1170-OR: CGM for Adults with Type 2 Diabetes Not on Insulin Therapy: The CONNECT Randomized Controlled Trial

Introduction and Objective: CGM can improve glucose levels for insulin-treated type 2 diabetes (T2D). Small trials have found benefits of CGM for T2D not on insulin therapy (NIT), but a fully powered RCT is needed to provide higher-level evidence for this population. To meet this need, we are conducting a multicenter RCT of CGM use in adults with T2D-NIT. Methods: At 21 primary care practices in the US, 283 adults with T2D-NIT and A1c ≥7.5% were randomly assigned 1:1 to Dexcom G7 CGM or routine care (RC) for 26 wks. Blinded CGM data were collected at baseline for both groups and at 4, 13, and 26 wks for the RC group. During the RCT, the CGM group used unblinded CGM throughout the 26 wks. Primary outcome was change in A1c from baseline to 26 wks. Results: Mean age was 60 ± 12 yrs; 32% were of a minority race or ethnicity (Table). Mean baseline A1c was 8.8 ± 1.2% (31% ≥9%) and baseline TIR 70-180 mg/dL was 30 ± 25%. Overall, 40% used an incretin mimetic (IM; GLP-1 RA or GLP-1/GIP RA) and 37% used an SGLT2 inhibitor (SGLT2i). Mean A1c was 8.6 ± 1.0% in IM users, 8.6 ± 1.0% in SGLT2i users, and 9.0 ± 1.5% in those using neither medication. Conclusion: In a primary care setting, many adults with T2D-NIT are not using an IM or SGLT2i despite an A1c well above ADA targets. CGM may be beneficial for these patients as well as for those who have elevated A1c despite using one of these medications. The CONNECT RCT will be completed in May 2026, and trial results will be presented. Disclosure T. Oser: Consultant; Ended; Dexcom, Inc. Research Support; Current; Dexcom, Inc. Advisory Panel; Current; Abbott Diabetes. Consultant; Ended; Medscape. Research Support; Current; Abbott Diabetes. Research Support; Ended; Insulet Corporation. R.W. Beck: Research Support; Current; MannKind Corporation, Abbott Diabetes, Dexcom, Inc., Tandem Diabetes Care, Inc., Sequel Med Tech, DreaMed Diabetes, Ltd. Consultant; Ended; Novo Nordisk, Eli Lilly and Company. Consultant; Current; Zucara Therapeutics. T. Martens: Other - Research support, consulting; Current; Dexcom, Inc. Other - Research support, advisory panel; Current; Abbott Diabetes. Other - Research support, consulting; Current; Lilly. Other - Research support, advisory panel; Current; Sanofi. Research Support; Current; Tandem Diabetes Care, Inc., MannKind Corporation, Zealand Pharma A/S. Research Support; Ended; Omnipod. Research Support; Current; Novo Nordisk, Medtronic, Sequel. E.S. Kramer: Research Support; Current; Dexcom, Inc. Other - Peer to Peer consultation; Current; Insulet Corporation. C. Presswood: None. M. Johnson: Employee; Current; Dexcom, Inc. K. Elkind-Hirsch: Employee; Current; Dexcom, Inc. S. Beck: Employee; Current; Dexcom, Inc. Funding Dexcom