CONNECT Trial Backs CGM for Non-Insulin Type 2 Diabetes Management

Findings from the CONNECT randomized controlled trial suggest continuous glucose monitoring (CGM) may play an important role in the management of adults with type 2 diabetes who are not on insulin, highlighting reduced hyperglycemia and subsequent reductions in A1C compared with a routine care control group.

The data were presented at the 2026 Scientific Sessions of the American Diabetes Association (ADA) in New Orleans, Louisiana.¹

"Since many of the patients with type 2 diabetes who use oral or non-insulin injectable therapies are seen in primary care settings, continuous glucose monitoring provides an opportunity to close a visible care gap," Thomas Martens, MD, co-author of the study, said in a statement.¹ "As the first major randomized controlled trial evaluating CGM in individuals with type 2 diabetes not using insulin, these findings can help reshape diabetes management and expand treatment options for patients, improve glucose levels and A1C management for clinicians, and ultimately reduce diabetes-related complications."

CGM has well-established efficacy in insulin-treated diabetes, but evidence has been more limited for the substantially larger population of patients managing type 2 diabetes with oral or non-insulin injectable therapies. The CONNECT trial is the first major RCT to address this gap in a primary care setting, and its findings arrive as the ADA's 2026 Standards of Care have already moved to recommend CGM use for adults on any diabetes treatment in which CGM aids management.²

CONNECT Trial Design and Primary Glycemic Outcomes

The multicenter trial enrolled 283 adults with type 2 diabetes not on insulin across 22 US primary care practices.¹ Mean participant age was 60 years; 32% identified as racial or ethnic minority. Baseline mean A1C was 8.8%, with 31% of participants carrying an A1C of ≥ 9%. Concomitant therapy was heterogeneous: 37% of patients were on an SGLT2 inhibitor and 40% were on an incretin-based agent, including GLP-1 receptor agonist (GLP-1 RA)-based medications.

In the trial, participants were randomly assigned to either the Dexcom G7 CGM device or routine care with standard blood glucose meter testing. The primary outcome was change in A1C at 26 weeks.

Results showed the CGM group achieved a 0.9% greater A1C reduction compared with the routine care group at 6 months.¹ Time in the glucose target range of 70 to 180 mg/dL was 5 hours per day greater with CGM than with routine care, a clinically meaningful difference in daily glycemic exposure.

Secondary Outcomes: Patient-Reported Satisfaction and Distress in CONNECT

Beyond glycemic metrics, participants in the CGM group reported greater satisfaction with glucose monitoring and reduced diabetes-related distress compared with the routine care group.¹ These patient-reported outcomes are relevant to primary care, where engagement and adherence often determine whether glycemic targets are sustained over time. The combination of objective A1C benefit and reduced psychological burden strengthens the case for CGM deployment in this setting, where most non-insulin-treated patients with type 2 diabetes receive their care.

The ADA's 2026 Standards of Care updated Recommendation 9.25 to formally recommend CGM use for adults with type 2 diabetes on any treatment in which CGM aids management.² This positions CONNECT data as timely evidentiary support for a guideline posture already tilting toward broader CGM uptake. The Time in Range Coalition has noted increasing evidence of CGM benefits in non-insulin-treated type 2 diabetes across A1C, time in range (TIR), time above range, and user-reported satisfaction.³

A six-month extension phase of the CONNECT trial is currently underway, with 12-month durability data anticipated.¹

References:

1. American Diabetes Association. 82% of adults with type 2 diabetes not on insulin improve blood glucose levels with continuous glucose monitoring. Published June 6, 2026. Accessed June 6, 2026. https://www.diabetes.org

2. American Diabetes Association. Summary of revisions: Standards of Care in Diabetes — 2026. Diabetes Care. 2026;49(Suppl 1):S6–S22. https://doi.org/10.2337/dc25-SREV

3. Time in Range Coalition. Time in range in the 2026 ADA Standards of Care. Published January 2026. Accessed June 6, 2026. https://www.timeinrange.org/time-in-range-in-the-2026-ada-standards-of-care/