Intermittently scanned continuous glucose monitoring provides no benefit over structured self-monitoring of blood glucose in type 2 diabetes not on prandial insulin, in the context of diabetes self-management education: GLucose monitoring programme SingaporE (GLiMPSE)

Objective: We evaluated the impact of intermittently scanned continuous glucose monitoring(is-CGM) over selfmonitoring of blood glucose(SMBG) in the context of diabetes self -management education (DSME) in suboptimally controlled type 2 diabetes(T2D) in a multi -ethnic setting. Research Design and Method: Randomized -controlled, open -label trial (NCT04564911), of T2D with HbA1c >= 7.5 <= 10 %, on oral agents with/without basal insulin was carried out. Intervention arm received 6 weeks(w) continuous is-CGM, followed by one is-CGM/month till 24w. Control arm was advised to perform 4 SMBG/day. Education was delivered at weeks 0, 2, 8, 16. Primary outcome: Change in HbA1c from baseline at 24w. Modified intention -to -treat (mITT) analysis with linear mixed -effect model for repeated measurements was performed. Results: 176 subjects, age 55 +/- 10.7 years(y), DM duration 11 +/- 7.3y, BMI 27.8 +/- 5.9 kg/m (2) , 58 % Male, 29.5 % basal insulin users were analysed. Within each arm, from baseline to 24w, mean HbA1c decreased by -0.6 % (-6.6.mmol/mol, p -value < 0.01) and weight decreased (isCGM: -1.44 kg; SMBG: -1.25 kg, both p < 0.01). These changes were sustained to one year. However, there was no significant difference in these parameters between arms (p -value > 0.05). Conclusion: In the context of DSME, use of either SMBG or is-CGM led to improved glycaemia and reduced weight over a period of 24 weeks, sustained to one year.