A Digital Diabetes Self-Management Education and Support Program Integrated With Continuous Glucose Monitoring for Type 2 Diabetes: Randomized Controlled Trial

Abstract Background Previous research has demonstrated that the use of continuous glucose monitoring (CGM) can improve glycemic control in people with type 2 diabetes when used regularly alongside a digital diabetes self-management education and support (DSMES) program. However, to date, there is limited evidence showing the benefits of a digitally delivered DSMES program combined with real-time CGM for adults with type 2 diabetes. Objective The objective of this study is to evaluate the impact of a DSMES program coupled with CGM on hemoglobin A 1c (HbA 1c ) and CGM-derived glycemic measures compared to usual care for adults with type 2 diabetes over 6 months. Methods Participants with type 2 diabetes and HbA 1c of 8% or higher (64 mmol/mol) who were not using mealtime bolus insulin (aged 26‐83 y; mean HbA 1c 9.6%, SD 1.4% [mean 81.2 mmol/mol, SD 15.8 mmol/mol]) were randomly assigned to a digital DSMES+CGM integrated solution (n=51) or usual care (n=49) for 6 months. The primary outcome was HbA 1c . The secondary outcomes were CGM-derived glycemic measures, including glucose management indicator, percent time in range 70 to 180 mg/dL, percent time above range (>180 mg/dL), percent time below range (