Use of Flash Continuous Glucose Monitoring Is Associated With A1C Reduction in People With Type 2 Diabetes Treated With Basal Insulin or Noninsulin Therapy
Open accessAbstract
BACKGROUND: Glycemic control is suboptimal in many individuals with type 2 diabetes. Although use of flash continuous glucose monitoring (CGM) has demonstrated A1C reductions in patients with type 2 diabetes treated with a multiple daily injection or insulin pump therapy regimen, the glycemic benefit of this technology in patients with type 2 diabetes using nonintensive treatment regimens has not been well studied. METHODS: This retrospective, observational study used the IBM Explorys database to assess changes in A1C after flash CGM prescription in a large population with suboptimally controlled type 2 diabetes treated with nonintensive therapy. Inclusion criteria were diagnosis of type 2 diabetes, age <65 years, treatment with basal insulin or noninsulin therapy, naive to any CGM, baseline A1C ≥8%, and a prescription for the FreeStyle Libre flash CGM system during the period between October 2017 and February 2020. Patients served as their own control subject. RESULTS: A total of 1,034 adults with type 2 diabetes (mean age 51.6 ± 9.2 years, 50.9% male, baseline A1C 10.1 ± 1.7%) were assessed. More patients received noninsulin treatments (n = 728) than basal insulin therapy (n = 306). We observed a significant reduction in A1C within the full cohort: from 10.1 ± 1.7 to 8.6 ± 1.8%; Δ −1.5 ± 2.2% (P <0.001). The largest reductions were seen in patients with a baseline A1C ≥12.0% (n = 181, A1C reduction −3.7%, P <0.001). Significant reductions were seen in both treatment groups (basal insulin −1.1%, noninsulin −1.6%, both P <0.001). CONCLUSION: Prescription of the flash CGM system was associated with significant reductions in A1C in patients with type 2 diabetes treated with basal insulin or noninsulin therapy. These findings provide evidence for expanding access to flash CGM within the broader population of people with type 2 diabetes.
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In adults with type 2 diabetes (both using and not using insulin), continuous glucose monitoring achieves improved glycated haemoglobin concentrations without impacting the rate of hypoglycaemia.
“Continuous glucose monitoring for adults with type 2 diabetes (both those using and not using insulin)24,25 also achieves improved glycated haemoglobin concentrations without impacting the rate of hypoglycaemia.”
From Blood glucose monitoring devices: current considerations (2023) · cites this paper as [25]
The Results (Outcomes; page not provided) report lower A1C after flash CGM prescription in adults with type 2 diabetes receiving basal insulin or noninsulin therapy. The Methods (Outcomes; page not provided) list A1C outcomes but no hypoglycemia-rate outcome, so the claim that hypoglycemia rates were unaffected is unsupported. The observational study also establishes an association after prescription, not that CGM caused the improvement. (LLM, conf=0.89)
Experimental — accuracy not yet measuredIn Wright et al. 2021, adults with T2DM receiving noninsulin therapies or basal insulin had a significant HbA1c reduction from 10.1 ± 1.7 to 8.6 ± 1.8% (difference −1.5 ± 2.2%, p < 0.001) 6 months after FSL initiation; the noninsulin therapy group had a mean HbA1c reduction of 1.6% (p < 0.001).
“Wright et al. reported a significant HbA1c reduction from 10.1 ± 1.7 to 8.6 ± 1.8% (difference −1.5 ± 2.2%, p < 0.001) 6 months after initiation of FSL. The noninsulin therapy group had a mean HbA1c reduction of 1.6% (p < 0.001).”
In adults with type 2 diabetes treated with basal insulin or noninsulin therapy, intermittently scanned CGM improves A1C levels.
“Furthermore, retrospective observational data in adults with type 2 diabetes treated with either basal insulin or noninsulin therapy have shown an improvement in A1C levels (85).”
From 7. Diabetes Technology: Standards of Care in Diabetes—2025 (2025) · cites this paper as [85]
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- Authors
- Wright, E. E., Kerr, M. S. D., Reyes, I. J., Nabutovsky, Y., & Miller, E.
- Affiliations
- Charlotte Area Health Education Center, Charlotte, NC
- Abbott (United States) (US)
- Diabetes Nation, Sisters, OR
- Corresponding author
- Wright, Eugene E.
- Venue
- Diabetes Spectrum
- Publisher
- American Diabetes Association
- Published
- 2021-02-10
- Volume
- 34
- Issue
- 2
- Pages
- 184-189
- ISSN
- 1040-9165 (ISSN-L)
- 1944-7353
- PMC
- PMC8178717
- OpenAlex
- W3128076258
- Cited by
- 115
- References
- 19
- Citations by year
- 2026: 14 · 2025: 17 · 2024: 34 · 2023: 19 · 2022: 19 · 2021: 12
- FWCI
- 15.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Spectrum (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Abbott Diabetes Care
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 2 diabetes, glycemic control, HbA1c reduction, basal insulin, FreeStyle Libre, suboptimal glycemic control, HbA1c
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