CGM study and coverage push highlight broader use in Type 2 diabetes

Continuous glucose monitoring could expand for people with type 2 diabetes as new trial results showed improved blood sugar control in adults using basal insulin and Dexcom said it is awaiting a Medicare coverage decision for non-insulin users. A new UK trial found CGM significantly reduced blood sugar levels compared with traditional finger-prick testing, while Dexcom said broader Medicare coverage could allow nearly 12 million people to access CGMs.

The findings from the UK trial, called FreeDM2, were presented at DUKPC and published in the Lancet Diabetes and Endocrinology. FreeDM2 recruited 303 adults with type 2 diabetes who were using basal (long-acting) insulin. All participants had HbA1c levels above recommended targets at the start of the trial, and participants were randomly assigned either to use a real-time CGM or to continue using finger-prick tests.

For the first 16 weeks of the study, participants managed their type 2 diabetes themselves using the monitoring method they were assigned. During the following 16 weeks, they reviewed their blood sugar levels with healthcare professionals, who could adjust treatment or add new type 2 diabetes medications if needed.

At the start of the study, average HbA1c levels were the same in both groups: 73 mmol/mol, or 8.8%. After 16 weeks, people using CGM saw a greater reduction in HbA1c than those using finger-prick testing. HbA1c fell by 9 mmol/mol (0.8%) in the CGM group, compared with 2 mmol/mol (0.1%) in the finger-prick group.

By 32 weeks, the benefits of CGM were maintained. Average HbA1c was 62 mmol/mol (7.8%) in the CGM group compared with 67 mmol/mol (8.3%) in the finger-prick group. People using CGM also spent around 10% more of the day within their target blood sugar range, with no increase in hypos, and reported greater satisfaction and more confidence in managing their diabetes.

The study adds evidence showing that CGM can improve blood sugar management for people with type 2 who use insulin. Separately, Dexcom said it has been waiting for a coverage decision from the Centers for Medicare and Medicaid Services on expanded Medicare coverage of continuous glucose monitors for people with type 2 diabetes who do not take insulin, and expects CMS to propose a coverage expansion in the first half of 2026.

Dexcom said it started to see commercial coverage unlock for type 2, non-insulin users toward the end of last year. The company said broader Medicare coverage for that group would allow nearly 12 million people to access CGMs.

The American Diabetes Association updated its guidelines last year to recommend clinicians consider using CGMs for type 2 diabetes when patients are taking glucose-lowering medications other than insulin. Dexcom said real world data it has been generating supports that decision, that it has launched a registry for non-insulin users, and that it plans to publish results of a 300-person randomized controlled trial mid-year comparing CGMs to the standard of care for type 2 non-insulin users.

Dexcom’s 2026 revenue forecast of 11% to 13% year-over-year growth assumes no benefit from type 2 coverage expansion. The company also began a launch of its 15-day sensor in December, starting with durable medical equipment providers, and said the rollout started in the U.S. and is planned to extend globally.