year observational study of more than 25,000 adults with type 2 diabetes also showed markedly better glycemic control with glucose sensors. ad-hoc-news.dead-hoc-news.dead-hoc-news.deOpen source ↗ An accompanying analysis of that cohort pointed to potential protection of kidney function, since users had lower amounts of protein in the urine.

The earlier IMMEDIATE trial, with 116 participants on oral antidiabetic drugs, documented after 16 weeks of flash glucose monitoring and education an increase in time in range of 9.9 percentage points and a reduction in HbA1c of 3 mmol/mol.