RESEARCH SUMMARY

Real-time CGM significantly improves HbA1c and time in range in poorly controlled type 2 diabetes

Moderate confidence
Some Concerns bias
Last updated May 7, 2026

Key takeaway:

A 6-month RCT in 172 adults with poorly controlled type 2 diabetes found that the Glunovo real-time CGM system significantly reduced HbA1c by 1.4% compared to 0.6% with standard glucometer monitoring, and increased time in range from 70% to 89%.

Study at a glance

Study type

RCTs

duration

Medium-Term (3–12 mo)

Intervention

Continuous glucose monitoring

Outcomes

HbA1c, Time in range, Time above range, Time below range, Fasting Plasma Glucose, Quality of life, Treatment satisfaction

Funding

Non-industry sponsored

What was studied

Glunovo rtCGM vs SMBG for glycemic control in T2D

What they found

  • ↓ HbA1c reduced by 1.4% with rtCGM vs 0.6% with SMBG (p<0.001)
  • ↑ Time in range improved from 70% to 89% with rtCGM (Δ=+18.4%, p<0.001)
  • ↓ Time above range decreased from 25% to 9.3% with rtCGM (p<0.001)

mainEffects

↓ HbA1c reduced by 1.4% with rtCGM vs 0.6% with SMBG (p<0.001)

↑ Time in range improved from 70% to 89% with rtCGM (Δ=+18.4%, p<0.001)

↓ Time above range decreased from 25% to 9.3% with rtCGM (p<0.001)

Evidence Suggest

  • Glunovo rtCGM significantly improves glycemic control in poorly controlled T2D compared to standard SMBG
  • Patient satisfaction with rtCGM was high and improved substantially over the study period
  • Overall well-being (WHO-5) showed no significant improvement despite better glycemic control

Who this applies to

Adults with poorly controlled type 2 diabetes (HbA1c 7.5-11%) on various treatment regimens including basal-bolus insulin, basal-oral therapy, or noninsulin agents. Results are most relevant to patients who are not using CGM technology and have suboptimal glycemic control.

Keep in Mind

The study was open-label, so patients knew they were using CGM, which may have influenced behavioral changes and satisfaction scores. The SMBG group did not have CGM data available for TIR/TAR/TBR comparison. Some patients discontinued due to technical issues with the new device. The WHO-5 well-being index may not be sensitive enough to capture diabetes-specific quality of life changes.

Between the Lines

  • Open-label design may introduce bias, particularly for patient-reported satisfaction outcomes
  • SMBG group lacked CGM-derived metrics (TIR, TAR, TBR) for direct between-group comparison
  • 7 participants (8.1%) in the rtCGM group discontinued due to device-related issues
  • Single-center study in Italy may limit generalizability to other populations and healthcare settings

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Sources

guidelines

International Consensus on Time in Range: Clinical Targets for Continuous Glucose Monitoring Data Interpretation

Battelino et al. (2019) established the international consensus recommendations for CGM-derived metrics including time in range targets (>70%), time below range (<4%), and time above range (<25%) that are used as reference standards in CGM research.
guidelines

ADA/EASD Consensus Report: The Management of Type 1 Diabetes in Adults

The American Diabetes Association and European Association for the Study of Diabetes joint consensus on diabetes management, including recommendations for CGM use in diabetes care and glycemic targets.
guidelines

Abaloparatide Followed by Alendronate Shows Promising Results for Women With Osteoporosis, T2D | American Association of Clinical Endocrinology

Abaloparatide followed by alendronate treatment may improve bone mineral density (BMD) in women with postmenopausal osteoporosis and type 2 diabetes (T2D), according to study results presented at the AACE 28th Annual Scientific & Clinical Congress.
guidelines

Connecting the Dots: Diabetes, CKD, and CVD Pathways | American Association of Clinical Endocrinology

Connecting the Dots: Diabetes, CKD, and CVD Pathways enhances clinical understanding of the interconnected conditions of type 2 diabetes (T2D), chronic kidney disease (CKD), and cardiovascular disease (CVD). Strengthen recognition of shared pathophysiology, apply evidence-based risk assessment and treatment strategies, and improve care coordination through timely and appropriate referrals to drive better outcomes for patients with complex cardiometabolic conditions with this FREE course.
guidelines

Episode 39: AACE 2023 Updated Comprehensive Type 2 Diabetes Management Algorithm | American Association of Clinical Endocrinology

Listen to AACE podcast episode 39 to learn about the latest updates to AACE’s 2023 diabetes algorithm, which provides concise guidance to assist health care professionals in clinical decision-making for the management of Type 2 diabetes (T2D).
guidelines

Linagliptin Does Not Increase Adverse Renal Events in Patients With T2D, Kidney Disease | American Association of Clinical Endocrinology

Treatment with linagliptin in patients with type 2 diabetes (T2D) and cardiovascular and/or kidney disease had no impact on risk for cardiovascular or kidney events or hospitalization for heart failure, according to results of the CARMELINA study (Cardiovascular and Renal Microvascular Outcome Study With Linagliptin in Patients With Type 2 Diabetes Mellitus) presented at the AACE 28th Annual Scientific & Clinic
guidelines

Non-Insulin Injectable Therapies for Diabetes Management | American Association of Clinical Endocrinology

An estimated 30.3 million Americans have type 2 diabetes (T2D), a complex, progressive disease that requires intensified treatment over time.1-3 The complexity of T2D management, coupled with the need to tailor treatment recommendations to individual patients, presents an ongoing clinical challenge. The number and variety of treatment options available for T2D has increased dramatically in the last 15 years, with several new drug classes emerging as safe and effective.2,4,5
healthAuthorities

WHO-5 Well-Being Index: A Systematic Review of the Literature

The WHO-5 Well-Being Index is a validated questionnaire for measuring general psychological well-being across 5 domains. Used as the well-being assessment tool in this study to evaluate patient-reported outcomes with rtCGM use.
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A Prospective Study of the Correlation Between Time in Range and Incidence of Diabetic Cardiovascular Autonomic Neuropathy in Patients with Type 2 Diabetes Mellitus.

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Using Nutrition to Improve Time in rangE (UNITE): A Randomized Clinical Trial with Continuous Glucose Monitoring in People with Type 2 Diabetes Not Taking Insulin.

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Quality-Score (Q-Score) Can Be More Sensitive than %Time in Range and Several Other CGM Metrics in Detecting Responses to Therapeutic Interventions.

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Time in range-A new gold standard in type 2 diabetes research?

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Associations of time in tight range, time in range, and glycated hemoglobin with albuminuria and diabetic kidney disease in adult type 2 diabetes: a cross-sectional study.

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