Continuous Glucose Monitoring Improves Outcomes for Type 2 Diabetes Patients on Basal Insulin

Patients with type 2 diabetes who used Abbott’s FreeStyle Libre continuous glucose monitoring (CGM) system experienced a significantly greater reduction in glycosylated hemoglobin (HbA1c) – 0.6% – compared to those relying on traditional finger-prick methods, according to results from the FreeDM2 randomized controlled trial (RCT). The findings were presented at the 19th International Conference on Advanced Technologies & Treatments for Diabetes (ATTD) in Barcelona.

Study Details and Findings

The FreeDM2 trial, conducted across 24 clinical sites in the UK, involved 303 participants with type 2 diabetes on basal insulin therapy. The study compared the effectiveness of CGM to capillary blood glucose self-monitoring (CBG). After four months, patients using CGM not only demonstrated the 0.6% reduction in HbA1c but also spent an average of 2.5 more hours per day within the healthy glucose range of 70-180 mg/dL – a 10.4% increase.

Importantly, study participants were often already utilizing advanced glucose-lowering therapies, such as SGLT2 inhibitors or GLP-1 receptor agonists, highlighting the added benefit of CGM even in patients with optimized treatment regimens. Abbott emphasizes that these improvements stemmed from participant-led self-management, guided by real-time CGM insights.

Real-Time Glucose Visibility Drives Improvement

Approximately 63 million people worldwide depend on insulin to manage type 2 diabetes ¹. Though, studies indicate that only 18%–30% of those using basal insulin achieve their target HbA1c levels ¹. This gap contributes to an estimated $217 billion in annual diabetes healthcare costs ¹.

“This study demonstrates the power of information on real-time glucose levels for people with type 2 diabetes treated with basal insulin,” said Emma Wilmot, MBChB, BSc (Hons), PhD., FRCP, Associate Professor, Faculty of Medicine, University of Nottingham, UK, and co-principal investigator of the FreeDM2 study.

Lala Leelarathna, MBBS, MSc, Ph.D., FRCP, Associate Professor at Imperial College London and also a principal investigator of the FreeDM2 study, added, “Even when people with type 2 diabetes are already receiving advanced therapies, such as SGLT2 inhibitors or GLP-1 receptor agonists, adding real-time glucose visibility provided significant improvements. Participants were able to proactively use the knowledge provided by CGM to adjust their diet, basal insulin, and activity to obtain better results.”

Italian Study Reinforces Findings

A separate, parallel interventional study conducted in Italy and also presented at ATTD, followed 88 adults with type 2 diabetes using Abbott’s FreeStyle Libre system even as on basal insulin therapy. After three months, participants showed improved average glucose levels, more time spent in a healthy glucose range, and an enhanced quality of life ³.

Mahmood Kazemi, medical director of Abbott, stated, “In both studies, real-time visibility into glucose gives people the insight they need to develop modest, informed adjustments throughout the day.” He further noted, “In the FreeDM2 study, people made these adjustments on their own; seeing similar patterns in the Italian study reinforces that the value comes from continuous access to glucose information itself, and not from a single device feature.”

Expanding CGM Access

Currently, CGM reimbursement in Europe and other regions is largely focused on individuals with type 2 diabetes using multiple daily insulin doses, leaving those on basal insulin without coverage. The evidence from the FreeDM2 study and the Italian research supports expanding CGM reimbursement to include patients with type 2 diabetes on basal insulin therapy, potentially improving disease control and quality of life for a wider population.