INTRODUCTION: Growing research suggests continuous glucose monitoring (CGM) may help improve glycemic outcomes in noninsulin-using people with type 2 diabetes (T2D). The continuous biofeedback from CGM provides considerable opportunities to support personalized behavior changes; however, limited research exists to describe what happens to glycemia in this population when CGM is removed. The purpose of this follow-up study is to evaluate the effects of CGM discontinuation in noninsulin-using people with T2D.
METHODS: The effects of CGM discontinuation were assessed using data from the UNITE study (NCT05928572). Phase 1 of UNITE was a two-month intervention that evaluated the impact of using a nutrition-focused approach during CGM initiation on glycemic measures in people with T2D. In Phase 2, after discontinuing CGM use for four months, blinded CGM data and other measures were collected at Follow-up and compared to data from the post-intervention (Post) period.
RESULTS: The percent time in range 70 to 180 mg/dL decreased from 77% in the Phase 1 Post period to 60% during the Phase 2 Follow-up period (95% confidence interval [CI] = -22%, -12%; P < .0001). Several additional glycemic metrics also worsened significantly from Post to Follow-up (P < .05). Dietary intake and exercise at Follow-up were not statistically different from Post (P > .05), but physical activity decreased (P = .01).
CONCLUSION: In noninsulin-using people with T2D, glycemic measures improved with real-time CGM use, but these improvements deteriorated substantially and significantly when CGM use was discontinued. More research and more sensitive behavioral assessments are needed to better understand which factors and behavior changes may account for the glycemic decline.