Why carry out this study

Suboptimal glycemic control is common among adults with type 2 diabetes (T2D) and therapy adjustments are often required to optimize control.

Episodic use of real-time continuous glucose monitoring (rtCGM) has been shown to significantly improve HbA1c in patients with T2D not on prandial insulin but CGM use patterns in prior studies do not match current reimbursement models or established CPT codes.

The COMMITED study was a pilot, randomized trial designed to be translatable to routine medical practice and to determine if episodic use of rtCGM in patients failing multiple non-insulin medications would facilitate improved lifestyle choices and/or better medication adherence and result in glycemic improvement compared to self-monitoring of blood glucose (SMBG).

What was learned from the study?

Median baseline HbA1c was 8.4% and 8.3% and median change in HbA1c at week 12 was − 0.5% and − 0.2% for the rtCGM and SMBG groups, respectively (between-group difference p = 0.74).

More than a third (34.1%) of participants in the rtCGM group and 17.4% in the control group reached an HbA1c of less than 7.5% at week 12. In other words, episodic rtCGM use (one 10-day wear per month for 3 months) enabled more than one-third of participants, who had poor glycemic control despite use of multiple oral agents, to make changes based on their CGM data that improved glycemic control, potentially obviating the need to escalate therapy.

These modest benefits were not sustained at 6 months, suggesting that additional rtCGM is required for durable glycemic benefits.