Continuous glucose monitoring for glycemic control in non-insulin-treated patients with type 2 diabetes

Continuous glucose monitoring (CGM) has been associated with improved glycemic control in individuals with non-insulin-treated type 2 diabetes (T2D), but adoption in endocrinology clinics remains limited.

This quality improvement (QI) project aimed to explore the use of CGM for non-insulin-treated patients with T2D within an endocrinology clinic in Los Angeles County and to evaluate feasibility of its adoption in this practice setting.

It was a retrospective chart review.

Eligible patients were adults (≥18 years) with T2D and hemoglobin A1c (HbA1c) >7% who had not been treated with insulin. Ten patients met inclusion criteria. Descriptive statistics summarized HbA1c and time-in-range (TIR) over 6 months. An interrupted time series was also conducted on two patients with sufficient longitudinal data to assess HbA1c changes before and after CGM use.

After 6 months of initial CGM use, 8 of 9 patients achieved HbA1c reductions of ≥0.3%. One patient demonstrated a ≥8% increase in TIR with adequate device use. Interrupted time series analyses illustrated individual HbA1c trajectories, showing immediate reductions after CGM initiation and nonsignificant downward trends over time.

This QI project showed that patients with T2D treated with noninsulin medications successfully initiated and used CGM. Early improvements in HbA1c were observed; however, sustained glycemic outcomes varied depending on consistent CGM wear and adherence to follow-up, underscoring the need for individualized support. Nurse practitioners can play a key role in promoting sustained CGM use through structured diabetes education, integration of CGM data into lifestyle counseling, and regular follow-up.