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

BACKGROUND: 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. LOCAL PROBLEM: 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. METHODS: It was a retrospective chart review. INTERVENTIONS: 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. RESULTS: 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. CONCLUSION: 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.