Behavior Modifications From CUT-DM, Including Lifestyle Modification and Self-Efficacy

OBJECTIVE To investigate the effects of diabetes self-management education and support (DSMES) and real-time continuous glucose monitoring (RT-CGM) on lifestyle among Latinx patients with type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS The CUT-DM (Diabetes Education With Real-time Continuous Glucose Monitoring) open-label randomized controlled trial enrolled 119 Latinx participants with uncontrolled diabetes receiving nonintensive insulin to investigate DSMES and RT-CGM effects on lifestyle and self-care and, in RT-CGM users, perception of benefit. All participants attended 12 sessions and were randomly assigned at a one-to-one ratio to education only with blinded CGM or education with RT-CGM. RESULTS Lifestyle improved over 12 weeks in both groups. Days of physical activity increased by 60% (95% CI 20–120%; P < 0.01), and days walking at least 10 min increased by 20% (95% CI 0–30%; P < 0.01). Nutrition summary scores improved by 1.7 (95% CI 1.0–2.3) units (P < 0.01). Self-efficacy improved by 1.2 (95% CI 0.8–1.7) points (P < 0.01). Self-care improved by 1.6 (95% CI 1.0–2.2) units for diet (P < 0.01), 1.1 (95% CI 0.6–1.7) units for exercise (P < 0.01), 1.6 (95% CI 1.0–2.2) units for foot care (P < 0.01), and 0.6 (95% CI 0.0–1.2) units for medication use (P = 0.063). Self-care for diet improved more with RT-CGM than with blinded CGM (2.4 [95% CI 1.3–3.4) vs. 0.8 [95% CI −0.3 to 1.9] points; P = 0.01). Nutrition score improvement differences were not significant (P = 0.5). Of RT-CGM participants, 97% reported that CGM benefited their health. CONCLUSIONS DSMES supported lifestyle modifications. Perception of benefit among RT-CGM users receiving education was high. CGM use likely enhances nutrition, physical activity, and self-care in T2D, but more research is needed.