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

What was studied

Glunovo rtCGM vs SMBG for glycemic control in T2D

Study type

Randomized Controlled Trials (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

Main effects

↓ 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 Summary

Intervention	Outcome	Measured Change	Study Effect
Continuous glucose monitoring (Devices & Technology)	Fasting Plasma Glucose (Glycemic Control)	Decrease	Strong
Continuous glucose monitoring (Devices & Technology)	HbA1c (Glycemic Control)	Decrease	Strong
Continuous glucose monitoring (Devices & Technology)	Quality of life (Patient-Reported)	Uncertain	Limited
Continuous glucose monitoring (Devices & Technology)	Time above range (Glycemic Control)	Decrease	Strong
Continuous glucose monitoring (Devices & Technology)	Time below range (Glycemic Control)	Uncertain	Mixed
Continuous glucose monitoring (Devices & Technology)	Time in range (Glycemic Control)	Increase	Strong
Continuous glucose monitoring (Devices & Technology)	Treatment satisfaction (Patient-Reported)	Increase	Strong

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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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Journal Reference

Lazzaroni E, Cimino V, Gandolfi A, et al. A Randomized Study of the Glunovo Real-time CGM Effectiveness in Individuals With Poorly Controlled Type 2 Diabetes. J Endocr Soc. 2026;10(2):bvaf165. doi:10.1210/jendso/bvaf165